The case described concerns a 54-year-old woman diagnosed with triple-negative breast cancer, which initially presented with metastatic disease in the breast, axillary lymph nodes, skin, and liver. The diagnostic and therapeutic process lasted over eight years and alternated the use of standard therapy based on available scientific evidence and local treatments for oligoprogression, ensuring the patient a long survival with a good quality of life, up to the point of being able to use sacituzumab govitecan, which she received for 28 cycles. The case is completed by genetic and molecular NGS profiling and explores the possibility of continuing treatment with sacituzumab govitecan in case of oligoprogression.

Metastatic triple-negative breast cancer (mTNBC) remains a highly aggressive disease with limited therapeutic options after progression to standard treatments. Together with cutaneous metastases they represent an unmet need in the clinical history of breast cancer patients. We report the case of a patient with recurrent TNBC, initially presenting with nodal relapse and subsequently developing extensive cutaneous involvement. Following progression after chemotherapy combined with immunotherapy, the patient received sacituzumab govitecan as second-line treatment. A significant clinical and metabolic response was documented on serial PET/CT scans, with disease control lasting more than 29 months. This case highlights the clinical benefit of sacituzumab govitecan in heavily pretreated mTNBC, including patients with extensive cutaneous involvement, and supports the growing role of antibody-drug conjugates in reshaping treatment paradigms in advanced disease.

We report the clinical case of a 64-year-old female patient who underwent a mastectomy with sentinel lymph node biopsy followed by adjuvant chemotherapy with anthracyclines and taxanes for triple-negative, BRCA wild-type invasive ductal carcinoma. Approximately five years later, she presented with recurrence of the disease in the brain and mediastinal lymph nodes, which was treated with neurosurgical resection of the brain lesion, radiotherapy to the tumour bed and first-line chemotherapy with capecitabine. After 4 months, due to progression of extra-cranial disease and poor gastrointestinal tolerance to oral chemotherapy, the patient was started on second-line chemotherapy with a CMF regimen, achieving a complete metabolic response in the extra-cranial sites. Subsequently, due to clinically symptomatic brain progression in the absence of extracranial recurrence and following multidisciplinary assessment, the patient was started on third-line therapy with sacituzumab govitecan, resulting in symptomatic improvement and a long period of clinical and radiological stability despite dose reduction.

During the Covid-19 pandemic, the importance of having a National Health Service (NHS) became clear, and the commitment of healthcare workers was expressed with admiration and solidarity. However, contrary to expectations, in the years that followed, there was no provision to allocate a growing share of GDP to this sector, reform community medicine and the training and placement of general practitioners, or introduce financial and regulatory measures to benefit medical and nursing staff. The issue of health and the functioning of the NHS is now a major public concern. This factor, the need to activate the facilities funded by the National Recovery and Resilience Plan (particularly the Case della Comunità), and the approaching end of the legislative term have prompted several stakeholders to submit proposals that touch on multiple aspects of the NHS. This article examines seven documents or legislative proposals presented over the past four years, highlighting their different approaches to several key issues: the financing of the NHS, the public-private relationship, and the organization of local healthcare. It also highlights how healthcare reform is a type of intervention that involves personnel and facilities, and therefore cannot be proposed without adequate funding and a clear understanding of how to secure resources.

This article examines the impact of artificial intelligence (AI) on cognitive processes and clinical practice, highlighting a delicate balance between benefits and risks. While AI enhances productivity and access to information, it also promotes cognitive offloading and deskilling, the progressive loss of clinical, decision-making, and interpersonal skills, exacerbated by automation bias and reliance. Several studies indicate reduced cognitive activity and autonomous performance when AI is heavily used, despite its proven effectiveness in diagnostic support. They are necessary mitigation strategies to preserve critical thinking and models of human-AI integration to save human clinical judgment. AI should not replace clinicians but support them, keeping core competencies such as critical thinking, empathy, and responsibility at the center.

Respiratory syncytial virus (RSV) prevention in early infancy has entered a new era with the availability of highly effective preventive strategies, particularly the long-acting monoclonal antibody nirsevimab. Real-world evidence from large population-based studies has confirmed a major reduction in RSV-related hospitalizations, pediatric intensive care admissions, and respiratory support requirements among infants receiving nirsevimab during their first RSV season. A recent French nationwide study involving more than 160,000 infants further supports the substantial clinical impact of this approach in routine practice. Maternal RSVpreF vaccination also represents an important preventive opportunity, especially when administered early enough during pregnancy to optimize transplacental antibody transfer and neonatal protection. Current evidence therefore supports the integration of both strategies into modern RSV prevention programs, with nirsevimab offering predictable protection independent of pregnancy timing and maternal vaccine uptake. The availability of effective immunoprophylaxis is reshaping pediatric RSV prevention and opens the possibility of substantially reducing the burden of severe bronchiolitis during infancy. In Italy, the implementation of uniform national strategies for nirsevimab administration and maternal RSV vaccination will be essential to ensure equitable access, organizational efficiency, and maximal public health impact.