DEAR MAYO CLINIC: My mother was recently diagnosed with breast cancer. Given my family history, when should I consider preventive surgical options, and what do those look like? Are there other risk factors I should be aware of? 

ANSWER: Given your family history, it's understandable to think proactively about your breast cancer risk. The good news is that today we have more tools than ever to help people understand their personal risk and choose prevention strategies that fit their goals, health needs and stage of life. 

An important first step is meeting with a healthcare clinician experienced in breast cancer risk assessment, such as a breast health specialist at a high-risk breast clinic. Clinicians use a combination of personal history, family history, genetic testing and validated risk-prediction models to estimate your lifetime risk of developing breast cancer. 

What factors increase breast cancer risk?

Risk factors may include: 

• Age. 

• Genetic mutations, such as BRCA 1 or BRCA 2. 

• Family history of breast or ovarian cancer. 

• Hormonal factors, including age at first menstrual period, pregnancy history and breastfeeding. 

• Prior breast biopsies or certain benign breast conditions. 

• Breast density on imaging. 

Reviewing risk, family history and any genetic results of family members with a genetic counselor may be helpful to determine whether genetic testing may be appropriate for you. 

Once your risk is better defined, your care team can recommend a personalized screening plan. For people at higher risk, this may include earlier and more frequent screening, often using breast MRI or other imaging options in addition to mammography. 

What are the options for reducing breast cancer risk?

Prevention strategies generally fall into three categories: 

Lifestyle approaches. Maintaining a healthy weight, staying physically active, limiting alcohol intake and avoiding smoking can help reduce breast cancer risk. Research shows that combining regular aerobic exercise with strength training offers the most significant benefit. 

Risk-reducing medications. Certain medications can lower breast cancer risk by about 50%-70% in select people. These are typically taken daily for several years and may be an option depending on your age, menopausal status and individual risk profile. 

Risk-reducing surgery. For some people at very high risk, including those with BRCA mutations, preventive surgery may be considered. A bilateral (double) mastectomy can reduce the risk of developing breast cancer by approximately 90%-95%, although no surgery can eliminate risk entirely. This is a permanent decision that affects appearance, sensation and quality of life, so it’s essential to carefully discuss this with your care team. 

When should preventive mastectomy be considered?

Risk-reducing mastectomy can be performed with or without breast reconstruction. There are different approaches to both mastectomy and reconstruction, and eligibility for a particular approach will be discussed by your care team. Options include: 

• Total mastectomy, which removes the breast tissue and results in a flat chest wall. 

• Skin-sparing mastectomy, which preserves most of the breast skin. 

• Nipple-sparing mastectomy, which preserves the skin and nipple-areola complex for select patients. 

Robotic-assisted nipple-sparing mastectomy can also be an option for select patients with increased risk of breast cancer who are considering a prophylactic (preventive) mastectomy. This approach also may be used for patients who have early-stage breast cancer with tumors located away from the nipple and skin. 

The minimally invasive approach allows the surgeon to remove breast tissue through a small incision near the side of the breast under the arm while preserving the skin and nipple-areola complex. Early experience suggests this technique may reduce visible scarring, improve cosmetic outcomes and improve patient-reported outcomes, such as postoperative physical well-being, while maintaining the same cancer-control principles as other surgical options.  

Ongoing evaluation and research continue to refine patient selection and outcomes for this innovative technique. 

How do you decide which prevention option is right for you?

Choosing whether, and when, to pursue medication or surgery to reduce breast cancer risk is a deeply personal decision. It also can change over time as circumstances evolve. Factors such as age, menopausal status, plans for pregnancy, family responsibilities and personal values all matter. 

Meeting with a breast surgical oncologist, genetic counselor and reconstructive plastic surgeon can help you fully understand your options and feel confident in your decision. 

Being proactive about your health is an important step. With individualized care and a thoughtful approach, you and your healthcare team can develop a plan that best supports your long-term well-being. 

Jeffrey E. Johnson, M.D., Breast and Melanoma Surgical Oncology, Mayo Clinic, Rochester, Minnesota, and Mara Piltin, D.O., Surgical Oncology, Mayo Clinic, Jacksonville, Florida

The post Mayo Clinic Q&A: When to consider preventive breast cancer surgery appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — Researchers in a Mayo Clinic-led study have shown how to detect a broad range of DNA mutations in noncancerous human tissues and across the genome. The analysis, drawing on more than 90 trillion DNA letters of sequencing data, could help scientists study when these changes arise — from early development through aging — and how they contribute to cancer and other diseases. 

Published in Cell, the study is the flagship paper in a package of roughly a dozen publications from the National Institutes of Health (NIH) Common Fund's Somatic Mosaicism across Human Tissues, or SMaHT, Network. The network includes more than 300 members from more than two dozen U.S. universities and hospitals. Researchers evaluated approaches for detecting somatic mutations ranging from single-letter DNA changes to large deletions, insertions and rearrangements. 

Alexej Abyzov, Ph.D., a Mayo Clinic professor of biomedical informatics who leads the Somatic Mutations in Development and Aging Laboratory, is the corresponding author of the Cell study. 

Reading the cellular mosaic

Unlike inherited genetic changes, somatic mutations arise after conception and accumulate over a lifetime. As cells divide, they can pass those changes to new cells, creating genetic differences within the same person, known as somatic mosaicism. Some somatic mutations can alter how cells behave and contribute to cancer, aging, and neurodevelopmental, cardiovascular and autoimmune diseases. 

These mutations can be difficult to detect when they are rare or occur in complex, repetitive regions of the genome. The SMaHT Network compared short- and long-read whole-genome sequencing, duplex sequencing, single-cell sequencing, and computational approaches. 

One of the clearest findings came from long-read sequencing, which reads longer stretches of DNA at a time. Much like reading a full sentence instead of a few scattered words, the added context made large genetic changes easier to find. Long-read sequencing detected about twice as many large DNA changes as short-read sequencing. It also found insertions that shorter reads often missed. 

Researchers improved detection in other hard-to-read parts of the genome too. In one benchmark, a more complete genome reference raised precision from 79% to 89%. Single-cell sequencing of 102 lung and colon cells revealed differences from cell to cell and helped trace their history back to early development. 

Companion study maps rare mutations across tissues

Dr. Abyzov also co-led a companion SMaHT paper published in The American Journal of Human Genetics. Deep whole-genome sequencing accurately detected rare, single-letter DNA changes present at levels below 1% in a tissue sample. 

Analyzing DNA from different organs also helped detect mutations that arose early in development and spread to multiple tissues. Combining lung and colon data uncovered 13 additional shared mutations, improving detection by 145% for these very rare mutations compared with analyzing either tissue alone. 

SMaHT aims to catalog somatic mutations across 10 to 15 tissue types from 150 donors while improving the tools used to detect them. NIH is planning a second stage focused on understanding how these mutations influence biological processes and disease. 

Dr. Abyzov says the research could eventually help identify people at higher cancer risk and track precancerous changes in tissues before developing symptoms.  

The studies were supported by the NIH Common Fund through the Office of Strategic Coordination in the NIH Office of the Director. The companion study received additional NIH support for work conducted at Mayo Clinic. For complete author lists, disclosures and funding information, review the Cell study and the companion The American Journal of Human Genetics study. 

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About Mayo Clinic   
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.   

Media contact:    

• Julie Ferris-Tillman, Ph.D., Mayo Clinic Communications, newsbureau@mayo.edu 

The post Large-scale study advances detection of DNA mutations across the human genome  appeared first on Mayo Clinic News Network.

As the fall and winter respiratory virus season arrives, simple but important hand hygiene remains a core line of defense. 

Marking Global Handwashing Day on Oct. 15 serves as a reminder that this simple habit helps prevent the spread of germs and keeps seasonal illness at bay. 

After coughing, sneezing or blowing your nose, respiratory droplets easily transfer to your hands, making hand-washing essential after tending to cold or flu symptoms. 

"Washing hands for 20 seconds with warm water and soap, making sure to massage soap between fingers, nails, and front and back sides of your hands, can help," says Dr. Summer Allen, a Mayo Clinic family physician. "It can prevent illnesses such as diarrhea/GI and/or respiratory bugs." 

Dr. Allen notes that staying well during respiratory illness season is best supported by healthy daily habits, including proper hand hygiene, quality sleep, balanced nutrition, and an approach to healthcare that reflects your individual goals and priorities.  

"Consider speaking with your primary care clinician regarding your healthcare goals and the immunizations available to you," says Dr. Allen.  

She emphasizes that hand-washing does not exist in a vacuum; it acts as a crucial anchor for overall wellness. Explaining how it applies to a broader lifestyle defense, Dr. Allen highlights its effects.  

"It ties most closely to protecting against illness that will lead to interruptions in sleep, and when ill, not eating properly, impacting nutrition," says Dr. Allen.  

What are common hand-washing mistakes?

Dr. Allen underscores that fending off seasonal illness requires paying attention to detail.  

She notes that even with the best intentions, people often unknowingly make mistakes in their own hygiene efforts.  

When trying to fend off cold and flu symptoms, Dr. Allen points out a frequent oversight. 

"Often, the length of time and/or forgetting to cover all surfaces of their hands and fingers or using their clean hand to turn off the faucet can be something that is missed," says Dr. Allen.  

She adds that if soap and water aren't available, hand sanitizer that contains at least 60% alcohol is a second choice. 

How should you wash your hands?

To properly wash your hands, follow these steps: 

• Wet your hands with clean, running water. 

• Apply any kind of soap, and lather well. 

• Rub your hands vigorously for at least 20 seconds. Remember to scrub all surfaces, including the backs of your hands, wrists, palms, between your fingers and under your fingernails. 

• Rinse well. 

• Use a clean towel to turn off the faucet and dry your hands.

 Learn more: Mayo Clinic Minute: Wash your hands for better health 

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October is Breast Cancer Awareness Month

ROCHESTER, Minnesota — You probably know that a lump in the breast may be a symptom of breast cancer. But what about breast cancer that develops without that warning sign? Inflammatory breast cancer is a fast-moving cancer that doesn't usually form a lump; instead, the skin on one breast changes rapidly, explains Tina Hieken, M.D., a surgical oncologist at Mayo Clinic Comprehensive Cancer Center.

Inflammatory breast cancer often comes with symptoms that mimic inflammation of the breast, such as a change in skin color to a pink, red, purple or bruised appearance, unusual warmth in the affected breast, and orange peel-like skin, a symptom known as peau d'orange.

As a result, inflammatory breast cancers may be misdiagnosed as cellulitis, mastitis, Paget’s disease of the breast, or other more benign conditions.

Inflammatory breast cancer accounts for roughly 1% to 5% of breast cancer diagnoses but 10% of breast cancer deaths, statistics show.

"When there are changes in the skin of the breast, particularly in women who aren't nursing and do not have breastfeeding-associated redness, that can be a warning sign of cancer and should be evaluated by a medical professional," Dr. Hieken says.

"In inflammatory breast cancer, symptoms can develop within a few months," she notes. "That's different from someone noting a lump in the breast over a period of time, and then secondarily, skin changes in the breast over a year or longer."

In inflammatory breast cancer, abnormal cells go through the lymphatic channels in skin and soft tissue, accounting for the skin changes in the breast, Dr. Hieken explains.

Inflammatory breast cancer treatment

Inflammatory breast cancer is treated first with systemic therapy: a treatment that goes through the whole body, she says. That therapy is based on the cancer's biological features, or subtype, such as whether it expresses the estrogen receptor or overexpresses the HER2 protein.

The systemic therapy is usually delivered intravenously and could be:

• Chemotherapy directed at rapidly dividing cells.
• Targeted therapy aimed at cells that overexpress the HER2 protein.
• Immunotherapy to help the body fight cancer that doesn't express the estrogen receptor or the HER2 protein; this is the least common type, Dr. Hieken says.

Then, surgery includes removal of the breast and  nearby lymph nodes, typically followed by radiation that includes the chest, armpit and shoulder. This three-mode approach of whole-body therapy, surgery and radiation is critical to disease control for cancer that has a high risk of spreading to other parts of the body or recurring in the breast and surrounding area, Dr. Hieken says. More common forms of breast cancer may not require all types of available treatments.

Advances in inflammatory breast cancer care

There have been several innovations in the treatment of inflammatory breast cancer.

"Very similar to non-inflammatory breast cancer, giving treatment at the beginning that is designed for one of those three or four subtypes of breast cancer is probably the biggest innovation," Dr. Hieken says. "I think in parallel, the other big innovation is better cross-sectional imaging so that, at the outset, we know whether patients have disease that has spread beyond the breast and the regional lymph nodes."

Among the breast cancer subtypes, progress has particularly been made in HER2-positive inflammatory breast cancer, with the addition of two different drugs that work in a complementary way to block the effects of the HER2 protein overexpression, she adds.

"It's been a huge advantage and has really improved outcomes for women," Dr. Hieken says. "Then, for those women who have less than a complete response to that systemic treatment, there are new targeted therapies that can be given after surgery."

Another improvement is intensity modulated radiotherapy, or IMRT, that is delivered using CT integrated planning, she says. This allows the care team to look at a patient in three dimensions and determine how to personalize radiation therapy to minimize the effects through such techniques as having the patient practice breath-holding or lie on her stomach during radiation therapy.

"We're learning a lot," Dr. Hieken adds.

A team approach to inflammatory breast cancer treatment

At Mayo Clinic, physicians from across treatment disciplines work alongside researchers seeking new care options for patients with this aggressive form of cancer.

Specialists from medical oncology, radiation oncology, surgical oncology and radiology work together. They collaborate with additional healthcare professionals such as genetic counselers, pathologists, social workers, occupational and physical therapists, psychotherapists, and integrative medicine experts, to offer comprehensive support to patients.

For more information about inflammatory breast cancer, visit mayoclinic.org and the Mayo Clinic Medical Professionals website.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Sharon Theimer, Mayo Clinic Communications, newsbureau@mayo.edu

The post Inflammatory breast cancer: Fast-moving form often lacks lump as warning sign appeared first on Mayo Clinic News Network.

On a cold December night more than a decade ago, a snowmobile crash on a rural Iowa road left Chad Rockow with a shattered lower leg — and months of surgeries, setbacks and pain so severe he considered amputation.

Nearly 13 years later, he learned the accident had set something else in motion: a Mayo Clinic discovery of a hidden, inherited disease affecting his entire family.

"At the time, the accident felt like the worst thing that could happen," Chad says. "My career, my life, everything turned upside down. But now I see it as the best thing because it may have saved my life, my sister's life, my brother's life and my dad's."

Watch: Chad's story | Videography by Kevin Sullivan, Mayo Clinic

Journalists: Broadcast-quality video (3:37) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

The reason for the phone call traces back to Chad's recovery. When his leg failed to heal properly, Chad came to Mayo Clinic for specialized care. During treatment, he enrolled in the Mayo Clinic Biobank, donating a blood sample and joining tens of thousands of volunteers helping researchers unlock the genetic roots of disease.

His leg eventually healed, and Chad returned to life on his Iowa farm, rarely thinking about the blood sample he had left behind.

A life-changing phone call

Nearly 13 years later, his phone rang.

On the line was a Mayo Clinic genetic counselor. Researchers had identified a rare inherited mutation in a gene called SDHD. The mutation is linked to paraganglioma-pheochromocytoma syndrome, a condition that can cause tumors to form, often without symptoms.

Some remain slow-growing for years. Others can become life-threatening if not caught early.

"I remember thinking, 'This can't be me,'" Chad says. "I had zero symptoms."

But as the counselor explained how the mutation is passed down, pieces of his family's history began falling into place.

Years earlier, his father had undergone surgery to remove tumors from his neck. Other relatives had faced similar diagnoses. One had suffered a devastating stroke after a tumor wrapped around a carotid artery.

Chad added his father to the call and gave permission to review decades-old medical records. There it was, buried in surgical notes: paraganglioma tumors.

"That's when the hair stood up on the back of my neck," Chad says. "Everything connected."

Follow-up clinical genetic testing confirmed the mutation across the family. His father tested positive first. Then Chad. Then his brother and sister — none of whom had any symptoms.

Targeted imaging revealed that the mutation had already left its mark on all four of them. Chad had three tumors in his neck, including one wrapped around a carotid artery.

His father's tumors have returned decades after his original surgeries. His sister has two tumors in her neck. His brother faces the most advanced disease, with multiple tumors, including a cancerous tumor near the skull and spine.

Chad and his brother have since undergone surgery at Mayo Clinic, with additional surgery planned for his brother. His father continues treatment there, and all four family members remain under specialized surveillance.

From biospecimens to breakthroughs

When the Mayo Clinic Biobank began enrolling volunteers in 2009, the sequencing technologies that would one day reveal Chad's mutation didn't yet exist.

"We never would have dreamed this was possible at that time to do the kind of research that we can do now," says Dr. Janet Olson, an epidemiologist who helped build the Mayo Clinic Biobank and now serves as its principal investigator.

"It took years to recruit the patients, collect the samples, extract the DNA and build the infrastructure," Dr. Olson says. Now we're getting back those gold nuggets, and Chad's story is a great example of one of those gold nuggets.”

What started as a research resource — linking blood samples, DNA and health data from thousands of volunteers — has become a powerful engine for discovery, supporting more than 500 studies.

Each sample contains layers of information such as DNA, serum, plasma and white blood cells, offering different windows into human health. Over time, when linked with medical records, these samples evolve into a powerful resource, enabling deeper understanding of disease, identifying risk and accelerating discovery.

One of the Biobank's most ambitious efforts focused on the DNA contained within those samples. Mayo Clinic Biobank Project Generation analyzed genetic data from more than 52,000 participants, searching for variants tied to 78 medically actionable conditions, including cancers and cardiovascular diseases where early detection can change outcomes.

The project ultimately identified Chad's mutation and has offered results to nearly 1,000 participants whose findings could directly affect their health.

A gold mine of discovery

Dr. Olson describes the Biobank as a "gold mine" built through years of scientific investment — and patient trust.

"It took years to recruit the patients, collect the samples, extract the DNA and build the infrastructure," Dr. Olson says. "Now we're getting back those gold nuggets, and Chad's story is a great example of one of those gold nuggets.”

Chad's story illustrates the vision behind Precure Research, Mayo Clinic's initiative to identify disease before symptoms appear and intervene earlier, when treatment has the greatest chance to change outcomes.

For Chad, the mutation may always be part of his family's story, but he hopes it will no longer define their future. For the first time in generations, his family can see it coming.

The post A shattered leg, a blood sample and a discovery that may have saved a family (VIDEO) appeared first on Mayo Clinic News Network.

When part of the liver is removed to treat cancer or other conditions, the remaining tissue must regenerate to restore liver function.  

In this Mayo Clinic Minute, Dr. Patrick Starlinger, a hepatobiliary and pancreas surgeon at Mayo Clinic Comprehensive Cancer Center, discusses research to help the liver regenerate after surgery. 

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (1:07) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

How does the liver regenerate after surgery?

"The liver can regenerate quite dramatically, probably the most potential to regenerate in the entire human body, and we leverage this in liver surgery," says Dr. Starlinger.  

Before surgery, the team measures liver volume and assesses liver function to determine how much can be safely removed to take out the tumor while leaving enough healthy liver to regenerate.  

But in some patients, that regeneration does not happen, which can lead to liver failure and limit which tumors can be removed.  

"Our area of research is so important to understand the mechanism of liver regeneration in humans, particularly because as we understand the mechanism, we can move forward with interventions to promote regeneration in these patients," says Dr. Starlinger.  

What role does blood clotting play in liver regeneration?

Mayo Clinic researchers have analyzed liver samples from patients with healthy livers and those with underlying liver conditions to better understand what drives regeneration.   

"We were able to discover that the blood coagulation system is crucially important to allow these mechanisms of liver regeneration to actually occur," says Dr. Starlinger.     

More research is needed, but researchers hope these findings could eventually lead to treatments that promote liver regeneration and expand the limits of liver surgery.

The post Mayo Clinic Minute: Unlocking how the liver regenerates after surgery (VIDEO) appeared first on Mayo Clinic News Network.

JACKSONVILLE, Fla. — Four decades ago, Mayo Clinic in Florida opened its doors to patients, beginning a transformation from a five-story building into a global medical destination that now serves more than 184,000 patients from more than 80 countries each year.

On Oct. 13, 1986, Mayo Clinic in Florida had 35 physicians and 145 support staff. Today, the campus employs nearly 12,000 staff members across 50 specialty areas, providing comprehensive diagnostic, medical, surgical and specialty care, including highly coordinated care for patients with complex and serious conditions.

Mayo Clinic in Florida is ranked the No. 1 hospital in Florida and nationally recognized in eight specialties in U.S. News & World Report's 2026–2027 "Best Hospitals" rankings. For the first time this year, Mayo Clinic in Florida also earned a place on the Honor Roll, recognizing the nation's top 20 hospitals. Newsweek recognized Mayo Clinic in Florida as the No. 1 hospital in the Southeast in its "World's Best Hospitals" rankings.

"Throughout the last 40 years, the dedication, resilience and ingenuity of our teams have driven remarkable progress as we've advanced new treatments and redefined what's possible for our patients," says Kent Thielen, M.D., CEO of Mayo Clinic in Florida. "As we look to the future, we remain committed to investing in our people, our facilities and innovative technologies that enable us to Cure, Connect and Transform healthcare, always guided by our primary value: The needs of the patient come first."

As Mayo Clinic in Florida looks to its next 40 years, investment in facilities through Bold. Forward. Unbound., technology and research will continue to transform how care is delivered.

Over the past decade, Mayo Clinic has invested more than $1 billion in campus development, more than doubling its physical footprint. Over $800 million has been invested in major capital projects that will add more than 725,000 square feet for patient care, biomedical research and technology over the next several years.

Recent campus milestones include:

• The five-floor hospital expansion, later named the Lee Ringhaver Tower in recognition of a $75 million gift from Paula and Randy Ringhaver, features advanced automation and digital patient care technology, including app-controlled room experiences, virtual family participation, less-intrusive monitoring, digital walls and autonomous carts.
• The 228,000-square-foot Duan Family Building houses the first carbon-ion therapy system in the Americas and technology capable of delivering both carbon ions and protons to the same cancer tumor.
• A new downtown Jacksonville presence focused on community health education, clinical trial participation, outreach and biomedical research to help address local health needs.
• A $50 million gift from Gilchrist and Amy Berg accelerated Mayo Clinic's Innovation Exchange, renamed the Mayo Clinic Berg Innovation Exchange, which connects innovators with Mayo expertise, resources and pathways for developing healthcare solutions.
• Mayo Clinic's Florida Transplant Center completed its 10,000th transplant, marking a significant milestone in the growth and maturation of a program central to Mayo Clinic's clinical presence in Florida.
• A research agreement with Carnegie Mellon University to bioengineer new approaches to organ transplantation and address long-standing barriers to successful transplantation.
• The eight-story, 252-room Hilton Jacksonville at Mayo Clinic opened on the Florida campus, providing patients, families and other visitors with convenient access to care and a supportive, resort-style hospitality experience.

Mayo Clinic in Florida 40^th Anniversary Media Kit

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Tia Ford, Mayo Clinic Communications, newsbureau@mayo.edu

The post Mayo Clinic in Florida marks 40 years of transforming care and shaping the future appeared first on Mayo Clinic News Network.

Instead of traditional implants manufactured in standard sizes, surgeons are using implants designed from a patient's own imaging. 

"The benefit of these is they're custom fitted for each particular patient," says Dr. Joshua Bakhsheshian, a Mayo Clinic neurosurgeon. "This gives us a little bit more control in terms of alignment restoration and also (vertebral) endplate coverage, which leads to better patient outcomes down the line." 

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (1:00) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

Personalized implants, personalized care 

Creating the implant starts with a CT scan. Resulting images are used to build a three-dimensional reconstruction of the patient's spine. From that reconstruction, an implant can be designed to fit the space between the vertebrae where it will be placed. 

This personalized fit is part of an evolution in spine surgery toward better tailored treatments. 

"Modern-day spine surgery requires a lot of planning beforehand," Dr. Bakhsheshian says. "The operation is mostly done before you even get to the operating room." 

For patients undergoing spinal fusion, implants help maintain the space between vertebrae while the bones heal together. Porous titanium also allows bone to grow into and integrate better with the implant. 

Better outcomes through customization 

Dr. Bakhsheshian says customization can also mean less adjustment to the implant  during the operation. 

"They're personalized to each patient, which allows me to finish the operation quicker because there's less 'carpentry' that's needed in the operating room," he says. 

This level of precision can also benefit patients after surgery. 

"Patients tend to recover faster, and they're able to return to their level of activity as desired sooner," Dr. Bakhsheshian says. 

A spinal implant may be small, but its role in supporting alignment, stability and healing is important. 

"I'm very excited about this technology," Dr. Bakhsheshian says. "Ultimately, it can help provide better outcomes."

The post Mayo Clinic Minute: 3D printing brings a personalized fit to spine surgery (VIDEO) appeared first on Mayo Clinic News Network.

"Today the only thing that is permanent is change." - Charles H. Mayo, M.D., Northwestern University Alumni News, July 1931.

Florida businessman J.E. Davis first took a special interest in healthcare after the passing of his father, Winn-Dixie founder William Milton Davis, following what the family felt was "an unnecessary loss."  

After William Milton's death, the Davis family became highly selective about where they sought care. At the recommendation of friends, the family began traveling to Mayo Clinic in Rochester, Minnesota, for their healthcare needs.  

During treatment for kidney stones in the 1970s, J.E. Davis developed a friendship with Hugh Butt, M.D., a gastroenterologist and internist at Mayo Clinic. One winter morning in 1978, Dr. Butt got frostbite on his cheek while walking to work. Upon hearing this, Davis quipped that Mayo Clinic ought to consider a location in a more temperate climate.  

A year later, as an evolving healthcare landscape that incentivized patients to seek local care rather than travel to a destination medical center brought new challenges to the enterprise, J.E. Davis hosted a group of Mayo Clinic leaders in Jacksonville, Florida, to scout land for a potential site, the first outside of Minnesota.  

Initially, Mayo Clinic leaders chose not to pursue building a Jacksonville site due to potential financial risk, the challenges of replicating the Mayo model of care outside of Minnesota and relocating staff, among other concerns. But J.E. Davis persisted, writing in his journal, "Someone has to get on fire for the great potential."  

In August 1984, Davis' efforts and those of a group of community members committed to bringing Mayo Clinic to Jacksonville came to pass. Then-Jacksonville Mayor Jake M. Godbold announced that Mayo Clinic would open a "satellite" clinic in the city, marking the start of the 120-year-old institution's expansion outside of Minnesota.  

Seventeen months later, on Oct. 13, 1986, Mayo Clinic in Florida opened its doors to 2,700 patients from 30 states and six foreign countries. In a year's time, physician head count had nearly doubled from the original 35 to 56. They, alongside 325 health staff, had seen over 10,000 patients.  

Mayo Clinic in Florida approached its 10th anniversary in 1996 as then-CEO Leo Black, M.D., oversaw considerable expansion to accommodate the imminent growth he envisioned for the campus.  

The institution's flagship Davis Building expanded by four floors, followed by the openings of both the Birdsall Medical Research Building and the Outpatient Surgery and Radiation Oncology Centers. Education and Research, two of the three shields comprising the Mayo Clinic portfolio, became prominent fixtures to the campus presence.  

A decade in, hundreds of medical students and more than 15,000 physicians had sought education at the Florida campus. Research portfolios grew from one trailer to 10 fully operational laboratories, producing 320 clinical studies exploring Alzheimer's disease, cancer and cardiovascular disease. 

As years passed, changes in healthcare and patient needs accelerated growth.  

Mayo Clinic in Florida's campus footprint had grown to over 2 million square feet across 13 buildings by 2006, with two off-site primary care centers and a forthcoming hospital tower. Three hundred physicians across 43 areas of expertise had seen approximately 500,000 patients from all 50 states and 131 countries. 

Today, after 40 years, more than 184,000 patients are seen annually at Mayo Clinic in Florida. Their multidisciplinary care teams, made up of 878 physicians and nearly 12,000 medical and health staff, united to inspire hope and promote health.  

Looking to the future of Mayo Clinic in Florida, Bold. Forward. Unbound., a multibillion-dollar investment across the Mayo Clinic enterprise, will grow hospital care and establish a biomanufacturing hub for cancer immunotherapies and transplantation advances. Among the most significant of these advancements is the opening of the Duan Family Building.  

The Duan Family Building houses the first carbon ion therapy program in the Western Hemisphere, bringing advanced-technology treatment to patients diagnosed with the most aggressive and treatment-resistant cancers. Mayo Clinic in Florida expects to treat its first carbon ion therapy patients in 2028. 

"The emerging treatments that will be offered in the Duan Family Building, including carbon ion therapy, are an important part of the integrated cancer practice at Mayo Clinic, ensuring constant, research-driven innovation in the care we are providing to patients," says Kent Thielen, M.D., CEO of Mayo Clinic in Florida.  

After four decades in Jacksonville, Mayo Clinic's primary value remains the driving force behind growth in Florida: The needs of the patients come first.  

For Sandra Hedrick, a pastor and yoga teacher who lives in northeast Florida, that meant having highly specialized care close to home after being diagnosed with olfactory neuroblastoma, a cancer affecting 1 in every 2.5 million people.  

Mayo Clinic in Florida is one of the nation's highest-volume centers for complex and rare head cancers. Sandra received care — from consultation and surgery to postoperative therapy — just a short drive from her home.  

Today, Sandra has returned to her daily life and approaches follow-up scans with confidence in her care team. Her experience reflects what Mayo Clinic's presence in Florida has made possible for patients in the region and what continued investment in the campus aims to carry forward.  

When asked what she would tell patients considering Mayo Clinic for rare cancer care, she says, "I would encourage them to go to Mayo. That's the place to go. That Mayo Clinic is right across the bridge is an incredible gift to our community."

Read more: Mayo Clinic in Florida marks 40 years of transforming care and shaping the future.

The post Blessing across the bridge: 40 years of Mayo Clinic in Florida appeared first on Mayo Clinic News Network.

Mayo Clinic scientists are pushing medicine beyond diagnosis, developing treatments for ultrarare genetic diseases while building a model that could accelerate the path to treatment for many more. 

Behind the glass walls of her Mayo Clinic neuroscience laboratory, Margot Cousin, Ph.D., watches tiny clusters of living neurons flicker across her computer screen. Magnified hundreds of times, the cells carry the genetic variant responsible for KCNK9 imprinting syndrome, one of the rarest neurological diseases in the world.

Dr. Cousin directs Mayo Clinic's N-of-1 Therapeutics Program, where scientists develop treatment strategies for diseases so rare they may affect only a single person. Each advance can help shorten the path for the next ultrarare disease, and the one after that.

"For decades, the greatest success we could offer many patients was finally putting a name to their disease," says Dr. Cousin, a clinical and translational scientist in Mayo Clinic's Center for Individualized Medicine. "A diagnosis is an extraordinary achievement, but it's no longer the end of the journey. The future of medicine is turning that diagnosis into a path toward treatment."

Watch: One patient at a time, Mayo Clinic takes on the world's rarest diseases

Videography by Kevin Sullivan, Mayo Clinic

Journalists: Broadcast-quality video (2:28) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

The neurons glowing on Dr. Cousin’s screen came from a small skin sample donated by Summer Nagele, a 21-year-old from Illinois living with KCNK9 imprinting syndrome. Low muscle tone affects her movement, speech and eating. She has reduced lung function, tires easily, sometimes uses a wheelchair for longer distances, and underwent spinal fusion for severe scoliosis at 13.

Yet Summer has built her life around the very things the disease makes difficult. She sings the national anthem before cheering crowds, performs in musical theater, competes in eight Special Olympics sports — gymnastics is her favorite — and advocates for people with disabilities.

Another part of Summer's story is unfolding somewhere far quieter — under Dr. Cousin's microscope.

Fewer than 100 people worldwide are known to have KCNK9 imprinting syndrome. Many are children.

Dr. Cousin knows them by name.

A path beyond diagnosis 

For ultrarare diseases, the path to treatment is especially difficult. There may be only a handful of patients to study, little clinical evidence to guide trials and almost no commercial incentive to develop a therapy.

Dr. Cousin and her collaborators are using advances in genetics, disease modeling, molecular therapeutics and artificial intelligence to find another way.

Every potential treatment begins with a small sample of cells donated by the people Dr. Cousin and her team hope to help.

In the laboratory, researchers coax skin cells backward into stem cells and forward into the types of neurons affected by the disease. As the neurons begin communicating, the effects of the mutation come into view — a gene that is too active or a protein that doesn't function as it should.

Those living cultures also become a testing ground. Along the lab bench, Dr. Cousin and her team use precision pipettes to introduce potential therapies into tiny wells of neurons, then watch how the cells respond. Some are existing FDA-approved drugs being tested for a new purpose. Others are experimental genetic therapies developed specifically for the disease.

Turning discovery into a treatment strategy 

What began as an effort to understand KCNK9 imprinting syndrome is now evolving into an international push to develop the disorder's first treatment. 

In 2022, Dr. Cousin and her team identified 15 previously unknown genetic changes that cause the disease. Those discoveries provided definitive diagnoses for 21 families and established a stronger scientific foundation for understanding the condition.  

Earlier this year, the team launched a natural history study to follow people with KCNK9 imprinting syndrome over time and better understand how the disease progresses. That information could help researchers identify measures for future clinical trials and determine whether a potential treatment is making a difference. 

In the laboratory, the team is investigating antisense oligonucleotides as one possible treatment strategy. The molecules can be designed to alter how genetic instructions are carried out inside cells. Researchers are still working to better understand the mechanisms driving KCNK9 imprinting syndrome and developing cell models needed to test potential therapies. 

Families are helping drive that momentum. Among them are Melissa and Sean Kelley, whose 12-year-old son, Preston, has one of the most severe forms of KCNK9 imprinting syndrome. He communicates through an eye-gaze device and relies on a wheelchair. The Kelleys founded the KCNK9 Foundation, helping transform a small group of isolated families into a global research community. 

"We share a special bond that no one else really understands," Melissa says. "For all of us with kids who are affected, our hope is to see a therapy in our lifetime." 

That community recently came together in Dallas, where Dr. Cousin joined families, clinicians and researchers from around the world for the third Global KCNK9 Imprinting Syndrome Symposium. For one of the world's rarest disorders, bringing so many families into one room was a milestone in itself. 

Sean says those face-to-face encounters give researchers "a much more nuanced view" of the disease and the many ways it can affect patients.  

Summer and her parents were part of the group that traveled to Dallas. "We trust Dr. Cousin," says her mother, Autumn Nagele. "When Summer was invited to be a part of the research, we knew her participation would be meaningful." Her father, Michael Nagele, puts their relationship with Dr. Cousin more simply: "She's family now." 

Summer's thoughts are on the younger children with KCNK9 imprinting syndrome. 

"I want the younger kids to be able not to go through the stuff that I do," Summer says. 

Scaling hope for ultrarare diseases

The search for a KCNK9 treatment is one part of a much larger effort. Across other ultrarare diseases, Dr. Cousin and her collaborators are applying the same approach, and in some cases, have already carried it from laboratory research to experimental treatment.

In 2025, they helped deliver the first custom experimental genetic treatments for Autosomal Dominant Leukodystrophy (ADLD) to a Mayo Clinic patient. The rare, fatal neurological disease slowly destroys the brain's white matter, disrupting the pathways that allow different regions of the brain to communicate.

Dr. Cousin and her collaborators have since built a comprehensive ADLD program, bringing together an international disease study and a dedicated ADLD Clinical Care Center to better understand the disorder, expand access to expert care and prepare for future treatment trials.

One by one 

For Dr. Cousin, the significance of the work is measured in much more than data points on a screen.

That became especially clear during Summer's skin biopsy.

With Dr. Cousin beside her, Summer began naming all the other children she had met through the KCNK9 community. One by one, she called them out, as if bringing them into the room with her.

"I thought of all the kids that I'm helping," Summer says.

Some breakthroughs are measured in millions of lives. In Dr. Cousin's laboratory, they begin with one.

The Bigger Picture

The work aligns with Mayo Clinic Research's Clinical Impact initiative, which is accelerating the path from scientific discovery to clinical trials and patient care. For ultrarare diseases, that means creating a more direct route from understanding the biology of a disorder to developing and testing potential therapies.

The Beyond the Breakthrough special series goes inside Mayo Clinic research to meet the people advancing medicine and cures for patients.

For more stories like this, visit Beyond the Breakthrough. 

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