Targeted bisulfite sequencing showed that the promoter methylation levels of AKR1B1, BNIP3, CRMP1, GSTP1, HOXA5, PAX6, and RASGRF2 were increased in ER-positive and HER2-negative breast cancers with ALNM, compared with ER-positive and HER2-negative breast cancers without ALNM (Fig 3). This evidence concerns the gene ESR1 and breast carcinoma.