Black women in the United States die from breast cancer at a rate roughly 40 percent higher than white women, even though they are diagnosed with the disease at a lower rate. New research suggests that advanced genetic tumor testing could play a meaningful role in closing that gap, and the findings point to a systemic failure in how standard diagnostic tools have been applied.
Researchers applied genetic testing to early-stage breast cancer tumor samples from more than a thousand women and found that Black patients were significantly more likely to have high-risk tumors that standard clinical biomarker testing, such as estrogen receptor status, failed to identify. The consequence of that missed identification is under-treatment, which carries predictably worse outcomes over time.
When tumors were analyzed using commercially available gene-profiling tools and patients received treatment matched to their actual risk level, Black women achieved the same outcomes as white women three years later. Among patients with low-risk tumors identified through genomic profiling, recurrence-free survival rates reached 97.7 percent regardless of race, an outcome the researchers described as excellent.
The study also found that roughly half of patients initially classified as low-risk based on standard testing turned out to have more aggressive tumors once genomic profiling was applied. Patients with high-risk tumors were five to ten times more likely to develop distant metastases than those with low-risk tumors, a disparity that held across racial groups. The findings, published in the journal npj Breast Cancer, suggest that genomic testing for all breast cancer patients could become a critical tool for guiding treatment decisions and ultimately reducing racial disparities in survival.
Heart attack survivors may not need lifelong beta-blockers
A clinical trial out of South Korea is challenging a long-standing convention in cardiac care: the assumption that heart attack survivors must take beta-blockers for the rest of their lives. The study suggests that stable, relatively low-risk patients may be able to safely stop the medication after just one year.
Researchers enrolled more than 2,500 patients who had recovered from a heart attack and had been taking beta-blockers as part of their standard post-cardiac care. Those who stopped the medication after at least 12 months showed similar rates of death, additional heart attacks, and hospitalizations for heart failure as those who continued taking it. At a median follow-up of 3.5 years, serious adverse events occurred in 7.2 percent of patients who discontinued compared to 9 percent of those who continued, a difference that did not reach statistical significance.
Beta-blockers, which work by lowering heart rate and blood pressure, have been a cornerstone of post-heart attack treatment for decades. Many of the studies that originally established their benefit, however, were conducted before modern cardiac procedures and medications were available, raising questions about whether their continued use reflects current clinical realities. The new findings were presented at the American College of Cardiology scientific meeting and published simultaneously in The New England Journal of Medicine.
Researchers noted that because all participants were enrolled in South Korea and relatively few women were included, the results may not apply universally. For stable patients experiencing side effects from beta-blockers, including fatigue, dizziness, or low blood pressure, the case for discussing discontinuation with a physician is now considerably stronger.
Common antidepressant shows promise for long COVID fatigue
An inexpensive and widely available antidepressant called fluvoxamine has shown significant promise in reducing fatigue among people living with long COVID, according to a clinical trial published in Annals of Internal Medicine.
The trial enrolled nearly 400 adults in Brazil who had been experiencing fatigue for at least 90 days following a confirmed COVID-19 infection. Participants were randomly assigned to receive fluvoxamine, the diabetes medication metformin, or a placebo over 60 days. Fluvoxamine outperformed the placebo with a 99 percent probability, meaningfully reducing fatigue and improving overall quality of life among participants.
Metformin, which has previously been shown to reduce the risk of developing long COVID when taken during an acute infection, did not demonstrate benefit for established long COVID fatigue in this trial. The distinction matters clinically because it suggests different interventions may be needed at different stages of the condition.
Researchers and outside experts welcomed the findings while urging caution. Because participants reported their own symptoms and the study focused narrowly on fatigue rather than the full spectrum of long COVID features, replication in broader patient groups will be essential before fluvoxamine can be considered a standard clinical recommendation.
