The histopathological examination findings were as follows: metastatic carcinoma, histological grade II, (3 + 3 + 1 = 6), estrogen receptor (ER) (+), progesterone receptor (PR) (−), human epidermal growth factor receptor 2 (HER2) (2+) (no amplification by fluorescence in situ hybridization, FISH), ki-67 40%, lymph node metastasis (1/17). The gene discussed is ESR1; the disease is metastatic malignant neoplasm in the lymph nodes.