Another ER transcriptional co-activator in breast cancer is CBP/p300-interacting transactivator with Glu/Asp-rich carboxy-terminal domain 2 (CITED2) which is overexpressed in breast cancer tissues and is associated with worse clinical outcome.360 Increased expression of this protein may result in estrogen-independent ER activation, thereby reducing estrogen dependence and response to hormone therapies.361 Jayaraman et al.362 has also documented that CITED2 can modulate macrophage recruitment to influence breast cancer growth. The gene discussed is ESR1; the disease is breast cancer.