Case DET52 (Figure S4A), an ER-positive/HER2+ ductal carcinoma, presented with widespread metastatic disease and had a tree rooted in a single brain metastasis resected surgically 18 months prior to death (Det52, mt4), with a clade formed by ovary (Det52, mt7), liver (Det52, mt5), and lung (Det52, mt6) metastases. The gene discussed is ESR1; the disease is metastatic neoplasm.