The indirect mechanism of ERα involves the regulation of target genes in ER+ breast cancer by activating the Wingless-Int1 (Wnt), phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT), and mitogen-activated protein kinase (MAPK) signaling pathways [38,39,40]. This evidence concerns the gene ESR1 and breast carcinoma.