A comparison of the gene expression signatures of temporally earlier  chest wall tumors (N = 3, day 373) to late chest wall metastases (N = 4, day 2033) of the TNBC index patient revealed downregulation of immune signaling pathways, in the late chest wall tumor samples, including IFNy signaling, members of the MHC/HLA class I and II loci, immune checkpoints (CTLA4, false discovery rate) (FDR < 0.02), TIGIT (FDR < 0.003) and inflammatory chemokines (CXCL9, FDR < 0.0013; CXCL13, FDR < 0.0052) (Supplementary Fig. 3a). Here, CTLA4 is linked to neoplasm.