Gogia A, Deo SVS, Sharma D, et al. - As in the management and prognosis of patients with metastatic breast cancer, discordance in biomarker—estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2/neu)—plays an essential role, researchers sought for the rates of discordance from developing countries, such as India. An ambispective review of paired biomarker status in 103 breast cancer patients—stage I, II, and III as per American Joint Committee on Cancer, 7th edition—who developed metastasis at recurrence was performed. Discordance for ER was present in 21.3%, for PR in 29.1%, and for HER2/neu receptor in 15.5%. In this cohort, 7.8% had positive to negative ER and 13.6% negative to positive; 21.4% had positive to negative PR, 7.8% had negative to positive PR; and approximately 6.8% had positive to negative HER2/neu receptor and 8.7% negative to positive. Single-site metastasis was observed in 41 patients (40%)—bone, 15.5%; lung, 11.7%; nonregional lymph node, 7.8%; liver, 3.9%; and brain, 0.97%. Sixty-two patients (60%) had more than one site of metastasis; the most common sites being visceral—lung and liver—followed by bone, nonregional lymph node, skin, and brain. As per these findings, change in the tumor biology characterizes metastatic disease evolution in breast cancer, which leads to discordance in receptor status.