Figure 6. A three‐gene based mitochondrial signature (Mito‐Signature) that effectively predicts recurrence and distant metastasis in high‐risk ER(+) breast cancer patients. Note that this Mito‐Signature (HSPD1/VDAC2/CPT1A) predicts tumor recurrence (Left; N = 152 patients; p = 7.3e‐10) and distant metastasis (Right; N = 149 patients; p = 8.1e‐07) in LN(+) luminal A patients treated with Tamoxifen therapy, indicative of treatment failure and Tamoxifen‐resistance. Patients with high‐expression levels of the Mito‐Signature showed a >5‐fold increase in recurrence and distant metastasis, while being treated with hormonal therapy. See also Tables 3 and 4. RFS, reccurence‐free survival; DMFS, distant metastasis‐free survival.