ESR1 and neoplasm: In our study, using the RoMMa and based on the average modified Magee score at a cutoff of ≤12, variables including ER, PR, Ki-67, as well as Nottingham score and tumor size were included and achieved an AUC of 0.94, with a sensitivity of 89%, a specificity of 100%, a PPV of 100%, and a NPV of 98% for excluding high ODX in the cases with a very low aMMs.