A 55-year-old woman presented with a large breast ulceration, biopsy specimen–diagnosed invasive ductal carcinoma (IDC), grade 3, ER+/PR+/HER2−…Palbociclib was switched for alpelisib (300 mg daily) with continuation of fulvestrant and zoledronic acid...Subsequent brain MRI at 3, 4, and 6 months showed stable disease without changes in measurements. This was compatible with a partial response per Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) criteria.