Histologic and immunohistochemical features according to metabolic phenotypes of breast cancer. The Warburg and mixed types show high histologic grade, estrogen receptor (ER) negativity and high Ki-67 labeling index (LI). In contrast, the reverse Warburg and null types show low histologic grade, ER positivity and low Ki-67 LI. ATP synthase and glutaminase were high in the reverse Warburg and mixed types and low in the Warburg and null types (P < 0.001). BNIP3, BCL2/adenovirus E1B 19-kDa interacting protein 3; CAIX, carbonic anhydrase IX; GLUT1, glucose transporter 1; H & E, hematoxylin and eosin; MCT4, monocarboxylate transporter 4.