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Dr. Gamliel, the local mammographer, refers a patient with a suspicious lesion that he doesn’t think is cancer to the local magnetic resonance imaging (MRI) machine for a further test. The result confirms his suspicion: the lesion he had seen on mammography appears benign and there is no apparent worry. However, unexpected news arrived in the report: there is another lesion in the same breast that had not been detected by the initial mammogram. Dr. Gamliel is about to recommend surgical biopsy when his expert colleague says she has just read an article in the Journal of the National Cancer Institute about these lesions and the patient need not be sent for any invasive procedures. Astonished, Dr. Gamliel asks his colleague, ‘‘Why is this lesion different from all other lesions’’? When his colleague has no satisfactory answer, he returns home to ponder the problem. Dr. Gamliel sat down at dinner faced with the intriguing challenge of the question at hand and immediately recognized that he had four children who could help him formulate an answer. He gave them a copy of the paper by Lawrence et al. (1), published in this issue of the Journal, and decided to pose to each of them a single question that would, in part, address the initial question and help develop a more complete answer. He asked his first-born son, the official at the country’s most powerful regulatory agency: ‘‘What do the label and promotional claims of the MRI manufacturer say regarding incidental lesions’’? (He did not like the label ‘‘serendipitous’’—it just seemed to have the wrong connotation.)

Serendipitous Breast Lesions on Magnetic Resonance Imaging: Why Is This Lesion Different From All Other Lesions?