Given the prevalence of PIK3CA mutations in benign proliferative lesions, its absence from some IDCs even in patients that have it in other sites, and the only very slightly increased risk of cancer associated with neoplastic lesions in general and CCL in particular, it is worth considering whether PIK3CA H1047R is really a driver of neoplasia at this stage of cancer development or a comparatively benign inducer of proliferation alone. The gene discussed is PIK3CA; the disease is cancer.