Roy-Chowdhuri et al. [59] analyzed 61 matched cases and observed 77% concordant mutations between primaries and metastases and 23% mutations only in metastases, including TP53, PIK3CA, KRAS, PTEN, BRAF, and AKT1. However, their group of patients focused primarily on the ER-positive subtype and included only 2% that were ER-negative/HER2-positive breast tumors and 25% that were TN breast tumors. This evidence concerns the gene ESR1 and breast neoplasm.