Nuclear staining for the neuroendocrine transcription factor Insulinoma-associated protein-1 (INSM1) has very high sensitivity and specificity (99 and 96% respectively) for GEP-NET, and 100% positive and negative predictive value for differentiating pancreatic NET from other pancreatic differentials including ductal adenocarcinoma, solid pseudopapillary neoplasm and acinar cell carcinoma [36–38]. This evidence concerns the gene INSM1 and invasive ductal breast carcinoma.