In general, the most common molecular alterations of ductal adenocarcinomas including mutations of KRAS, TP53, DPC4, and p16 genes are absent or rare in ACCs, while losses of chromosome 11p, alterations in the APC/β-catenin pathway, and loss of DCC expression have been observed in several cases. Here, SMAD4 is linked to invasive ductal breast carcinoma.