Young Breast Cancer Patients Have Low Risk of Isolated Locoregional Recurrence After Surgery: JAMA

USA: A large retrospective study found that young women diagnosed with breast cancer have a relatively low risk of isolated locoregional recurrence (LRR) after initial treatment. Researchers concluded that long-term LRR risk should not influence surgical decision-making in this population.

Published in JAMA Surgery, the study was led by Dr. Laura S. Dominici from the Division of Breast Surgery at Brigham and Women’s Hospital, Boston, along with colleagues from the multicenter Young Women’s Breast Cancer Study. It aimed to evaluate the long-term rates of isolated LRR based on molecular subtypes in women aged 40 or younger at the time of diagnosis.

The cohort included 1,135 women with stage I to III breast cancer, diagnosed between 2006 and 2016. The median follow-up was 10.1 years, making it one of the most comprehensive evaluations of long-term outcomes in this demographic. Over the follow-up period, 59 patients experienced isolated local recurrence (5.2%), and four had isolated regional recurrence (0.4%), leading to an overall LRR rate of 5.6%.

Participants were stratified by age at diagnosis: 12.8% were under 30 years, 28% were aged 31 to 35, and the remaining 59.2% were between 36 and 40. The study also accounted for molecular subtypes and types of local therapy, such as breast-conserving treatment (BCT), unilateral mastectomy, and bilateral mastectomy.

Based on the study, the researchers reported the following findings:

  • Among the participants, 32% had luminal A–like tumors, 21% had luminal B–like tumors, 20% had luminal ERBB2-positive (formerly HER2-positive) tumors, 8% were ERBB2-positive, and 18% had triple-negative breast cancer.
  • Despite the variation in tumor subtypes, the cumulative incidence of isolated locoregional recurrence (LRR) remained low across all groups.
  • The LRR rates ranged from 2.2% in ERBB2-positive cases to 6.5% in patients with triple-negative breast cancer.
  • At the 10-year mark, LRR occurred in 6.7% of women who received breast-conserving therapy (BCT).
  • The LRR rate was 6.5% in women who underwent mastectomy without radiation.
  • The lowest LRR rate of 2.4% was observed in those who had mastectomy with radiation.
  • Although mastectomy with radiation showed the lowest recurrence rate in multivariable analysis, no significant differences in LRR were found when treatment outcomes were evaluated within individual molecular subtypes.

The findings challenge the long-held belief that young women with breast cancer are at a markedly higher risk of recurrence regardless of treatment strategy. Instead, this study suggests that surgical choices should not be dictated by concerns over long-term recurrence alone.

Researchers emphasized that these results underscore the importance of personalized treatment planning, rather than defaulting to more aggressive surgical approaches based solely on age or tumor subtype. The relatively low incidence of recurrence over a decade post-diagnosis supports shared decision-making that aligns with patient preferences and overall health goals.

Reference:

Dominici LS, Zheng Y, King TA, et al. Long-Term Locoregional Outcomes in a Contemporary Cohort of Young Women With Breast Cancer. JAMA Surg. Published online July 23, 2025. doi:10.1001/jamasurg.2025.2324

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Low-dose three-phase brain perfusion imaging and AI-based parameter map generation:Study

Computed Tomography Perfusion (CTP) is a critical tool for rapidly evaluating brain blood flow in suspected stroke patients, guiding time-sensitive treatment decisions. However, standard CTP requires continuously scanning the brain over 40-60 seconds, capturing numerous time points. This results in high cumulative radiation doses, poses risks for patients with kidney problems due to the contrast agent load, and is sensitive to patient movement, leading to complex processing and potential failure. While reducing the number of scans seems logical, randomly skipping time points often misses crucial peaks in blood flow, severely underestimating key parameters. Thus, how to optimize scanning protocols to reduce CTP radiation dose and address the complexity of current functional imaging processes are urgent issues to address.

Now, team from the First Affiliated Hospital of Jinan University and Southern Medical University, have developed an innovative CTP scanning protocol and a deep learning model that can generate the vital blood flow maps needed to assess stroke patients. This work has proofed the proposed low radiation dose imaging program can slash radiation exposure by over 80% compared to current methods. This innovation promised to make stroke diagnosis safer and more accessible, particularly for vulnerable patients.

Addressing Limitations in Conventional CTP

Despite its clinical value, traditional CTP is associated with significant drawbacks. These include:

  1. High Radiation Dose: Conventional protocols can reach cumulative doses around 5260 mGy·cm, notably higher than CTA (~3222 mGy·cm).
  2. Motion Sensitivity: Repeated scans across timepoints make the technique vulnerable to patient motion, requiring sophisticated registration algorithms.
  3. Workflow Complexity: The image processing burden and risk of failure hinder routine use in clinical settings.

Previous strategies for reducing radiation via temporal subsampling risk omitting critical arterial enhancement peaks, underestimating hemodynamic parameters. While multiphase CTA (mCTA) has shown promise in capturing arterial and venous phases, it requires large contrast volumes (~80 mL), posing risks for patients with impaired renal function, and lacks quantitative perfusion data.

A Three-Phase CTP with Deep Learning Enhancement

Inspired by the temporal structure of mCTA, the team introduced a three-phase CTP protocol that drastically reduces temporal sampling while preserving essential perfusion information. A generative adversarial network (GAN)-based model was developed to directly synthesize perfusion parameter maps from only three timepoints.

In internal validation datasets, the model-produced maps showed high structural and perceptual fidelity compared to ground truth, demonstrating its capability to reconstruct key perfusion features. Further experiments explored how variations in the selected three-phase combinations affected performance. Even with ±2-second deviations from the ideal timepoints, the model maintained high predictive accuracy, although performance dropped with deviations beyond 4 seconds. These findings support both the practical feasibility of the protocol and the robustness of the model.

Reference:

Cuidie Zeng, Xiaoling Wu, Fusheng Ouyang, Baoliang Guo, Xiao Zhang, Jianghua Ma, Dong Zeng, Bin Zhang. Perfusion Parameter Map Generation from 3 Phases of Computed Tomography Perfusion in Stroke Using Generative Adversarial Networks. Research. 2025;8:0689.DOI:10.34133/research.0689.

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A media–public disconnect exists on wild meat narratives in central Africa during COVID-19

A new study published by researchers from the University of Oxford, the Wildlife Conservation Society (WCS), CIFOR-ICRAF, and institutional partners reveals a disconnect between media and public perceptions of the risks of consuming wild meat in Central Africa during COVID-19, and sheds light on the complex relationship between media reporting, community beliefs, and behavior change—offering important lessons for wildlife management and public health strategies.

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Intense, persistent grief linked to nearly double mortality risk over 10 years

Grief after the loss of a loved one is a natural response—an inevitable part of living and loving. But in a minority of the bereaved, grief is so overwhelming that it can lead to physical and mental illness, even if they don’t necessarily qualify for a diagnosis of the mental health condition of prolonged grief disorder. For example, studies have shown that people who recently lost a loved one use health care services more often, and have an increased mortality rate over the short term.

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Long-term exposure to outdoor air pollution linked to increased risk of dementia

An analysis of studies incorporating data from almost 30 million people has highlighted the role that air pollution—including that coming from car exhaust emissions—plays in increased risk of dementia.

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TyG Index Potential Marker for evaluating kidney function and Diabetic Kidney Disease: Study

A new study published in the Journal of Diabetes & Metabolic Disorders found TyG Index as an indicator for diabetic kidney disease (DKD) in individuals with type 2 diabetes (T2D), highlighting its potential clinical use in evaluating renal function deterioration.

Diabetes continues to have an unacceptably high incidence worldwide, with a steady upward trend. The mortality of diabetes patients and the frequency of cardiovascular events are significantly impacted by end-stage renal disease (ESRD). A higher percentage of people with type 2 diabetes experience DKD than those with type 1 diabetes.

Numerous cardiovascular conditions, including atherosclerosis, acute coronary syndrome, and heart failure, have been discovered to be strongly correlated with the TyG index, a new measure generated from triglycerides (TG) and fasting plasma glucose (FPG). TyG Index is a straightforward indicator of insulin resistance. It is unknown how it affects the development of diabetic kidney disease (DKD) in people with type 2 diabetes. Thus, this study examined the relationship between the TyG index and the advancement of DKD in T2D.

This study included 428 T2D patients with and without DKD. According to the Kidney Disease Improving Global Outcomes (KDIGO) criteria, the progression of DKD was determined. The TyG index was used to separate patient demographic data into quartiles. The relationship between the TyG Index and metabolic markers was examined using multiple regression.

According to the findings, 257 individuals (60.0%) experienced DKD. The TyG index was considerably higher in the DKD group than in the non-DKD group (9.9 ± 0.7 vs. 9.4 ± 0.6, P < 0.001). Age, systolic blood pressure, glycated hemoglobin, triglycerides, urea, total cholesterol, uric acid, LDH, creatinine, albumin creatinine ratio, and TyG index (P < 0.05 for each), glycated hemoglobin, triglycerides, and eGFR were all lower in the DKD group.

An elevated TyG index was identified as an independent risk factor for DKD. Overall, the TyG Index may be an indication of DKD in T2D patients. This data confirms the clinical value of TyG index in evaluating renal function worsening in DKD patients.

Source:

Siddiqui, K., Nawaz, S. S., George, T. P., David, S. K., Alfadda, A. A., & Rafiullah, M. (2025). Association of triglyceride-glucose index with diabetic kidney disease in patients with type 2 diabetes. Journal of Diabetes and Metabolic Disorders, 24(2), 171. https://doi.org/10.1007/s40200-025-01680-y

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FDA approves first cream for treating chronic hand eczema

The U.S. Food and Drug Administration (FDA) has signed off on the first-ever cream specifically approved for treating chronic hand eczema (CHE).

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Research findings could improve outcomes for critically ill patients on ventilators, study finds

A seven-year international, multi-center clinical trial led by London Health Sciences Centre Research Institute (LHSCRI) and St. Michael’s Hospital, a site of Unity Health Toronto, has found that a new ventilation mode called proportional assist ventilation (PAV+) could improve outcomes for patients in the intensive care unit (ICU) who require help breathing. The study is published in the New England Journal of Medicine.

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Tezepelumab effective as Add-On Therapy in Both T2-High and T2-Low Severe Asthma: Study

According to a real-world study, tezepelumab is an effective add-on biologic with a rapid onset of action for patients with both T2-high and T2-low severe asthma. The study was published in International Immunopharmacology by Pelaia and colleagues.

The trial involved 30 patients who had been diagnosed with either T2-high or T2-low severe asthma. Patients were evaluated at baseline and subsequently after 4 weeks of tezepelumab add-on therapy. The clinical symptom control, asthma-related quality of life, lung function, inflammatory biomarkers, and use of oral corticosteroid (OCS) were among the assessments. The participants were recruited from a single centre and comprised those who had and had not received prior treatment with other biologic drugs.

Markers of inflammation also showed significant reductions. Fractional exhaled nitric oxide (FeNO), the eosinophilic airway inflammation biomarker, declined significantly. Counts of blood basophils, another indicator of allergic and inflammatory reaction, also decreased. In cytokines, serum levels of interleukin-2 (IL-2) and vascular endothelial growth factor (VEGF) were significantly decreased, evidencing the extensive immunomodulatory actions of tezepelumab.

Key Findings

 • 30 patients with severe asthma were assessed

• Substantial symptom improvement quantified by ACT score and AQLQ

• Improved lung function: FEV1, FEF25–75, and Rtot

• Reduced inflammatory markers: FeNO, basophil count

• Decreased cytokines: IL-2, VEGF

• Effects observed in both T2-high and T2-low patients

• Beneficial regardless of previous biologic use

Efficacy Across Asthma Phenotypes

Significantly, the study confirmed that the benefits of tezepelumab extended to both T2-high and T2-low phenotypes of severe asthma. In addition, the drug’s efficacy was unaffected in patients whether they had been exposed to prior use of other biologic medicines or not. This highlights tezepelumab’s sole strength: it neither depends on eosinophilic nor allergic biomarkers to act on patients with severe asthma. Hence, it is a therapy universally applicable across all cases of severe asthma.

In this real-world investigation, tezepelumab demonstrated rapid and robust improvements in asthma control, lung function, and inflammatory markers for both T2-high and T2-low phenotypes. Its efficacy, irrespective of previous biologic exposure, attests to its utility as a useful add-on treatment with widespread use in severe asthma. Future long-term research may further confirm such encouraging initial findings and optimize its placement within asthma treatment guidelines.

Reference:

Pelaia, C., Greco, M., Iaccino, E., Crimi, C., Biafora, M., Dragone, F., Vatrella, A., & Pelaia, G. (2025). Short-term therapeutic effectiveness of tezepelumab in patients with severe asthma: A real-world study. International Immunopharmacology, 162(115185), 115185. https://doi.org/10.1016/j.intimp.2025.115185

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Doppler Ultrasound-Based Approach Reduces Complications in Pregnancies With Reduced Fetal Movements: Lancet Study

Netherlands: A new international study has found that using a cerebroplacental ratio (CPR)-based management approach in pregnancies at term—where women report reduced fetal movements—can help lower the risk of adverse perinatal outcomes, even in fetuses that are not classified as small-for-gestational-age (non-SGA). The findings, published in The Lancet Obstetrics, Gynaecology & Women’s Health, were led by Dr. Laura Lens and her team from the University Medical Centre Groningen, Netherlands.

The cerebroplacental ratio is a Doppler ultrasound measurement that compares blood flow in the fetal brain and the umbilical cord. A low CPR suggests that the fetus may be redirecting blood flow to the brain due to placental dysfunction, an indication that the baby might be under stress despite appearing normally grown.

The CEPRA trial (Cerebroplacental Ratio-based Management) is the first randomized study to evaluate whether using this ratio to guide clinical decisions could improve outcomes in pregnancies where mothers feel reduced fetal movement, but the fetus is not underweight.

The study enrolled 1,815 pregnant women across 23 hospitals—22 in the Netherlands and one in Australia—between July 2020 and September 2024. All participants were carrying singleton pregnancies in a cephalic presentation at term and had reported reduced fetal movement. Women were eligible only if their estimated fetal weight was above the 10th percentile and there was no immediate reason for inducing labor.

Hospitals were randomly assigned to two groups: one where CPR results were disclosed and used to guide clinical management (revealed group), and the other where care proceeded according to usual hospital protocols without disclosing CPR values (concealed group). In the revealed group, women with a CPR below 1.1 were advised expedited delivery, while those with higher ratios continued with routine monitoring.

The study revealed the following findings:

  • A total of 1,684 women were in the modified intention-to-treat analysis.
  • Adverse perinatal outcomes occurred in 12% of women who received CPR-based management.
  • In the standard care group, adverse outcomes were in 15% of women; corresponding to a relative risk reduction of 24% in the CPR-guided group.
  • There were no stillbirths in either group.
  • One neonatal death occurred in each group.
  • The adverse outcomes included neonatal mortality, low five-minute Apgar scores, low umbilical artery pH, emergency births due to fetal distress, and severe neonatal morbidity.
  • Serious adverse events were slightly more common in the standard care group.
  • None of the serious adverse events were related to the study protocol.

The research offers a new perspective on managing pregnancies where reduced fetal movements are reported but fetal growth appears normal. “These findings suggest that CPR can help distinguish between cases that require early intervention and those that do not,” said co-author Dr. Sanne Gordijn. “This ensures that both mother and baby receive the care best suited to their situation.”

The authors concluded, “The study reinforces the value of Doppler-based screening in identifying hidden risks in term pregnancies. It provides a foundation for updating clinical guidelines in managing reduced fetal movements in non-SGA fetuses.”

Reference:

Lens, L. A., Posthuma, S., Damhuis, S. E., Burger, R. J., Groen, H., Duijnhoven, R. G., Kumar, S., Heazell, A. E. P., Khalil, A., Ganzevoort, W., & Gordijn, S. J. (2025). Cerebroplacental ratio-based management versus care as usual in non-small-for-gestational-age fetuses at term with maternal perceived reduced fetal movements (CEPRA): A multicentre, cluster-randomised controlled trial. The Lancet Obstetrics, Gynaecology, & Women’s Health, 100002. https://doi.org/10.1016/j.lanogw.2025.100002

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