“…In the absence of ligand, much of WT ERα, as well as that of other NR superfamily members, are bound by heat shock proteins, 4 an interaction that protects them from proteolysis and from which they can be released in an active form by ligand binding. Even without ligand, however, WT ERα may still regulate some genes and cellular functions, often through post-transcriptional modifications 37,38 that respond to other growth-regulating signaling systems, such as epidermal or insulin-like growth factors 39–42 . Also, the estrogen receptor does not work in isolation, and alterations in the levels and nature of associated and interacting factors—coregulators, other transcription factors, modifiers of the epigenome, post-translational modifications, cell-signaling pathways, the ERβ subtype 43 —can all modify how breast cancer will respond to hormone deprivation and antiestrogen treatments and lead to ligand-independent activation.…”