Women who had ER-positive, PgR-positive, or GATA3-positive cancer were infrequently diagnosed first with lung metastases (20 (14.1%) of 142 vs. 21 (23.3%) of 90, P = 0.072; 13 (12.3%) of 106 vs. 29 (23.4%) of 124, P = 0.030; and 21 (13.9%) of 151 vs. 16 (23.5%) of 68, P = 0.079, respectively). The gene discussed is ESR1; the disease is cancer.