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Speaker 1: We're talking about breast cancer.

Speaker 2: Yeah.

Speaker 1: Are we talking about excisional biopsy or needle biopsy? When we're talking about treatment, are we talking about radical mastectomy and hormonal therapy? I just want to define what we're talking about.

Speaker 2: So I think, again, you could do something if you were to have someone who has an indolent tumor, if you could do a simple resection, but you wouldn't do a mastectomy, you wouldn't do a lump resection, you wouldn't put them on years of hormone therapy.

Speaker 1: So I just want to clarify, so the data you're talking about is you're removing... You're trying to excise what it is, and it's not a needle biopsy in breast cancer.

Speaker 2: Yeah, from this old study. But there are now, and I don't have time to go into it, but there are a number of prospective studies that show now that these are people who have very, very low risk. And I think it is, again, what you're trying to do is establish that there is a range— I mean, part of the problem is not how to define breast cancer like in 1890, we know a whole lot more. And we ought to challenge ourselves to think differently about, this is how we've defined it pathologically, but what are those triggers that allow people to grow or not? And how can we think a little bit differently and start to adjust our treatments accordingly?

Because what happens when we're anxious is we treat a hundred percent of people to help those three or four people that might have progressed. Whereas we might say we could do a whole lot less, reduce the morbidity for almost everybody, and likely not harm those three or four people if we caught them by following them. It's just a notion of how we change our thinking about it. And it's like, there's no perfect data that we're going to have. I think you have to believe that there's a spectrum of disease, and if it's true, it's likely to be true across all cancers. We know that these exist. We can learn from each other and help say, "this is a category that is uncertain." There are other diseases where it's uncertain, where we're not... Where people can also make better judgments about, the most risk-averse person might still want to do an update, but someone who's more neutral might say, oh no, that seems crazy.