A recent meta-analysis of the results of 88 trials involving women with estrogen receptor-positive (ER+) BC identified higher tumor grades as moderately predictive of the risk of distant recurrence during years 5 to 20 (rate ratio of low vs. high grade = 0.50, 95% CI: 0.37-0.67, p <0.001) (6). The gene discussed is ESR1; the disease is breast cancer.