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For example, a 2021 review discussed possible ways NAC could help counter ROS-related survival, metastasis, and drug-resistance pathways in triple-negative breast cancer.39 And in a small uncontrolled pilot study involving women with breast cancer, NAC supplementation was associated with reduced markers of tumor cell proliferation.40 But animal research has found concerning effects in other contexts

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Key implications Study protocols must justify the relevance of each patient-reported outcome (PRO)