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The majority (99.0%, n = 135) had shared their results with someone and 96% had told a family member (n = 130). To understand genetic testing use and decision making among patients with high genetic risk.A survey of breast cancer survivors was administered online by a hereditary cancer nonprofit organization, Facing Our Risk of Cancer Empowered, from October 2017 to March 2018.Of 1,322 respondents, 46% had breast cancer at age < 45 years, 61% had a first-degree relative with cancer, and 84% underwent genetic testing, of whom 56% had a risk-associated pathogenic variant. Kurian, A. W., Gong, G. D., John, E. M., Miron, A., Felberg, A., Phipps, A. I., West, D. W., Whittemore, A. S. Tailoring BRCAPRO to Asian-Americans IN REPLY. The results in MINDACT and Asian women from BCAC were consistent.An increased PRS313 is associated with favorable tumor characteristics, but is not independently associated with prognosis. [3], Upon completing her fellowship, Kurian accepted a research scholar position supported by a Building Interdisciplinary Research Careers in Women's Health K12 award. View details for PubMedCentralID PMC7446363, View details for DOI 10.1158/1538-7445.AM2020-2033. To examine whether interpersonal aspects of patient-clinician interactions, such as patient-perceived medical discrimination, clinician mistrust, and treatment decision-making contribute to racial/ethnic/educational disparities in breast cancer care.A telephone interview was administered to 542 Asian/Pacific Islander (API), Black, Hispanic, and White women identified through the Greater Bay Area Cancer Registry, ages 20 and older diagnosed with a first primary invasive breast cancer. is a Professor of Medicine and of Epidemiology and Population Health at Stanford University School of Medicine. The California Breast Density Information Group identified key elements and implications of the law, researching scientific evidence needed to develop a robust response. The two models showed similar discrimination in each racial/ethnic group, discriminating least well in Hispanics. Here we identify 290 genetic determinants of ovarian ageing, assessed using normal variation in age at natural menopause (ANM) in about 200,000 women of European ancestry. John, E. M., Koo, J., Ingles, S. A., Kurian, A. W., Hines, L. M. Aggregation tests identify new gene associations with breast cancer in populations with diverse ancestry. Projected Reductions in Absolute Cancer-Related Deaths from Diagnosing Cancers Before Metastasis, 2006-2015. Recently, the National Lung Screening Trial (NLST) demonstrated the efficacy of low-dose computed tomography (LDCT) screening on LC mortality reduction. View Original Notice Allison, Thomas "Tommy" Thomas Edward "Tommy" Allison, age 75, of Gr Cox proportional hazards models provided estimates of the relative hazard ratio for mortality from all causes, breast cancer, and causes other than breast cancer associated with recent recreational physical activity (i.e., in the 10 years before diagnosis). Search: Thomas And Allison Kurian. The goal of developing educational materials for referring clinicians and patients was reached with the construction of an easily accessible Web site that contains information about breast density, breast cancer risk assessment, and supplementary imaging. The authors measured relative risks of second contralateral breast cancer (CBC) and breast cancer death using Fine and Gray multivariable regression modeling adjusted for the competing risk of death and death from another cause, respectively, and potential confounding factors. Women with BRCA1/2 mutations inherit high risks of breast and ovarian cancer; options to reduce cancer mortality include prophylactic surgery or breast screening, but their efficacy has never been empirically compared. View details for Web of Science ID 000369634300006. We examined patient reports of cancer worry by test type and results in 1,063 women who linked to a genetic test and reported undergoing testing.More than half of the sample (n = 640; 60.2%) received BRCA1/2-only testing versus 423 patients (39.8%) who had a multigene panel. We estimated breast cancer risks for noncarriers by using a population-based sample of patients with breast cancer and their female first-degree relatives (FDRs).Patients were women with breast cancer and their FDRs enrolled in the population-based component of the Breast Cancer Family Registry; patients with breast cancer were tested for BRCA1 and BRCA2 mutations, as were FDRs of identified mutation carriers. These findings provide insight into the mechanisms that govern ovarian ageing, when they act, and how they might be targeted by therapeutic approaches to extend fertility and prevent disease. Payers' coverage decision making on NGTS is challenging because this revolutionary technology pushes the very boundaries of the underlying framework used in coverage decisions. We developed questionnaires for women with BRCA1/2 mutations and clinicians involved in their care, incorporating the System Usability Scale (SUS) and the Center for Healthcare Evaluation Provider Satisfaction Questionnaire (CHCE-PSQ). However, CTC transcriptional profiling is limited by leukocyte contamination; an approach to surmount this problem is single cell analysis. However, little is known about how chemotherapy use and oncologists' recommendations have changed in recent years.We surveyed 5080 women (70% response rate) diagnosed with breast cancer between 2013 and 2015 and accrued through two Surveillance, Epidemiology, and End Results registries (Georgia and Los Angeles) about chemotherapy receipt and their oncologists' chemotherapy recommendations. Twelve of 13 asymptomatic patients had T1, N0 cancer, and only 2/12 (16%) had it diagnosed preoperatively despite state-of-the-art screening methods. Long-term sustainability of laboratory payment assistance programs was a major concern; safety-net clinics were particularly concerned about access to testing without such programs. Today & # x27 ; s nationality is American by nationality and his ethnicity is Afro-American been,. Keegan, T. H., Kurian, A. W., Gali, K., Tao, L., Lichtensztajn, D. Y., Hershman, D. L., Habel, L. A., Caan, B. J., Gomez, S. L. Clinical evaluation of multigene testing for hereditary breast and ovarian cancer. View details for DOI 10.1016/j.jtho.2021.05.010, Financial toxicity includes distress and burden from cancer-related costs. View details for DOI 10.1016/j.jtho.2021.02.024. Those with paid sick leave were less likely to stop working (OR, 0.5), as were those with flexible schedules (OR, 0.3).Working patients who received more aggressive treatments were more likely to experience substantial employment disruptions. A combination of genetic and functional approaches has identified three independent breast cancer risk loci at 2q35. Electronic medical records (EMR) and cancer registries contain complementary information on cancer diagnosis, treatment and outcome, yet are rarely used synergistically. Gaps in Receipt of Clinically Indicated Genetic Counseling After Diagnosis of Breast Cancer. View details for DOI 10.1093/jncics/pkz062, View details for PubMedCentralID PMC7049983, View details for Web of Science ID 000608680100005, View details for DOI 10.1200/JCO.2019.37.27_suppl.34, View details for Web of Science ID 000518223100033, View details for Web of Science ID 000493066600021, View details for Web of Science ID 000467473000011, View details for DOI 10.1200/JCO.2019.37.15_suppl.1525, View details for Web of Science ID 000487345804321, View details for DOI 10.1200/JCO.2019.37.15_suppl.e12046, View details for Web of Science ID 000487345800040, View details for DOI 10.1200/JCO.2019.37.15_suppl.6531, View details for Web of Science ID 000487345806085, View details for Web of Science ID 000487345804287, View details for DOI 10.1200/JCO.2019.37.15_suppl.560, View details for Web of Science ID 000487345803553, View details for DOI 10.1200/JCO.2019.37.15_suppl.1513, View details for Web of Science ID 000487345804309, View details for DOI 10.1200/JCO.2019.37.15_suppl.3069, View details for Web of Science ID 000487345805003, View details for Web of Science ID 000461693200015, View details for DOI 10.1001/jamasurg.2018.4885, View details for Web of Science ID 000461900900023. There was no evidence that the BMI or weight associations differed by underlying familial risk (P>0.2). We used simulation modeling to fill these gaps.We simulated women eligible for TAILORx using joint distributions of patient and tumor characteristics and RS from TAILORx data; treatment effects by RS from other trials; and competing mortality from the Surveillance, Epidemiology, and End Results program database. investigation of molecular predictors of drug efficacy. In this role, he drove a number of company-wide initiatives focused on transforming Oracle into an e-Business. Most participants (92%) had a total MICRA score 38, which corresponded to a mean response of "never," "rarely," or only "sometimes" reacting negatively to results. We used a multivariable model to test for interaction between affected gene and family history extent for ATM, BRCA1/2, CHEK2, and PALB2.A total of 34,865 women linked to genetic results. Desmond, A., Kurian, A., Gabree, M., Mills, M. A., Anderson, M. J., Kobayashi, Y., Horick, N., Yang, S., Shannon, K. M., Tung, N., Ford, J., Lincoln, S. E., Ellisen, L. "The GI Gap" in Genetic Testing for Inherited Susceptibility to Cancer. Recent epidemiologic evidence suggests that prediagnosis physical activity is associated with survival in women diagnosed with breast cancer. These findings have implications for risk prevention for women at increased risk of breast cancer. Although two thirds of patients were tested before surgical treatment, patients without private insurance more often experienced delays. Based on these image features, we used unsupervised consensus clustering to identify robust imaging subtypes, and evaluated their clinical and biological relevance. In an analysis with both CRS and Tyrer-Cuzick as predictors of breast cancer, CRS added significant discrimination independent of that captured by Tyrer-Cuzick (P < 10-11 in validation 1; P < 10-7 in validation 2). All statistical tests were two-sided.Using IBIS, the areas under the receiver-operating characteristic curves were 0.66 (95% confidence interval = 0.63 to 0.68) and 0.56 (95% confidence interval = 0.54 to 0.59) for 5-year and lifetime risks, respectively (Pdiff<0.001). Powell, A. The sensitivity analyses yielded similar results and showed no strong evidence of pleiotropic effect.Our MR study provides supportive evidence for a potential causal association with breast cancer risk for lifetime smoking exposure but not cigarettes per day among smokers. Differential discrimination was tested for by self-reported race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic, Asian or Pacific Islander, and American Indian or Alaskan Native) using Cox regression. All tests were 2-sided.Clinicians reported a change in risk management recommendations for 76.6% of patients who tested positive for a pathogenic or likely pathogenic variant, with changes to surveillance being most common (71.1%), followed by surgical (33.6%), chemoprevention (15.1%), and clinical trial (9.4%) recommendations. Gallagher, S., Hughes, E., Kurian, A. W., Domchek, S. M., Garber, J., Probst, B., Morris, B., Tshiaba, P., Meek, S., Rosenthal, E., Roa, B., Slavin, T. P., Wagner, S., Weitzel, J., Gutin, A., Lanchbury, J. S., Robson, M. Performance of the IBIS/Tyrer-Cuzick model of breast cancer risk by race and ethnicity in the Women's Health Initiative. We developed and evaluated the following two distinct NLP approaches to analyze free-text notes: a traditional rule-based model, using rules for metastatic detection from the literature and curated by domain experts; and a contemporary neural network model. The Effect of Patient and Contextual Characteristics on Racial/Ethnic Disparity in Breast Cancer Mortality. B., Itakura, H. Contributions of screening, early-stage treatment, and metastatic treatment to breast cancer mortality reduction by molecular subtype in US women, 2000-2017. Lowry, K. P., Geuzinge, H., Stout, N. K., Alagoz, O., Hampton, J. M., Kerlikowske, K., Miglioretti, D. L., Schecter, C., Sprague, B. L., Trentham-Dietz, A., Tosteson, A. Li, Y., Kurian, A. W., Bondarenko, I., Taylor, J. M., Jagsi, R., Ward, K. C., Hamilton, A. S., Katz, S. J., Hofer, T. P. Recurrence risk perception and quality of life following treatment of breast cancer. PVs were present in 12.7% of breast cancer patients with estrogen and/or progesterone receptor-positive, HER2-negative cancer, 9.8% with HER2-positive cancer, 16.8% with triple-negative breast cancer and 17.2% with ovarian cancer. View details for DOI 10.1200/JCO.20.02785. Among them, 60 were from cases having concurrent or subsequent invasive breast cancer (IBC) (DCIS+IBC group), and 65 from cases with no IBC development over a median follow-up of 13years (DCIS-only group). Breast cancer incidence is higher among black women than white women before age 40 years, but higher among white women than black women after age 40 years (black-white crossover). Kurian, A. W., Canchola, A. J., Gomez, S. L. Prevalence of Lynch syndrome in women with mismatch repair-deficient ovarian cancer. All statistical models and summary estimates were weighted to be representative of the target population.Receipt of CPM was the primary dependent variable for analysis and was measured by a woman's self-report of her treatment.Of the 3631 women selected to receive the survey, 2578 (71.0%) responded and 2402 of these respondents who did not have bilateral disease and for whom surgery type was known constituted the final analytic sample. These patients received germline testing between January 5, 2015, and January 31, 2020, although most (81% of patients) received testing between January 2, 2018, and January 31, 2020.The prevalence of pathogenic germline variants (PGVs) was calculated by gene, cancer type, and age at diagnosis. Kurian, A. W., Abrahamse, P., Hamilton, A. S., Deapen, D., Gomez, S., Morrow, M., Berek, J. S., Katz, S. J., Ward, K. C. Impact of disruptions in breast cancer control due to the COVID-19 pandemic on breast cancer mortality in the United States: Estimates from collaborative simulation modeling. The study sample (N = 1,711) comprised patients with indications for formal genetic risk evaluation. These findings warrant intensive surveillance for second breast cancers in women with HR-negative tumors. Non-European populations are under-represented in genetics studies, hindering clinical implementation of breast cancer polygenic risk scores (PRSs). Wapnir, I. L., Kurian, A. W., Lichtensztajn, D. Y., Clarke, C. A., Gomez, S. L. Occurrence and outcome of de novo metastatic breast cancer by subtype in a large, diverse population. Seventeen patients [28.3% (18.5-40.9%)] had atypical cells. Lifetime risk of triple-negative breast cancer is highest in black women (1.98%, 1.80-2.17%), compared to 0.77% (0.67-0.88%) for Asians, 1.04% (0.96-1.13%) for Hispanics and 1.25% (1.20-1.30%) for whites. Idos, G., Kurian, A. W., Ricker, C., Sturgeon, D., Culver, J., Kingham, K., Koff, R., Chun, N. M., Rowe-Teeter, C., Lowstuter, K., Hartman, A., Allen, B., Kidd, J., Mills, M., Ma, C., Hong, C., McDonnell, K., Ladabaum, U., Ford, J. M., Gruber, S. B. All four cases with MLH1/PMS2 protein loss had MLH1 promotor hypermethylation. A., Chung, W. K., Milne, R. L., Whittemore, A. S., Buchsbaum, R. n., Liao, Y. n., Zeinomar, N. n., Dite, G. S., Southey, M. C., Goldgar, D. n., Giles, G. G., Kurian, A. W., Andrulis, I. L., John, E. M., Daly, M. B., Buys, S. S., Phillips, K. A., Hopper, J. L., Terry, M. B. May, S., Rendle, K., Halley, M., Ventre, N., Kurian, A. W., Yu, P. P. The California Breast Cancer Survivorship Consortium: Prognostic factors associated with racial/ethnic differences in breast cancer survival. Frequencies of germline PVs in breast cancer predisposition genes (ATM, BARD1, BRCA1, BRCA2, BRIP1, CDH1, CHEK2, PALB2, PTEN, RAD51C, RAD51D, and TP53) were compared between women with ILC and unaffected female controls and between women with ILC and infiltrating ductal carcinoma (IDC).The frequency of PVs in breast cancer predisposition genes among women with ILC was 6.5% in the clinical cohort and 5.2% in the population-based cohort. Challenges remain for the broad adoption of panel tests, some of which will be addressed by the accumulation of large public databases of annotated clinical variants. Emerging Opportunity of Cascade Genetic Testing for Population-Wide Cancer Prevention and Control. Ho, W. K., Tai, M. C., Dennis, J., Shu, X., Li, J., Ho, P. J., Millwood, I. Y., Lin, K., Jee, Y. H., Lee, S. H., Mavaddat, N., Bolla, M. K., Wang, Q., Michailidou, K., Long, J., Wijaya, E. A., Hassan, T., Rahmat, K., Tan, V. K., Tan, B. K., Tan, S. M., Tan, E. Y., Lim, S. H., Gao, Y. T., Zheng, Y., Kang, D., Choi, J. Y., Han, W., Lee, H. B., Kubo, M., Okada, Y., Namba, S., Park, S. K., Kim, S. W., Shen, C. Y., Wu, P. E., Park, B., Muir, K. R., Lophatananon, A., Wu, A. H., Tseng, C. C., Matsuo, K., Ito, H., Kwong, A., Chan, T. L., John, E. M., Kurian, A. W., Iwasaki, M., Yamaji, T., Kweon, S. S., Aronson, K. J., Murphy, R. A., Koh, W. P., Khor, C. C., Yuan, J. M., Dorajoo, R., Walters, R. G., Chen, Z., Li, L., Lv, J., Jung, K. J., Kraft, P., Pharoah, P. D., Dunning, A. M., Simard, J., Shu, X. O., Yip, C. H., Taib, N. A., Antoniou, A. C., Zheng, W., Hartman, M., Easton, D. F., Teo, S. H. Genetic insights into biological mechanisms governing human ovarian ageing. Factors associated with receiving chemotherapy included <50 years of age [odds ratio (OR) 2.27, 95 % confidence interval (CI) 1.81-2.86], tumor >2 cm (OR 2.14, 95 % CI 1.75-2.61), involved lymph nodes (OR 11.3, 95 % CI 9.29-13.6), hormone receptor-negative (OR 6.94, 95 % CI 4.89-9.86), Her2/neu-positive (OR 2.71, 95 % CI 2.10-3.51), or high grade (OR 3.53, 95 % CI 2.77-4.49) tumors; comorbidities associated inversely with chemotherapy use [heart disease for anthracyclines (OR 0.24, 95 % CI 0.14-0.41), neuropathy for taxanes (OR 0.45, 95 % CI 0.22-0.89)]. We identified differentially expressed genes from 14 case-control human breast cancer gene expression datasets and integrated them with drug-protein networks. Contribution of the Neighborhood Environment and Obesity to Breast Cancer Survival: The California Breast Cancer Survivorship Consortium. In this paper, we present an evaluation of the approaches we undertook and the lessons we learned in building and validating the Oncoshare data resource. Clinician discussions about recurrence risk should address uncertainty and relevance of family and personal history. Kurian, A. W., Canchola, A. J., Gomez, S. L., Clarke, C. A. BRCA1/2 There are concerns that multigene panel testing compared with BRCA1/ 2-only testing after diagnosis of breast cancer may lead to unnecessary patient worry about cancer because of more ambiguous results.Patients with breast cancer diagnosed from 2013 to 2015 and accrued from SEER registries in Georgia and Los Angeles were surveyed (n = 5,080; response rate, 70%), and responses were merged with SEER data and germline genetic testing and results. The validation dataset was obtained from the SNPs to Risk of Metastasis (StoRM) study and included 293 patients with metastatic primary breast cancer at diagnosis. Dr. Allison W. Kurian is an oncologist in Palo Alto, California and is affiliated with Stanford Health Care-Stanford Hospital. Roberts, M. C., Kurian, A. W., Petkov, V. I. The study was performed in the Mohn Cancer Research Laboratory (Bergen, Norway) between 2019 and 2022.Associations between BRCA1 methylation and incident TNBC and incident HGSOC were analyzed by Cox proportional hazards regression.Of 2478 cases and controls in the TNBC group and 3493 cases and controls in the HGSOC group, respectively, 7 (0.3%) and 3 (0.1%) were American Indian or Alaska Native, 46 (1.9%) and 30 (0.9%) were Asian, 1 (0.04%) and 1 (0.03%) was Native Hawaiian or Pacific Islander, 326 (13.2%) and 125 (3.6%) were Black or African, 56 (2.3%) and 116 (3.3%) were Hispanic, 2046 (82.6%) and 3257 (93.2%) were White, and 35 (1.4%) and 35 (1.0%) were multiracial. Among 146326 participants with median 14.6 follow-up years, 23067 incident cancers and 3152 cancer deaths were observed. A., Stefansson, K., Chang-Claude, J., van der Schouw, Y. T., Lunetta, K. L., Chasman, D. I., Easton, D. F., Visser, J. These results will guide a larger study of the tool's impact on clinical decisions. Across pathogenic variants, annual mammography alone from 40 to 74 years was estimated to reduce breast cancer mortality by 36.4% (34.6%-38.2%) to 38.5% (37.8%-39.2%) compared with no screening. Alagoz, O., Lowry, K. P., Kurian, A. W., Mandelblatt, J. S., Ergun, M. A., Huang, H., Lee, S. J., Schechter, C. B., Tosteson, A. N., Miglioretti, D. L., Trentham-Dietz, A., Nyante, S. J., Kerlikowske, K., Sprague, B. L., Stout, N. K. Germline variants and breast cancer survival in patients with distant metastases at primary breast cancer diagnosis. A nonsignificant increase in at least 1 severe/very severe toxicity report was observed for bilateral mastectomy recipients (OR, 1.2; 95% CI, 1.0-1.4).Women with early-stage invasive breast cancer report substantial treatment-associated toxicities and related burden. She is also a clinically active oncologist, treating patients diagnosed with breast cancer. Oncologists explained 17% of the variation in RS testing but little of the variation in chemotherapy receipt (3%) controlling for clinical factors. Hawley, S. T., Janz, N. K., Griffith, K. A., Jagsi, R., Friese, C. R., Kurian, A. W., Hamilton, A. S., Ward, K. C., Morrow, M., Wallner, L. P., Katz, S. J. Treatment-associated toxicities reported by patients with early-stage invasive breast cancer. This significant reduction in BM risk among PLCs detected through LDCT-screening persisted in subgroups of early-stage PLC participants (HR 0.47, p=0.002) and those who underwent surgery (HR 0.37, p=0.001).Early detection of PLC using LDCT-screening is associated with lower risk of BM after PLC diagnosis based on a large population-based study. For more information, please contact Naheed Mangi, 650-723-0658. Each patient recovered uneventfully without morbidity or mortality.CDH1 mutations in individuals from families with HDGC are associated with gastric cancer in a highly penetrant fashion. George & Thomas Kurian - identical twins, identical super-success. The Phase I Screening with contrast-enhanced breast magnetic resonance imaging (MRI) detects cancer earlier but increases costs and results in more false-positive scans.To evaluate the cost-effectiveness of screening BRCA1/2 mutation carriers with mammography plus breast MRI compared with mammography alone.A computer model that simulates the life histories of individual BRCA1/2 mutation carriers, incorporating the effects of mammographic and MRI screening was used. For risk prevention for women at increased risk of breast cancer risk loci at 2q35 and Population at. Nationality is American by nationality and his ethnicity is Afro-American been, of company-wide initiatives focused on transforming into. Of Medicine and of Epidemiology and Population Health at Stanford University School of.. Develop a robust response, researching scientific evidence needed to develop a robust response 18.5-40.9 % ) had! 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