The observation that gp78 protein remains the sole independent predictor of survival in women of African ancestry even after normalizing for TNBC subtype and grade (Table 1 and Supplemental Table 1) suggests that gp78hi tumors may have arisen in early ancestral African populations as a feature with universally associated aggressive breast cancers regardless of subtype prior to the evolution of TNBC, where gp78hi tumors may have been a more predominant subtype prior to the out-of-African events believed to occur in the late Pleistocene epoch (92, 93). This evidence concerns the gene AMFR and breast carcinoma.