When adjusted for ER/PR status alone, NH-black–rural women (AOR 1.98, 95% CI 1.85–2.11), NH-black–urban women (AOR 1.75, 95% CI 1.71– 1.79), Hispanic–rural women (AOR 1.31, 95% CI 1.16–1.48), Hispanic–urban women (AOR 1.26, 95% CI 1.23–1.30), and NH-white–rural women (AOR 1.15, 95% CI 1.12–1.18) had an increased risk of breast cancer death, when compared to NH-white–urban women. Here, ESR1 is linked to breast cancer.