The second primary breast cancer of the right breast was found to be stage IIIB, clinical stage T4d (inflammatory carcinoma-breast was erythematous and edematous, marked skin thickening noted on mammography), stage N1 (multiple mobile lymph nodes palpated and assess on with ultrasound in the axilla), with weekly positive ER, negative PR, positive HER2 [4]. This evidence concerns the gene ESR1 and breast carcinoma.