Histopathologically, the presence of intra-epithelial spaces, invasive ductal carcinoma cells, and dense stromal desmoplasia (Figure 1) confirms the aggressive nature of the tumors in our cohort.15 Immunohistochemical analysis revealed strong, complete membrane staining for HER2/neu in over 10% of tumor cells, with estrogen receptor (ER) and progesterone receptor (PR) scores indicating significant hormonal influence (80% moderate positive for ER and PR) (Figures 2 and 3). The gene discussed is ESR1; the disease is invasive ductal breast carcinoma.