ESR1 and neoplasm: Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death among women aged 20 to 49 years in the US.1 Young women are more likely to develop breast cancer with more aggressive biological features compared with older women, including larger tumor size, advanced tumor stage, negative hormone receptors status (estrogen receptor [ER] and progesterone receptor [PR]), and overexpression of the human epidermal growth factor receptor 2 (ERBB2; formerly HER2),2,3,4 all contributing to the poorer prognosis among young female patients with breast cancer.