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

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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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ROCHESTER, Minn. — When back or spine problems persist, figuring out where to go for care can be confusing. Should you see a neurosurgeon or an orthopedic surgeon? A neurologist or rehabilitation specialist? And if you see a spine surgeon, does that mean you'll need surgery?

Spine conditions often cross medical specialties, which is why getting the right diagnosis is an important first step, say Mayo Clinic spine experts Benjamin Elder, M.D., Ph.D., a neurosurgeon, and Mel Helgeson, M.D., an orthopedic surgeon.

"The optimum benefit is that patients get thorough evaluations from multiple clinicians with different perspectives to figure out the best route forward," Dr. Elder says.

Coordinated, multidisciplinary evaluation provides clarity, removes guesswork

At Mayo Clinic Spine Centers in Arizona, Florida, Rochester and Northwest Wisconsin, patients with a range of spinal conditions can be evaluated by specialists across neurosurgery, orthopedic surgery, neurology, physical medicine and rehabilitation, pain medicine, and other areas. The goal is to understand what is driving a patient's symptoms and determine the most appropriate path forward.

"Our model of care removes any bias that might drive spinal treatment," Dr. Helgeson says. "We can communicate with other professionals on the team and focus on doing what is right for each individual patient."

That broader perspective can be particularly important because symptoms that seem to stem from the spine may occur alongside neurological or other medical problems. Specialists can review records and imaging, and they can coordinate additional testing or consultations when needed.

For patients, that means the starting point doesn't necessarily have to be choosing the right specialty themselves. Instead, a coordinated evaluation can bring together the expertise needed to reach a diagnosis and develop an individualized treatment plan — and surgery isn't always the answer.

"We generally first determine the least invasive option that will provide a solution to patients and then develop treatment plans in coordination with their wishes," Dr. Elder says.

Treatment approach is tailored to each patient's needs

Depending on the diagnosis, treatment may include rehabilitation, pain management and other nonsurgical approaches. When surgery is appropriate, Mayo Clinic's neurosurgeons and orthopedic surgeons collaborate with other specialists to determine the approach that best fits the patient's condition and needs.

If a patient does need a surgical procedure, some may also require additional medical treatment before surgery, such as improving their bone health, and Mayo has one of the most advanced programs in preoperative optimization and bone health.

For people seeking care for a back or spine problem, Drs. Elder and Helgeson say an important consideration is whether the care team can look beyond a single procedure or specialty and offer a range of options.

"All that expertise is brought together for comprehensive diagnosis and treatment," Dr. Helgeson says.

Ultimately, the objective is not simply to treat an image or a diagnosis but to help people regain function and quality of life.

"Spinal conditions are complex, and we always put the needs of the patient first," Dr. Helgeson says. "The goal is to take people from a place of significant pain and dysfunction and return them to as normal a quality of life as we can."

Drs. Elder and Helgeson are available for interviews.

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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

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WAKEFIELD, R.I., and ROCHESTER, Minn. — South County Health (SCH) and Mayo Clinic today announced SCH has become the first healthcare organization in Rhode Island to join the Mayo Clinic Care Network, a select group of independent healthcare organizations carefully vetted by Mayo Clinic and granted special access to Mayo Clinic's knowledge, expertise and resources.

The milestone represents a significant advancement for healthcare in Rhode Island and serves as a foundational step in South County Health's vision to create a new model for independent community healthcare — one that combines world-class clinical expertise, advanced digital capabilities, and local, patient-centered care. As part of the Mayo Clinic Care Network, South County Health healthcare professionals can quickly access Mayo Clinic's latest research, diagnostic and treatment recommendations whenever they feel it will benefit their patients.

"Today marks a defining moment for South County Health and the communities we serve," says Aaron Robinson, president and CEO of South County Health. "Becoming a member of the Mayo Clinic Care Network brings together the best of both worlds: trusted local care and the knowledge, expertise, and resources of one of the world's leading healthcare organizations, while preserving the personalized, community-based care that has always been at the heart of South County Health."

South County Health healthcare professionals can consult Mayo Clinic expertise when they determine it would benefit a patient, at no additional cost to the patient. This can provide additional clinical input while supporting care close to home.  The Mayo Clinic Care Network membership expands the tools and expertise available to local clinicians, enhancing the high-quality care already available in the community and providing additional support for complex cases and specialized needs.

As a member of the Mayo Clinic Care Network, South County Health clinicians will have access to:

• AskMayoExpert – Provides trusted, expert information to help healthcare professionals find the right answers when they need them. Created and used by Mayo Clinic physicians, all the information in AskMayoExpert is regularly reviewed and represents the latest in Mayo Clinic's medical expertise.
• eConsults – Direct connections to Mayo Clinic specialists for complex cases.
• eBoards – Multidisciplinary case reviews with Mayo Clinic experts and other network members.
• Mayo Clinic Platform – Advanced digital and AI-enabled clinical tools.

"We are pleased to welcome South County Health into the Mayo Clinic Care Network," says Ryan Uitti, M.D., medical director, Mayo Clinic Platform. "Their commitment to quality, safety and patient-centered care aligns well with the values of the Mayo Clinic Care Network."

South County Health was selected to join the Mayo Clinic Care Network by demonstrating a commitment to quality and patient-centered care. Founded in 2011, the Mayo Clinic Care Network reached a 15-year milestone as a global community of more than 50 member organizations, representing 80 hospitals and nearly 20,000 physicians.

"For many independent health systems across the country, the traditional path to sustainability has required sacrificing independence to gain access to the resources, scale and expertise needed to compete in a rapidly changing healthcare landscape," Robinson adds. "We believe there is another path. This is about creating a model that improves administrative work and advances clinical care. That means a stronger local health system today and greater access to world-class healthcare for generations to come."

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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.

About Mayo Clinic Platform
Mayo Clinic Platform is a strategic initiative of Mayo Clinic that enables collaboration, data-driven innovation and responsible AI development to transform healthcare globally. Mayo Clinic Platform is reimagining healthcare as an ecosystem — one where data, digital solutions and expertise flow seamlessly between innovators and care teams to improve care for patients everywhere.

About South County Health
South County Health is an independent, nonprofit health system featuring a 100-bed community hospital (South County Hospital) along with six ambulatory locations across central and Rhode Island. With a commitment to clinical excellence, patient-centered care and community well-being, South County Health provides a full range of inpatient, outpatient and specialty services. South County Health is proud to be Rhode Island's Most Trusted Health Partner.

Media contacts:

• Matt Moeller, South County Health, mmoeller@southcountyhealth.org
• Caroline Auger, Mayo Clinic Communications, newsbureau@mayo.edu

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ROCHESTER, Minn. — Mayo Clinic announces a generous gift from the Penske Foundation to support Bold. Forward. Unbound. in Rochester, part of Mayo Clinic’s $10 billion investment to transform healthcare through integrated digital and physical spaces. 

In recognition of this gift, Mayo Clinic will name the Penske Arrival Building, a new gateway to Mayo Clinic's downtown Rochester campus designed to provide patients and families with a warm, welcoming and seamless experience from the moment they arrive.

Recognizing that a patient's care experience begins well before they reach an exam room, Mayo Clinic designed the building to make arrival and departure an extension of care — integrating transportation, navigation, hospitality and human support to reduce logistical burdens so patients and families can focus on their health and one another. 

The Penske Foundation's leadership reflects a long-standing commitment to philanthropic and civic investment. That legacy of service is reflected in its relationship with Mayo Clinic, where its generosity has helped advance and strengthen patient care.

"The Penske Foundation is proud to support Mayo Clinic and its vision for transforming the patient experience. The Penske Arrival Building represents an important part of that vision by making the arrival experience easier and more welcoming for patients and their families," says Blair Penske Hall, president of the Penske Foundation. "We are honored to continue our long-standing partnership with Mayo Clinic and support its commitment to putting patients at the center of everything it does."

The Penske Foundation's support advances Bold. Forward. Unbound, Mayo Clinic's investment to create a fundamentally new model for how care is delivered and experienced. Through innovative care concepts, digital technologies and purpose-built environments like the Penske Arrival Building, Mayo Clinic is creating a Category-of-One experience that is designed around the needs of each patient and visitor.

The building will feature approximately 15,000 square feet of thoughtfully designed interior space, advanced valet services, patient and visitor amenities, and a direct subway connection to Mayo Clinic's established and new clinical buildings.

The Penske Arrival Building will begin welcoming patients with valet and drop-off service on Oct. 8. Parking will become available in April 2027, providing nearly 500 parking spaces for patients at the heart of Mayo Clinic in Rochester's downtown campus.

"The needs of the patient come first in everything we do," says Gianrico Farrugia, M.D., Mayo Clinic's president and CEO. "The Penske Arrival Building will bring parking, transportation, navigation and personal support together in one place and make it easier for patients and families to begin and end their time at Mayo Clinic. It is a fitting reflection of the Penske Foundation's commitment to service, and we are truly grateful for their enduring partnership."

The Penske Foundation's past philanthropic support for Mayo Clinic has accelerated the institution's top priorities through the President's Strategic Initiative Fund and advanced the Mayo Clinic Model of Care, Research and Education. The Penske Foundation is recognized by Mayo Clinic as a Philanthropic Partner, its highest level of distinction for benefactors.

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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:

• Terri Malloy, Mayo Clinic Communications, newsbureau@mayo.edu

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Mayo Clinic findings also link specific gut bacteria to cancer survival and identify a pretreatment signal associated with chemotherapy toxicity

ROCHESTER, Minn. — Mayo Clinic researchers have discovered distinct gut microbiome patterns in adults age 50 or younger with colorectal and breast cancers compared with those diagnosed later in life — one of several findings from an analysis of stool samples from 1,364 patients with cancer across cancer types, stages and treatments.

Among younger patients, those with colorectal cancer had higher lactate levels and more Veillonella parvula, a gut bacterium that feeds on lactate. Early-onset breast cancer showed changes across 64 bacterial species and lower levels of primary bile acids.

Published in Cell, the findings come from the Mayo Clinic Cancer Microbiome cohort, a real-world study that recruited cancer patients at Mayo Clinic in Arizona, Florida and Minnesota, representing 40 states. Stool samples were collected before patients began a new treatment regimen and linked to detailed clinical data on side effects and outcomes. The samples provided a window into the gut microbiome — the trillions of microbes living in the digestive tract.

Cancer-specific microbiome patterns emerge

Researchers first compared patients with cancer with 287 people without cancer to identify broad microbiome differences. Comparisons across cancer types then revealed more specific signals. After accounting for other health conditions, researchers pinpointed 341 bacterial species associated with five cancer groups.

Among those groups, neuroendocrine tumors showed a broad loss of common, health-associated gut bacteria. Liver and intrahepatic bile duct cancers had higher levels of several bacteria, including Enterococcus faecalis, while esophageal cancer had higher levels of six species, including several Streptococcus bacteria. Distinct associations were also found in lymphoid leukemia and multiple myeloma and related plasma cell cancers.

Distinct patterns in early-onset cancers 

The findings come as colorectal and breast cancer rates rise among younger adults. Colorectal cancer incidence is increasing about 3% a year among adults ages 20 to 49, while breast cancer incidence is rising 1.4% a year among women younger than 50, according to the American Cancer Society.

The colorectal finding raises questions about a possible biological connection: Tumors can produce high levels of lactate, which Veillonella parvula uses to grow. Whether that relationship plays a role in early-onset disease is not yet known.

In breast cancer, one of the 64 species that differed in younger patients was Clostridium scindens, a bacterium involved in bile acid and steroid metabolism.

No comparable age-related microbiome differences were found in brain cancer, the third cancer examined in the early-onset analysis. The colorectal and breast cancer findings do not establish that these microbial or metabolic differences cause early-onset disease, but they identify associations that warrant further study.

Gut microbiome linked to survival and treatment side effects 

Researchers also identified specific gut bacteria associated with survival in colorectal, liver and intrahepatic bile duct, melanoma, ovarian and prostate cancers. In liver and intrahepatic bile duct cancer, Bifidobacterium longum was associated with longer survival and Blautia A massiliensis with shorter survival.

Researchers also studied whether the gut microbiome before treatment was associated with diarrhea during chemotherapy, a side effect that can make treatment harder to tolerate. Among patients receiving 5-fluorouracil, or 5-FU, a chemotherapy used to treat many types of cancer, those who later developed diarrhea had lower levels of bacterial genes capable of breaking down the drug. Much of that function came from Anaerostipes hadrus, a common gut bacterium.

The same signal was not linked to diarrhea in patients receiving carboplatin, another chemotherapy drug, suggesting the finding was specific to 5-FU.

"The microbiome is not the sole driver of cancer or treatment outcomes, but it is an underappreciated component that has not traditionally been considered in therapeutic approaches," says senior author Purna Kashyap, M.B.B.S., a gastroenterologist, director of the Mayo Clinic Microbiome Program and Bernard and Edith Waterman Director, Microbiomics Program, Mayo Clinic Center for Individualized Medicine. "This gives us a proof of concept that we can begin to understand why some patients experience a particular side effect and identify a target that could potentially be acted upon."

Next, researchers will investigate whether cancer-specific microbial signals play a causal role in disease and validate the microbiome's potential to predict treatment side effects in larger patient groups.

The research was supported in part by the National Institutes of Health and philanthropic gifts from the Valhalla Foundation, the Maxine & Jack Zarrow Family Foundation, and other benefactors to the Mayo Clinic Microbiome Program and Center for Individualized Medicine.

Jun Chen, Ph.D., professor of biostatistics and consultant in Mayo Clinic’s Division of Computational Biology, is also a co-corresponding author. For a complete list of authors, disclosures and funding, review the 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 

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ROCHESTER, Minn. — Mayo Clinic researchers led a multicenter study that found dividing radiation into several treatments, known as fractionated stereotactic radiosurgery, reduced the risk of cancer returning after surgery for brain metastases and was associated with improved survival compared with delivering radiation in a single treatment.

The findings are being presented today at the 2026 American Society for Radiation Oncology (ASTRO) Annual Meeting in Boston.

Brain metastases, also called metastatic brain tumors, are cancerous tumors that spread to the brain from elsewhere in the body. Radiation therapy is a standard treatment after surgery, but researchers note that about 30% to 40% of patients experience cancer recurrence at the surgical site despite treatment with single fraction radiosurgery.

"The study findings give us the evidence necessary to transform clinical practice. We can now offer patients a treatment that controls their disease and is associated with improved survival," says Paul D. Brown, M.D., radiation oncologist at Mayo Clinic Comprehensive Cancer Center and co-principal investigator of the study.  

Why dividing radiation may improve outcomes

Stereotactic radiosurgery uses 3D imaging to precisely deliver high doses of radiation while limiting exposure to surrounding healthy tissue. It is typically delivered in a single treatment and is commonly used to treat brain metastases.

"We see high recurrence rates in patients with brain metastases because the challenge is eliminating microscopic cancer cells left behind after surgery without exposing too much healthy brain tissue to high doses of radiation," says Dr. Brown.

Dividing radiation into multiple treatments allows clinicians to deliver a higher total dose. It also gives healthy tissue time to recover between treatments, while tumor cells do not have the same ability to repair.  

Previous retrospective studies have suggested that fractionated stereotactic radiosurgery is effective, but the approach had not been validated in a randomized clinical trial.

How researchers studied fractionated radiosurgery

The study enrolled 242 patients with one to four brain metastases. Each patient had at least one metastasis larger than 2 centimeters that had been surgically removed.

Patients were randomly assigned to receive either a single treatment of stereotactic radiosurgery or fractionated stereotactic radiosurgery delivered in three or five treatments. Radiation doses were based on the size of the treatment area. Brain metastases that had not been surgically removed were treated according to the same assigned schedule.

Researchers followed patients for a median of four years.

One year after treatment, 87% of patients who received fractionated stereotactic radiosurgery had no recurrence at the surgical site, compared with 81% of patients who received a single treatment. Fractionated radiosurgery also better controlled brain metastases that had not been surgically removed, although this result was not statistically significant.

Median overall survival was 29 months for patients who received fractionated stereotactic radiosurgery, compared with 20 months for patients who received a single treatment. Fractionated treatment was associated with a 31% lower risk of death.

"The survival benefit was an unexpected finding, and while the exact mechanism remains unclear, we suspect that advances in systemic therapies over the past decade may be interacting with better control of disease within the brain, and overall, better outcomes for patients," says Dr. Brown.

Researchers found no difference in side effects or complications between the two treatment approaches.

"This is a practice-changing clinical trial in our field, demonstrating that fractionated radiosurgery not only reduces recurrence after surgery for large brain metastases but may also improve overall survival," says Robert Mutter, M.D., chair of research in the Department of Radiation Oncology and co-leader of the Novel Therapeutics and Therapeutic Modalities Research Program at Mayo Clinic Comprehensive Cancer Center. 

For more information, funding and authors, read the ASTRO abstract.

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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.

About Mayo Clinic Comprehensive Cancer Center
Designated as a comprehensive cancer center by the National Cancer Institute, Mayo Clinic Comprehensive Cancer Center is defining the cancer center of the future, focused on delivering the world's most exceptional patient-centered cancer care for everyone. At Mayo Clinic Comprehensive Cancer Center, a culture of innovation and collaboration is driving research breakthroughs in cancer detection, prevention and treatment to change lives.

Media contact:

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

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ROCHESTER, Minn. — Mayo Clinic researchers will present findings on emerging technologies, precision treatments and new radiation therapy techniques at the 2026 American Society for Radiation Oncology (ASTRO) Annual Meeting, Sept. 26–30 in Boston.

Mayo Clinic experts will participate in nearly 65 poster, education, quick-pitch, scientific, oral, plenary and presidential sessions and present 45 abstracts. Their presentations will cover topics ranging from artificial intelligence (AI) and advanced technologies in radiation therapy to clinical outcomes of precision treatments and novel techniques.

Meeting highlights include:

Presidential Symposium: Data to Dialogue: Communicating Radiotherapy's Value to Advance Care - Session II: Challenges and Opportunities in Scientific Knowledge Creation and Dissemination
Presentation time: Sunday, Sept. 27, 9:49–9:53 a.m. EDT
Description: This session will explore how today's science and healthcare information will be disseminated tomorrow, and look at the roles of journals, websites, online platforms and AI-powered content.
Panelist: John D. Halamka, M.D., Dwight and Dian Diercks president, Mayo Clinic Platform

Scientific Session: Clinical Trials Session
Presentation time: Sunday, Sept. 27, 2:10–2:20 p.m. EDT
Presentation title: Stereotactic Body Radiation Therapy (SBRT) and Comprehensive Metastasis-Directed Therapy for Ewing Sarcoma Patients Enrolled on AEWS1221: A Report from the Children's Oncology Group (COG)
Description: The study examines the feasibility and safety of SBRT and comprehensive metastasis-directed therapy for patients with metastatic Ewing sarcoma. Researchers report the highest event-free survival to date in cooperative-group trials of metastatic Ewing sarcoma.
Presenter: Nadia Laack, M.D., radiation oncologist, Mayo Clinic Comprehensive Cancer Center in Rochester

Education Session: Artificial Intelligence, Robotics and Emerging Technologies in Gynecologic Radiation Oncology: From Automation to Precision Delivery
Presentation time: Sunday, Sept. 27, 3:02–3:17 p.m. EDT
Presentation title: AI-Driven Automation in Pelvic Radiation Therapy: From Contouring to Plan Optimization
Description: The presentation explores prediction-guided care, including the use of artificial intelligence to identify each patient's risk of side effects and help physicians make more personalized treatment decisions.
Presenter: Andres Portocarrero Bonifaz, Ph.D., radiation oncology medical physicist, Mayo Clinic in Florida

Quick Pitch: Neurocognition and Novel Therapies in Glioma
Presentation time: Monday, Sept. 28, 8:25–8:30 a.m. EDT
Presentation title: Patterns of Failure After 18F-DOPA PET and MRI–Guided Hypofractionated Proton Therapy in Older Adults with Glioblastoma
Description: Researchers will present patterns of radiographic failure at the first progression of glioblastoma in older adults treated with hypofractionated proton therapy guided by 18F-DOPA PET and MRI.
Presenter: Diego Santos Toesca, M.D., radiation oncologist, Mayo Clinic in Arizona

Education Session: Spatially Fractionated Radiation Therapy (SFRT): Biological Mechanisms and Clinical Translation
Presentation time: Monday, Sept. 28, 8:32–8:47 a.m. EDT
Presentation title: Delivering Minibeam Radiotherapy: Clinical Workflow and Translational Insights
Description: The presentation will share results from Mayo Clinic's first-in-human clinical translation of minibeam radiotherapy. Read the news release.
Presenter: Michael Grams, Ph.D.,  radiation oncology medical physicist, Mayo Clinic Comprehensive Cancer Center in Rochester

Oral Session: Patient Reported Outcomes/QoL/Survivorship
Presentation time: Monday, Sept. 28, 8:32–8:47 a.m. EDT
Presentation title: Comparative Prognostic Value of Disease Specific Patient Reported Outcomes in Prostate Cancer
Description: The study compares how well patient-reported outcome measures predict overall survival, with the goal of informing evidence-based selection of these measures in prostate cancer.
Presenter: Minji Lee, Ph.D., scientist in radiation oncology, Mayo Clinic in Rochester

Scientific Session: Some crHEME with Your Coffee? A Winning Blend of Radiation and Systemic Therapy in Hematologic Malignancies
Presentation time: Monday, Sept. 28, 11:15–11:25 a.m. EDT
Presentation title: Safety of Maintenance Pembrolizumab (Pembro) and Concurrent Radiotherapy (RT) in Pediatric Participants with Classic Hodgkin Lymphoma (cHL) and Slow Early Response (SER) to Front-Line Chemotherapy (Chemo): Post Hoc Analysis of the KEYNOTE-667 Study
Description: Researchers evaluated the safety of concurrent immunotherapy and radiation therapy in pediatric patients with Hodgkin lymphoma who were treated as part of a chemo-immunotherapy study.
Presenter: Brad Hoppe, M.D., radiation oncologist, Mayo Clinic Comprehensive Cancer Center in Florida

Plenary Session
Presentation time: Monday, Sept. 28, 2:04–2:13 p.m. EDT
Presentation title: Alliance A071801 Phase III Trial Postoperative Single Fraction Stereotactic Radiosurgery (SRS) vs. Fractionated SRS (fSRS) for Resected Brain Metastasis
Description: Researchers report findings from a randomized trial comparing fSRS with single-fraction SRS for resected brain metastases.
Principal investigator: Paul D. Brown, M.D., radiation oncologist, Mayo Clinic Comprehensive Cancer Center in Rochester

Scientific Session: Optimizing Therapy, Toxicity, and Supportive Care in Head and Neck Cancers
Presentation time: Tuesday, Sept. 29, 12:57–1:06 p.m. EDT
Presentation title: First Report from the Headlight Trials: Postoperative Hypofractionated Proton Therapy for Head and Neck Cancers Unrelated to HPV
Description: Researchers will report results from clinical trials evaluating a shorter course of proton therapy for head and neck cancer.
Presenter: Scott Lester, M.D., radiation oncologist, Mayo Clinic Comprehensive Cancer Center in Rochester

Scientific Session: The Automated Clinic: AI-Powered Contouring, Monitoring, and Data Extraction
Presentation time: Tuesday, Sept. 29, 2:25–3:35 p.m. EDT
Presentation title: Personalizing PSA Follow-Up after Prostate Radiation Therapy: Developing a Patient-Specific AI-Powered Predictive Model for Clinically Meaningful Recurrence
Description: Researchers developed a machine-learning model that uses patient-specific clinical data and prostate-specific antigen kinetics to predict prostate cancer recurrence after definitive radiation therapy.
Presenter: Mariana Borras-Osorio, M.D., research fellow in radiation oncology, Mayo Clinic in Rochester

Learn more about ASTRO 2026.

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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.

About Mayo Clinic Comprehensive Cancer Center
Designated as a comprehensive cancer center by the National Cancer Institute, Mayo Clinic Comprehensive Cancer Center is defining the cancer center of the future, focused on delivering the world's most exceptional patient-centered cancer care for everyone. At Mayo Clinic Comprehensive Cancer Center, a culture of innovation and collaboration is driving research breakthroughs in cancer detection, prevention and treatment to change lives.

Media contact:

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

The post Mayo Clinic experts present radiation oncology research at ASTRO 2026 appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — A large prospective study published today in Nature Medicine found that a blood test designed to detect multiple cancers identified cancer signals across 17 broad cancer types, such as ovarian, lung, breast and colorectal cancers, and many which do not have recommended screening tests.

Mayo Clinic was among the institutions participating in the prospective, interventional study, which enrolled 35,878 adults age 50 and older. Karthik Giridhar, M.D., a Mayo Clinic medical oncologist, was a study investigator and senior author.

The multicancer early detection (MCED) test analyzes small fragments of DNA that cells release into the bloodstream. Researchers use patterns in these fragments to detect signals associated with cancer. When a cancer signal is detected, the test also predicts the likely location of the cancer to help physicians determine appropriate follow-up testing.

Among 32,007 participants included in the study's performance analysis, 287 had a positive MCED test result. Cancer was diagnosed in 173 of those participants. The test had a positive predictive value of 60.3% and specificity of 99.64%. Among participants with a true-positive result, the test correctly predicted one of the two most likely cancer signal origins in 91.3% of cases.

"One of the challenges in cancer screening is that most cancers do not have an established screening test," says Dr. Giridhar. "This study helps us better understand how a multicancer blood test might complement existing screening approaches by identifying cancer signals that otherwise may not be detected through routine screening."

Researchers found that 72.8% of cancers detected by the MCED test were cancer types without U.S. Preventive Services Task Force grade A or B screening recommendations. Among the 151 participants with at least one newly diagnosed primary cancer detected by the test, 53% had stage 1 or 2 disease and 70.9% had stage 1, 2 or 3 disease.

Giridhar also notes that these tests are not yet a substitute for established cancer screenings. Instead, they may supplement existing screening approaches and help expand understanding of cancer detection.

PATHFINDER 2 was a single-arm study, and its endpoints were descriptive, with no comparator group or formal hypothesis testing. The authors say randomized trials and further follow-up are needed to determine the clinical utility of MCED testing in routine clinical practice. The study also used an earlier version of the test that has since been replaced by a commercially available version.

The study was designed and funded by GRAIL Inc., which also participated in data analysis and interpretation and preparation of the manuscript. Dr. Giridhar reports consulting and advisory relationships with GRAIL and other organizations and travel expenses from GRAIL. A complete list of author disclosures is included in the published 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 Multicancer blood test detects 17 cancer types in large prospective study appeared first on Mayo Clinic News Network.

Helix to generate clinical whole genome sequencing and multi-omics data from one million biospecimens, advancing precision medicine as the standard of care

ROCHESTER, Minn. and SAN MATEO, Calif. — Precure, LLC today announced the selection of Helix as its multi-omic laboratory and AI tools provider supporting plans to generate comprehensive molecular data from approximately one million biospecimens and accelerate the integration of molecular insights into routine clinical care at Mayo Clinic and across health systems more broadly.

Less than a week ago, Mayo Clinic announced the launch of Precure, LLC, with founding partner Thermo Fisher Scientific, to help transform how the life sciences community understands the biological changes that occur as disease develops before symptoms occur. Precure, LLC brings together clinical expertise, de-identified longitudinal health information and population-scale molecular data to accelerate the development of new approaches to care.

Helix will provide both advanced AI tools for delivery of genomics into the clinic and biomarker driven research, and population scale multi-omic capability that encompasses clinical whole genome sequencing (WGS) and research grade proteome sequencing. Linked with longitudinal clinical information and high performance compute infrastructure, the objective is to create new opportunities for prevention, diagnosis and treatment.

“Our goal is to generate genomic information that can help inform patient care while creating a powerful resource for discovery,” said Aaron Mangold, M.D., chief medical officer, Precure, LLC. “We are working to make clinical whole genome sequencing and multi-omics a foundation of care, helping us detect disease sooner and act earlier.”

Building on prior work which utilized Helix’s Exome+ ^® sequencing technology, Precure, LLC extends that collaboration by leveraging Helix's experience providing workflow orchestration, (CLIA/CAP) genomic sequencing, data infrastructure, and AI tools to its health system partners. Precure, LLC and Helix have selected Ultima Genomics’ UG200™ Ultra Sequencing Platform as part of the program’s large-scale multi-omics initiative. Helix will use a fleet of Ultima’s next-generation platforms to generate high-quality genomic data for WGS and read-out for proteomics at scale.

“The genome is becoming an enduring patient resource, providing a precision baseline for a lifetime of care,” said James Lu, M.D., Ph.D., CEO of Helix. “Helix brings together the laboratory and data capabilities to make this possible at scale.”

Mayo Clinic's involvement in Precure, LLC is intended to advance its nonprofit mission. Any financial returns to Mayo Clinic would be reinvested in its mission of patient care, research and education. Visit mayo.edu/research/precure for more information.

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About Precure, LLC
Precure, LLC is a Mayo Clinic-controlled company established to generate and responsibly integrate population-scale molecular data with longitudinal clinical information. Precure, LLC creates the infrastructure and scale needed to enable external collaborations, disease-focused discovery and the development of new diagnostics, therapeutics and other healthcare solutions. It complements Mayo Clinic’s investigator-led research and clinical translation activities.

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.  

About Helix
Helix is an enterprise genomics company connecting clinical care and discovery. Its platform brings together clinical sequencing, integration of genomic information into healthcare, and research tools built on linked genomic and longitudinal clinical data. Through its health system partnerships, the Helix Research Network and GenoSphere, Helix helps healthcare and life sciences organizations apply genomics to patient care and the development of new diagnostics and treatments. Learn more at www.helix.com.

Media contacts:

• Tom Millikin, Mayo Clinic Communications, newsbureau@mayo.edu
• Caty Reid, Helix, helix@highwirepr.com

The post Precure, LLC selects Helix as multi-omics lab and AI tools provider appeared first on Mayo Clinic News Network.