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Large-scale sequencing has recently revealed the presence of highly complex, localized chromosomal rearrangements in cancer genomes. The authors discuss the evidence that such rearrangements can occur through at least two mechanisms: chromosomal shattering (chromothripsis) and template switching initiated by local defective DNA replication (chromoanasynthesis). They propose use of the term chromoanagenesis to describe this class of rearrangements, regardless of the initiating mechanism.