While circulating plasma-derived lncRNA H19 was reported to be a promising biomarker (AUC = 0.81) of BC,157 serum EV-derived H19 was significantly elevated in BC patients compared to benign breast disease and control with an AUC of 0.87 as opposed to CEA153(0.822) and CEA (0.811).158 In this cohort, H19 also acted as a prognostic marker as it was associated significantly with Estrogen Receptor (ER), Progesterone Receptor (PR), human epidermal growth factor receptor-2 (Her-2), tumor node metastasis (TNM) stages, lymph node metastasis (LNM), and distant metastasis. This evidence concerns the gene ESR1 and breast fibrocystic disease.