DR. OSSAMA W. TAWFIK, M.D.,PHD

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Researchers compared three molecular testing strategies—a small in-house gene panel, a targeted multi-gene assay, and comprehensive next-generation sequencing sent to an outside lab—for detecting cancer-driving mutations in lung and colon cancer patients at a community hospital. The small in-house panel was fastest but missed more mutations and had higher failure rates in lung cancer, while comprehensive sequencing found the most alterations but took longer and failed more often in colon cancer. The findings show that no single approach is ideal, and a testing strategy combining speed, reliability, and breadth is needed to get patients to targeted therapies faster.

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This randomized trial compared two bone-drilling techniques for placing dental implants in the back of the upper jaw: a newer method called osseodensification, which compacts bone rather than removing it, versus standard drilling. Osseodensification produced higher and more stable implant stability scores in the first month after placement, avoiding the typical early dip in stability seen with standard drilling, and had a slightly better implant survival rate at 12 months. The results suggest osseodensification can help implants integrate more predictably in an area of the mouth where bone quality is often poor.

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Using 3D dental scans from 52 patients, this study measured the gap that forms between the outer wall of a tooth socket and a dental implant when an implant is placed immediately after extraction, a space known as the jumping gap. The gap was smallest at the front teeth—about 1.2 mm at central incisors—and largest at the first premolars at 3.7 mm, with canines and premolars showing gaps large enough to accommodate standard implants comfortably. These measurements suggest that immediate implant placement carries more risk at front teeth and should be approached cautiously, while canine and premolar sites are more forgiving.

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This randomized trial compared two methods for rebuilding missing gum tissue between teeth—using a patient's own connective tissue taken from the palate versus using a processed platelet-rich fibrin membrane made from the patient's own blood—to reduce black triangles between teeth. Both treatments produced similar improvements in papilla height and black triangle fill at 12 months, but patients who received the blood-derived membrane needed significantly fewer pain medications afterward. The blood-derived option offers a simpler, less painful alternative to palate grafting with equivalent cosmetic outcomes.

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This prospective study compared bone resorption after immediate dental implant placement in patients with either thin or thick bone on the cheek side of the socket, following current guidelines that recommend avoiding thin bone. Both groups experienced similar amounts of bone loss and ended up with comparable bone thickness after 18 months, with good aesthetic results in both cases. The findings challenge the assumption that thin buccal bone is a contraindication for immediate implants, suggesting that with proper technique, outcomes can be successful regardless of initial bone thickness.

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Researchers compared two ways of sampling pancreatic cancer tissue through an endoscope—fine-needle aspiration, which suctions cells, versus fine-needle biopsy, which removes a small tissue core—to determine which provides better material for genetic testing. Fine-needle biopsy samples were adequate for molecular testing in 71% of cases versus only 32% for aspiration, and adequate for comprehensive genomic sequencing in 46% versus 24%. These results show that the biopsy needle yields substantially better tissue for the genetic tests now needed to guide personalized treatment decisions in pancreatic cancer.

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This randomized trial compared two approaches for crown-lengthening surgery in patients whose teeth appear too short due to excess gum tissue: a minimally invasive flapless technique using ultrasonic instruments versus a conventional open-flap approach. The flapless technique caused significantly less postoperative pain and swelling and provided more stable gum position in the early months after surgery, while both techniques achieved similar long-term aesthetic and clinical outcomes. The findings support the flapless approach as a less uncomfortable option with comparable results for this common cosmetic dental procedure.

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This study found that a protein called IRAK1 is elevated in advanced ovarian cancer and that a molecule abundant in the fluid that accumulates in the abdominal cavity of these patients activates IRAK1, which in turn promotes cancer stem cell behavior and treatment resistance. Blocking IRAK1—either by gene silencing or with a compound called TCS2210—reduced tumor growth in lab models and in mice, and worked even better when combined with standard chemotherapy. IRAK1 is identified as a viable drug target for a cancer where most patients do not survive beyond five years.

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This case report describes a 30-year-old man who developed recurring bloody fluid around his heart during a COVID-19 infection, which initially appeared to be inflammatory but was ultimately diagnosed as a rare and aggressive cancer called pericardial angiosarcoma. Standard anti-inflammatory treatments failed, and the correct diagnosis was only reached after a biopsy and full-body imaging scan. The case underscores that recurring hemorrhagic pericardial effusions that do not respond to standard therapy should prompt early investigation for a malignant cause.

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This small randomized trial tested whether surgeons need to completely remove all inflamed tissue inside deep gum pockets during a minimally invasive periodontal surgery, or whether leaving some tissue behind produces similar results. Both complete and partial tissue removal led to comparable improvements in pocket depth and attachment levels at nine months, with no statistically significant differences between groups. The results suggest that partial tissue removal may be a viable option, though larger studies are needed to confirm this finding.

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This review examines how excess iron in the body contributes to atherosclerosis—the buildup of fatty plaques in arteries that causes heart attacks and strokes—through a process called ferroptosis, a form of cell death triggered when iron generates damaging free radicals in blood vessel cells. The evidence shows ferroptosis destabilizes plaques and worsens arterial disease, and that drugs which bind iron or neutralize free radicals can reduce this damage in laboratory studies. Targeting this iron-driven cell death pathway represents a promising but largely unexplored approach to slowing cardiovascular disease.

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Researchers found that a protein called DCLK1 is elevated in head and neck and anal squamous cell cancers, particularly in HPV-negative tumors that are harder to treat, and that its levels correlate with worse patient survival. Suppressing DCLK1 with gene silencing reduced tumor growth, cancer stem cell formation, and cell migration in lab models. A compound called DiFiD was identified as a highly selective DCLK1 inhibitor that caused cancer cells to stop dividing and die, and shrank tumors in mice, establishing DCLK1 as a viable treatment target in squamous cell cancers.

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This study compared two types of biopsy needles used during bronchoscopy to sample lung lymph nodes: a newer Franseen fine-needle biopsy tool versus the standard aspiration needle. The biopsy needle diagnosed benign lymph node conditions in 82% of cases versus 46% for the standard needle and provided tissue adequate for comprehensive genetic sequencing in 76% versus 47% of lung cancer cases, while requiring fewer needle passes. The Franseen needle substantially improves both diagnostic accuracy and the quality of tissue available for molecular testing in lung cancer.

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This case report describes a 27-year-old woman with recurrent severe stomach bleeding caused by an extremely rare tumor called a gastric glomus tumor, which was initially mistaken for a common gastrointestinal stromal tumor on imaging and endoscopy. The correct diagnosis was only confirmed after surgical removal and detailed tissue analysis, including specialized protein staining. The case highlights that glomus tumors of the stomach can cause life-threatening bleeding and closely mimic other tumors, requiring surgery and pathology to distinguish them.

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This report describes a systematic gap analysis conducted by a multidisciplinary team to identify failures in how pathology tissue specimens are processed and how results are communicated to clinicians in the era of precision medicine, where genetic testing of tumors is now essential for treatment decisions. The team mapped the full workflow from sample collection through reporting and identified specific breakdowns in knowledge, skills, and processes that delay or derail molecular test results reaching patients. A practical collaborative framework was developed to guide institutions toward faster, more reliable specimen handling that supports personalized cancer treatment.

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Researchers developed an animal model called MIND (Mouse-INtraDuctal) by injecting pre-invasive human breast cancer cells directly into mouse mammary ducts to study which cases of ductal carcinoma in situ will progress to invasive cancer. Of 37 patient samples tested, 54% progressed to invasion in the mice, and only elevated progesterone receptor levels in the original patient tumor predicted invasive behavior—not genetic mutations. The model demonstrates that invasive progression of early breast cancer appears to be driven more by the tumor's environment and biology than by its genetic mutations alone.

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This retrospective study evaluated how often navigational bronchoscopy—a GPS-like guided biopsy technique for lung nodules—provided enough tissue to test for a protein called PD-L1, which determines whether a lung cancer patient can benefit from immunotherapy. In 102 consecutive lung cancer cases, 73% of samples were adequate for PD-L1 testing, and only 4% of patients required an additional biopsy procedure to get sufficient tissue. Navigational bronchoscopy performs well for obtaining PD-L1 test-ready samples, reducing the need for more invasive repeat procedures.

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This analysis of the large I-SPY2 breast cancer trial examined whether patients who had no remaining invasive cancer after chemotherapy but still had residual non-invasive lesions (DCIS) in their surgical specimens had worse long-term outcomes than those with completely clear specimens. Among 337 patients with no residual invasive cancer, the 21% who still had DCIS had identical three-year survival and recurrence rates to those with no residual disease at all. The results support counting DCIS-only residual disease as a complete response to chemotherapy, simplifying how treatment success is defined in breast cancer trials.

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This study investigated whether elevated levels of the NRAS protein in pre-invasive breast lesions called ductal carcinoma in situ can drive progression to more aggressive, harder-to-treat basal-like invasive breast cancer. Tumor samples and cell line experiments showed that high NRAS in DCIS correlates with basal-like features and markers of aggressive behavior, and that artificially raising NRAS in less aggressive cells caused them to take on invasive characteristics. These findings suggest NRAS is not just a marker but an active driver of breast cancer progression, making it a potential therapeutic target to prevent DCIS from becoming invasive.

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This study examined how corporate governance practices affect company performance across Gulf Cooperation Council countries, with particular attention to the unique role of royal family ownership in these monarchies. Smaller boards, high-quality international auditors, and royal ownership were all associated with better firm performance, while institutional ownership and CEO duality correlated with worse performance. The findings provide practical guidance for corporations in the GCC region on governance structures that complement the region's distinctive ownership patterns.

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This case report describes a patient with Merkel cell carcinoma, a rare aggressive skin cancer, whose disease spread to the stomach, small intestine, and pancreas, causing gastrointestinal bleeding and bile duct obstruction. Bleeding was controlled by blocking the blood supply to the vessel feeding the tumor, and a stent was placed in the bile duct to relieve the obstruction. The case illustrates that this rare skin cancer can metastasize to the digestive system in unusual ways and that endoscopic and imaging surveillance is important in patients with known distant spread.

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This review explains why detecting MET exon 14 skipping—a mutation found in a subset of non-small cell lung cancers that makes tumors responsive to targeted MET inhibitor drugs—is technically challenging and why the choice of genetic testing platform matters significantly. The mutation involves a complex splicing event that some next-generation sequencing panels handle better than others, and community oncologists need to understand these differences to ensure patients are not missed. Broad and optimized molecular testing is essential for identifying all patients who could benefit from targeted lung cancer therapies.

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This randomized trial tested whether drilling a slightly wider hole than the implant diameter—called oversized drilling—produces better implant stability compared to the standard manufacturer-recommended drilling technique in the back of the upper jaw. The oversized drilling group showed a steady increase in stability from day one onward, while the standard group experienced a typical early stability dip in the first four weeks; at six months, the oversized group also had less bone loss around the implant. These results suggest oversized drilling may support faster and more stable implant healing in this challenging area, though larger studies are needed.

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This study found that pancreatic cancer cells produce elevated levels of the prolactin receptor and that prolactin signaling promotes tumor cell growth, migration, and stem cell formation in laboratory and mouse models. Researchers identified that antipsychotic drugs of the diphenylbutylpiperidine class—particularly penfluridol—block prolactin signaling in these cells, and treating mice bearing pancreatic tumors with penfluridol significantly slowed tumor growth by reducing cell proliferation and inducing autophagy. These findings repurpose an existing class of psychiatric medications as potential treatments for pancreatic cancer, which has very few effective therapies.

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Using a patient-derived breast cancer mouse model, researchers discovered that a protein complex involving BCL9 and STAT3 activates gene networks that drive non-invasive breast lesions to become invasive cancer by binding to specific regulatory regions of DNA. Blocking two of the genes activated by this complex—integrin β3 and MMP16—significantly reduced invasive progression in the model. Importantly, a natural compound found in rosemary extract was shown to target BCL9 and suppress malignant progression, raising the possibility of a dietary chemopreventive approach for women with early-stage breast lesions.

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The I-SPY2 trial followed 950 women with high-risk early breast cancer treated with various neoadjuvant chemotherapy regimens and confirmed that patients who had no remaining cancer in their surgical specimens—a pathologic complete response—had dramatically better three-year outcomes. Patients who achieved complete response had a 95% three-year survival free of distant recurrence, compared to those who did not, representing roughly an 80% reduction in recurrence risk that held across all breast cancer subtypes and treatment regimens tested. These results validate pathologic complete response as a reliable indicator of long-term benefit across a wide range of experimental treatments in breast cancer.

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Researchers analyzed gene expression data from head and neck cancers and found that tumors caused by HPV infection have substantially higher expression of DNA repair genes compared to HPV-negative tumors, which may explain why HPV-positive cancers respond better to radiation and chemotherapy. This finding was confirmed in a separate tumor tissue microarray showing higher levels of DNA repair proteins in HPV-positive tumors. The elevated DNA repair activity in HPV-positive head and neck cancers correlates with better patient survival, providing a potential molecular explanation for their more favorable treatment outcomes.

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This study compared levels of a protein called MIC-1 in the blood and urine of African American and Caucasian men with prostate cancer to investigate whether it could explain the known disparity in disease severity between these groups. African American men in the study had higher tumor grades at earlier disease stages, and elevated urine MIC-1 was a strong predictor of aggressive prostate cancer specifically in this population, with an area under the curve of 0.85 compared to 0.56 in Caucasian men. Urine MIC-1 may serve as a more sensitive biomarker for detecting aggressive prostate cancer in African American men, though validation in a larger cohort is needed.

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This study investigated how high-risk HPV—the virus that causes cervical cancer—affects the cell's ability to repair DNA damage through a pathway called translesion synthesis, which normally prevents dangerous DNA errors from being permanently copied. The HPV E6 protein blocks a key DNA repair enzyme by degrading the tumor suppressor p53, which prevents cells from responding properly to DNA damage and makes them more sensitive to treatments like UV light and the chemotherapy drug cisplatin. These findings reveal a mechanism by which HPV undermines DNA repair and suggest that this vulnerability could potentially be exploited in treatment strategies.

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This rabbit study tested four variations of composite skin-and-cartilage grafts used in nasal reconstruction to determine how the design—specifically the relative amounts of skin and cartilage—affects graft survival. Grafts in which the skin and cartilage were physically separated and placed back together survived at only 45% compared to greater than 80% for grafts where skin and cartilage remained attached, demonstrating that the connection between skin and the cartilage membrane is critical for the graft to receive a blood supply and survive. Surgeons performing nasal reconstruction with ear cartilage grafts should preserve the attachment between skin and the cartilage's outer membrane to maximize graft survival.

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This study found that in breast cancer cells resistant to aromatase inhibitor hormonal therapy, an oncoprotein called MUC1 interacts with a signaling molecule called STAT1 to drive overexpression of IFITM1, a protein that promotes aggressive cancer behavior. Blocking MUC1 with gene silencing or drugs reduced IFITM1 levels and caused resistant cancer cells to die, and in mouse models, combining estrogen with a JAK inhibitor shrank tumors and reduced expression of this signaling circuit. A tumor microarray of nearly 100 patient samples confirmed that co-expression of MUC1 and IFITM1 correlates with worse survival and resistance to aromatase inhibitors.

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Researchers built a three-dimensional lung organoid—a miniature lung-like structure grown in a dish with air sac architecture and functional surfactant production—and used it to model how cancer spreads to the lung, the most common site for solid tumor metastasis. When patient-derived colon and ovarian cancer cells were grown in this system with chemotherapy, their responses matched the patients' actual clinical responses to those drugs, while standard flat-dish cultures did not predict outcomes as accurately. This tumor-in-a-dish platform offers a way to predict individual patient responses to therapy before treatment begins, potentially guiding more personalized cancer treatment decisions.

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This small pilot clinical trial tested whether adding a week of antibiotics to standard gum disease treatment could reduce the elevated levels of inflammatory immune cells and the immune imbalance seen in periodontitis patients. Patients who received antibiotics alongside standard care showed reductions in a specific type of inflammatory dendritic cell in their blood and decreased conversion of regulatory immune cells into inflammatory Th17 cells, bringing these markers closer to levels seen in healthy individuals. The findings suggest antibiotics can modulate the systemic immune dysfunction in gum disease, at least in the short term, which may be relevant given the links between periodontitis and systemic diseases.

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Researchers found that a protein called KDM3A, which modifies how tightly DNA is packaged and thereby controls which genes are turned on, is overexpressed in pancreatic cancer and promotes cancer stem cell behavior and tumor invasion by driving expression of another cancer-promoting protein, DCLK1. Turning off KDM3A in pancreatic cancer cells reduced their ability to invade, form stem cell clusters, and grow tumors in mice, while forcing normal pancreatic cells to overexpress KDM3A caused them to form tumors and spread. High levels of both KDM3A and DCLK1 in patient tumors correlate with shorter survival, identifying this regulatory axis as a potential therapeutic target in pancreatic cancer.

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This study examined how Porphyromonas gingivalis, a major gum disease bacterium, manipulates human dendritic cells—key immune sentinels—to promote its own survival by simultaneously blocking cell self-digestion and preventing cell death. The bacterium activates the Akt/mTOR signaling pathway through its surface structures, which shuts down autophagy and increases levels of a survival protein called Bcl2, allowing infected dendritic cells to live longer and harbor the bacteria. Disrupting the Bcl2 survival signal with a pharmacological agent restored normal cell death, suggesting this pathway as a target for treating chronic periodontitis.

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This systematic review compiled published data on lip repositioning surgery for excess gum display, a procedure that limits upper lip elevation to reduce the visibility of the gums when smiling. Across 22 studies meeting inclusion criteria, the estimated average improvement was 3.4 mm of gum reduction, and the procedure was generally reported as effective. The review highlights that study quality is limited and evidence is largely based on small case series, calling for more rigorous clinical trials to better define outcomes and long-term stability.

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Researchers created a laboratory model of radiation-induced fibrosis—scarring that is a common and treatment-limiting side effect of cancer radiotherapy—by exposing human oral fibroblasts first to radiation and then to a pro-fibrotic signaling protein called TGF-β. The treated cells showed increased collagen production, faster growth, and greater ability to invade surrounding tissue, closely mimicking what happens in patients. Both a clinically approved anti-fibrotic drug and a curcumin-derived compound reduced collagen buildup in this model, validating it as a practical tool for testing new treatments for radiation-induced scarring.

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This study found that CD74, a receptor for an inflammatory signaling molecule called MIF, is substantially more abundant in endometriosis tissue than in normal uterine lining, in both women with endometriosis and in baboons with experimentally induced disease. Blocking CD74 in endometriosis cell lines reduced cell growth and levels of a pro-inflammatory protein called interleukin-8 that helps these lesions survive outside the uterus. CD74 appears to promote endometriosis lesion survival and represents a potential therapeutic target for a condition that affects millions of women and currently has limited treatment options.

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Researchers sequenced the gene expression of fibroblasts from juvenile nasopharyngeal angiofibroma—a rare, highly vascular tumor that grows in the nasal cavity of adolescent males—and identified over 1,000 genes that are abnormally active or suppressed compared to normal tissue. The most prominently activated pathway involved VEGF, a key driver of blood vessel growth, with VEGF-A elevated 4.4-fold and a second angiogenic receptor called FGFR2 absent in normal tissue but present in the tumor. These findings suggest that blocking VEGF or FGFR signaling could be effective treatments for this tumor, which currently requires surgery that carries significant risk in young patients.

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This brief case report describes a pediatric patient with giant cell myocarditis who presented with ventricular arrhythmia that could not be controlled with standard treatments, emphasizing that this rare inflammatory heart condition should be considered in any child with refractory dangerous heart rhythms. Endomyocardial biopsy is identified as the essential step to confirm the diagnosis. Early diagnosis is critical because giant cell myocarditis requires specific immunosuppressive treatment.

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This study identified that a protein called MTBP suppresses the spread of liver cancer by blocking a key signaling pathway—specifically by preventing an activated form of Erk1/2 from entering the cell nucleus where it would otherwise activate the transcription factor Elk-1 and turn on genes that promote metastasis. MTBP achieves this by physically binding to the nuclear transport protein that carries activated Erk1/2 into the nucleus, keeping it trapped in the cytoplasm. High MTBP levels in human liver cancer samples correlated with cytoplasmic Erk1/2 localization, supporting MTBP as a natural brake on liver cancer metastasis that could be therapeutically exploited.

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This study found that cancer-associated fibroblasts—cells that make up the majority of the tumor mass in late-stage head and neck cancer—secrete a growth factor called HGF that switches cancer cells to produce energy through a less efficient but faster process called glycolysis, while the cancer cells in turn feed the fibroblasts by secreting bFGF to boost the fibroblasts' own energy production. This metabolic cooperation creates a cycle that drives tumor growth, and blocking both signaling arms simultaneously with c-Met and FGFR inhibitors significantly reduced tumor growth in lab and animal models. The findings identify a metabolic feedback loop between head and neck cancer cells and their surrounding fibroblasts as a targetable vulnerability.

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Researchers created a mouse model for triple-negative breast cancer—the most aggressive subtype with no hormone receptor or HER2 targets—by injecting cancer cells directly into the mammary ducts of immunocompetent mice, mimicking the natural disease progression from an in-situ to invasive and metastatic state. The model replicated all stages of breast cancer progression and showed lung metastasis within four weeks, occurring through both lymphatic and blood vessel routes. This syngeneic MIND model provides a platform for studying triple-negative breast cancer biology and testing new treatments in a native immune environment, which was previously lacking.

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This study examined how the immune checkpoint protein PD-L1 is expressed across primary breast tumors, nearby lymph node metastases, and distant metastases to understand its relevance for immunotherapy selection. PD-L1 expression in primary tumors matched exactly with paired lymph node metastases, but dropped dramatically in distant metastases—present in only 2-4% of distant sites versus 17-20% in primary tumors. This near-disappearance of PD-L1 in distant metastases suggests that testing primary tumors or lymph nodes may overestimate the likely benefit of PD-L1-targeted immunotherapy in patients with widely spread breast cancer.

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This randomized trial compared lip repositioning surgery—a procedure that limits how far the upper lip retracts to reduce the appearance of a gummy smile—with and without also cutting the underlying muscle. Adding muscle severance produced greater and more stable reduction of excess gum display at 12 months (3.57 mm reduction versus 2.73 mm), while pain, swelling, and lip length changes were similar between both techniques. Cutting the muscle during lip repositioning improves long-term stability of the result and should be considered when treating patients who want a lasting correction of excessive gum display.

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This single-institution study reviewed outcomes for 24 patients with undifferentiated endometrial carcinoma, a rare and often misdiagnosed subtype of uterine cancer that is typically found at an advanced stage. Despite a 42% rate of locally advanced or metastatic disease at diagnosis, survival outcomes for these patients were comparable to those with the more common high-grade endometrioid uterine cancer treated over the same period. The findings suggest undifferentiated endometrial carcinoma is not necessarily more lethal than other high-grade uterine cancers, though its rarity and frequent misclassification make it difficult to study and optimal treatment remains uncertain.

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This study showed that Porphyromonas gingivalis, the key bacterium driving chronic gum disease, promotes both immune suppression and cancer cell growth through two distinct mechanisms involving different bacterial surface proteins—one suppresses immune killing of cancer cells by generating regulatory immune cells, and the other directly stimulates oral cancer cell growth through the CXCR4 signaling receptor. Both pathways converge on the same intracellular survival signaling circuit involving pAKT, FOXO1, and related proteins, which was confirmed in human gum tissue biopsies. These findings establish a direct biological link between chronic periodontitis and oral cancer progression, suggesting that treating gum infection could reduce the risk of oral cancer in affected patients.

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This study found that cancer-associated fibroblasts in head and neck cancer have abnormally high autophagy activity—a cellular recycling process—and that this autophagy drives secretion of tumor-promoting inflammatory proteins including IL-6 and IL-8 that fuel cancer growth. Blocking autophagy in fibroblasts reduced their ability to promote cancer cell growth, and in a mouse model, combining an autophagy inhibitor with cisplatin chemotherapy was more effective than chemotherapy alone. The findings identify secretory autophagy in tumor-supporting fibroblasts as a previously unrecognized driver of head and neck cancer progression and a potential therapeutic target.

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This review covers the current understanding of ductal carcinoma in situ—the most common non-invasive form of breast cancer—including how mammography screening has shifted its detection to earlier, non-palpable stages and how treatment approaches have evolved to mirror those used for invasive breast cancer. Key ongoing controversies include whether preoperative MRI improves outcomes and how much radiation benefit patients truly receive after surgery, given that many women with DCIS may be overtreated. The review calls for better molecular markers to identify which lesions genuinely need aggressive treatment and which can be safely managed with less.