However, our prior studies have shown that TMEM doorway score is prognostic for distant recurrence specifically in the first 5 years of ER + /HER2- breast cancer in multiple clinical cohorts20,21, as well as it being independent of genomic assay, oncotype score, indicating a independent prognostic indicator of metastasis despite intrinsic tumor biology features. Here, ESR1 is linked to breast carcinoma.