PTEN and Cowden disease: In this regard, besides BRCA mutations, the PI3K (Phosphatidyl-inositol 3-kinase)/AKT/mTOR (the mammalian target of rapamycin) pathway, the ATM gene, TP53 gene, and Li-Fraumeni syndrome, PTEN (Phosphatase & Tensin homolog) and Cowden syndrome, STK11 or LKB1 and Peutz-Jeghers syndrome, PALB2 (Partner and Localizer of BRCA2), Checkpoint kinase 2, and CDH1 germline mutations are the most frequently detected BC oncogenic alterations [5].