Treat HR + cancer, lower estrogen levels, often after surgery, as adjuvant therapy, as neoadjuvant therapy, treat metastatic disease in postmenopausal women, treat advanced cancer with no prior treatment with other hormone therapy or upon response failure of other hormone drugs, for ovarian ablation, for combination therapy (e.g., LHRH agonist, CDK 4/6 inhibitor, PI3K inhibitor). This evidence concerns the gene PIK3CA and metastatic neoplasm.