Although a PIK3CA mutation was found to be associated with a lower histologic grade (Fig. 2C, p < 0.05), the PIK3CA mutated IDC with a synchronous TP53 mutation and/or MYC amplification showed a significantly higher histologic grading score as compared to those without a synchronous TP53 mutation or MYC amplification (Fig. 5A,B, p < 0.05), suggesting that TP53 mutation and MYC amplification are more advantageous in tumor evolution towards a higher histologic grade or a more aggressive phenotype compared to a PIK3CA mutation. Here, PIK3CA is linked to neoplasm.