In a study of 96 breast cancer samples, promoter methylation of the Dickkopf (DKK) family member DKK3 was found to be significantly enriched in tumors from patients with advanced disease, lymph node metastasis, and positive Estrogen Receptor alpha (ERα) status (42 of 47 samples were ER+) (99). The gene discussed is ESR1; the disease is metastasis.