In multivariable analysis adjusted for patient age, tumour size, tumour subtype (St Gallen), and systemic adjuvant therapy, the increased risk for IBTR in the HIF-1α positive group remained an independent risk factor in the total patient population (HRadjusted = 1.8 [1.1–2.8], p = 0.01, Table 2). This evidence concerns the gene HIF1A and neoplasm.