Guidelines focus on syndromes associated with an increased risk of breast and/or ovarian cancer. Sposto, R., Keegan, T. H., Vigen, C., Kwan, M. L., Bernstein, L., John, E. M., Cheng, I., Yang, J., Koo, J., Kurian, A. W., Caan, B. J., Lu, Y., Monroe, K. R., Shariff-Marco, S., Gomez, S. L., Wu, A. H. Statin use and all-cancer survival: prospective results from the Women's Health Initiative. Yet little is known about whether MGPT results prompt changes to clinicians' risk management recommendations and whether those recommendations adhere to guidelines.We assessed cancer risk management recommendations made by clinicians ordering MGPT for hereditary cancer at a diagnostic laboratory using an internet-based survey. The expected regional variability in percent human epidermal growth factor receptor 2 (HER2)-positive breast cancers is not currently clear.Data from the 2006 to 2011 California Cancer Registry were examined by county and health service area. Use of the 21-gene recurrence score (RS) did not change among node-negative/micrometastasis patients, and increasing RS use in node-positive patients accounted for one-third of the chemotherapy decline. Kurian, A. W., Ward, K. C., Abrahamse, P. n., Bondarenko, I. n., Hamilton, A. S., Deapen, D. n., Morrow, M. n., Berek, J. S., Hofer, T. P., Katz, S. J. Genetic instruments were single nucleotide polymorphisms (SNPs) associated in UK Biobank with wrist-worn accelerometer-measured overall physical activity (nsnps=5) or sedentary time (nsnps=6), or accelerometer-measured (nsnps=1) or self-reported (nsnps=5) vigorous physical activity.Greater genetically-predicted overall activity was associated with lower breast cancer overall risk (OR=0.59; 95% confidence interval (CI) 0.42 to 0.83 per-standard deviation (SD;~8 milligravities acceleration)) and for most case-groups. Regional Variability in Percentage of Breast Cancers Reported as Positive for HER2 in California: Implications of Patient Demographics on Laboratory Benchmarks. Consideration of prophylactic mastectomy surgery following transplantation requires complex medical decision-making, and bias against elective surgery exists because of concern for post-operative complications. Regression models examined factors associated with chemotherapy recommendations and receipt by the RS and subgroups.There were 1527 patients with stage I/II, estrogen receptor/progesterone receptor-positive, human epidermal growth factor 2-negative disease: 778 received an RS (62.6% of patients with node-negative, favorable disease, 24.3% of patients with node-negative, unfavorable disease, and 13.0% of patients with node-positive disease; P, View details for Web of Science ID 000394719100007. Comparison of the Prevalence of Pathogenic Variants in Cancer Susceptibility Genes in Black Women and Non-Hispanic White Women With Breast Cancer in the United States. Mantz, A. If results are promising, they may justify a randomized trial of statins for breast cancer chemoprevention, with a focus on HR-negative disease. Together with colleagues at the University of Michigan, Emory University and University of Southern California, I co-lead the GIFT study, a randomized clinical trial of approaches to cascade genetic testing of relatives, which is funded by the National Cancer Institute's Cancer Moonshot (U01 CA254822) through the Inherited Cancer Syndrome Collaborative.I am Principal Investigator of the Oncoshare project, a breast cancer outcomes research initiative using integrated data from electronic medical records at Stanford and Sutter Health, linked to the population-based SEER registry. Out of the total compensation, he received $800,000 as a salary, $3,612,553 as a bonus, $69,380,000 as stock options, and $7,337 from other types of compensation. Drugs used in chemotherapy, such as doxorubicin hydrochloride, cyclophosphamide, and
Kurian, A. W., Bernhisel, R. n., Stefanick, M. L. Identification of novel breast cancer susceptibility loci in meta-analyses conducted among Asian and European descendants. Several people who have attended the meetings over the years said all the top Oracle executives have assigned seats - including Ellison himself, the two co-CEOs Safra Catz and Mark Hurd, and. Scott, D. n., Friedman, S. n., Telli, M. L., Kurian, A. W. Modeling reductions in absolute cancer mortality from diagnosing cancers before metastasis, 2006-2015. The minor rs45446698-C allele was associated with lower oestrone-3-glucuronide (-49.2%, 95% CI -56.1% to -41.1%, P=3.110-18); in follow-up analyses, rs45446698-C was also associated with lower progesterone (-26.7%, 95% CI -39.4% to -11.6%, P=0.001) and reduced risk of oestrogen and progesterone receptor-positive breast cancer (OR=0.86, 95% CI 0.82-0.91, P=6.910-8).The CYP3A7*1C allele is associated with reduced risk of hormone receptor-positive breast cancer possibly mediated via an effect on the metabolism of endogenous sex hormones in premenopausal women. To address this knowledge gap, the California Breast Cancer Survivorship Consortium (CBCSC) harmonized and pooled interview information (e.g., demographics, family history of breast cancer, parity, smoking, alcohol consumption) from six California-based breast cancer studies and assembled corresponding cancer registry data (clinical characteristics, mortality), resulting in 12,210 patients (6,501 non-Latina Whites, 2,060 African Americans, 2,032 Latinas, 1,505 Asian Americans, 112 other race/ethnicity) diagnosed with primary invasive breast cancer between 1993 and 2007. View details for DOI 10.1200/JCO.2015.63.5524. We trained the NLP models using 894 randomly selected patient records that were manually reviewed by clinical experts and evaluated model performance using 179 hold-out patients (20%) as a test set.The median follow-up time was 19 quarters (5 years) for the training set and 15 quarters (4 years) for the test set. Contralateral second primary breast cancers occur in 4% of female breast cancer survivors. The two models showed similar discrimination in each racial/ethnic group, discriminating least well in Hispanics. These chromatin alterations are reflected in transcriptional profiles of pre-malignant tissues from BRCA2 carriers and, therefore, may reflect naturalsteps in human disease. To characterize patients' treatment and survivorship experiences, we reported the tumor features and treatments associated with risk-reducing interventions; for example, in most BRCA2 mutation carriers (81%), MRI screening diagnoses stage I, hormone receptor-positive breast cancers, which may not require chemotherapy.Cancer risk-reducing options for BRCA1/2 mutation carriers vary in their impact on cancer incidence, recommended treatments, quality of life, and survival. Minority patients were significantly more likely to have unmet need for discussion (failure to discuss genetic testing with a health professional when they had a strong desire for testing): odds ratios of 1.68, 2.44, and 7.39 for blacks, English-speaking Latinas, and Spanish-speaking Latinas compared with whites, respectively. Staton, A. D., Kurian, A. W., Cobb, K., Mills, M. A., Ford, J. M. Magnetic resonance galactography: A feasibility study in women with prior atypical breast duct cytology. Specifically, we determined that 1) the state or regional cancer registry makes the most efficient starting point for determining inclusion of subjects; 2) the data dictionary should be based on existing registry standards, such as Surveillance, Epidemiology and End Results (SEER), when applicable; 3) the Social Security Administration Death Master File (SSA DMF), rather than clinical resources, provides standardized ascertainment of mortality outcomes; and 4) CER database development efforts, despite the immediate availability of electronic data, may take as long as two years to produce validated, reliable data for research. Of the 3672 eligible women, 2502 responded (68%); 1006 who reported working before their diagnosis were analyzed. Additional studies are required to quantify the penetrance of identified mutations and determine clinical utility. Strong desire for testing was more common in younger women, Latinas, and those with family history. Yet little is known about how doctors approach these discussions.A weighted random sample of newly diagnosed early-stage breast cancer patients identified through SEER registries of Los Angeles and Georgia (2013-2015) was sent surveys about~2months after surgery (Phase 2, N=3930, RR 68%). response to PM01183 in Metastatic Breast Cancer (MBC) patients, to evaluate the safety
Weldon, C. B., Liang, S., Phillips, K. A., Douglas, M. P., Scheuner, M., Kurian, A. W., Schaa, K., Roscow, B., Erwin, D., Trosman, J. R. The Impact of COVID-19 on Patients With Cancer: A National Study of Patient Experiences. () RSNA, 2017 Online supplemental material is available for this article. More than one third of pathogenic variants (34%) were not included in the differential diagnosis. Evaluation of a cancer gene sequencing panel in a hereditary risk assessment clinic. Sensitivity analyses indicated that the breast cancer mortality impact would be approximately double if the modeled pandemic effects on screening, symptomatic diagnosis, and chemotherapy extended for 12months.Initial pandemic-related disruptions in breast cancer care will have a small long-term cumulative impact on breast cancer mortality. 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. "This was a population-based cohort survey study of 7303 eligible women ages 20 to 79 years with stage I and II breast cancer diagnosed in 2013 to 2015 and identified from the Georgia and Los Angeles County, California, Surveillance, Epidemiology, and End Results registries. The entire coding region, exon-intron boundaries, and all known pathogenic variants in other regions were sequenced for 42 genes that had cancer risk associations. Luhn, P., O'Hear, C., Ton, T. G., Hsieh, A., Yi, J., Chang, C. W., Funke, R., Kurian, A. W. Molecular receptor profiles in male mutation carriers with breast cancer. Refining Breast Cancer Risk Stratification: Additional Genes, Additional Information. Furthermore, in the 57 carriers and subsequently tested relatives with two years of follow-up, a total of three cancers (one in a proband and two in relatives) were detected through interventions recommended on the basis of the pathogenic variant. Polygenic risk scores (PRS) for epithelial ovarian cancer (EOC) have the potential to improve risk stratification. Other notable work includes the development of a decision support tool to help women with BRCA1/2 mutations manage their cancer risks, and research on the clinical impact of next-generation sequencing for hereditary cancer risk assessment. Neoadjuvant gemcitabine (1,000 mg/m(2) intravenously [IV] on days 1 and 8), carboplatin (area under curve of 2 IV on days 1 and 8), and iniparib (5.6 mg/kg IV on days 1, 4, 8, and 11) were administered every 21 days for four cycles, until the protocol was amended to six cycles. Gallagher, S., Hughes, E., Rosenthal, E., Kurian, A. W., Domchek, S., Garber, J., Probst, B., Morris, B., Tshiaba, P., Roa, B., Slavin, T. P., Wagner, S., Weitzel, J. N., Gutin, A., Lanchbury, J. S., Robson, M. E. Triple-negative breast cancer (TNBC) risk with pathogenic variants (PV) in hereditary cancer predisposition genes. The investigators
veliparib in combination with TMZ or in combination with carboplatin and paclitaxel compared
B., Eliassen, A. H., Eriksson, M. n., Evans, D. G., Fasching, P. A., Figueroa, J. n., Fritschi, L. n., Gabrielson, M. n., Gago-Dominguez, M. n., Gao, C. n., Gapstur, S. M., Gaudet, M. M., Giles, G. G., Gonzlez-Neira, A. n., Gunel, P. n., Haeberle, L. n., Haiman, C. A., Hkansson, N. n., Hall, P. n., Hamann, U. n., Hatse, S. n., Heyworth, J. n., Holleczek, B. n., Hoover, R. N., Hopper, J. L., Howell, A. n., Hunter, D. J., John, E. M., Jones, M. E., Kaaks, R. n., Keeman, R. n., Kitahara, C. M., Ko, Y. D., Koutros, S. n., Kurian, A. W., Lambrechts, D. n., Marchand, L. L., Lee, E. n., Lejbkowicz, F. n., Linet, M. n., Lissowska, J. n., Llaneza, A. n., MacInnis, R. J., Martinez, M. E., Maurer, T. n., McLean, C. n., Neuhausen, S. L., Newman, W. G., Norman, A. n., O'Brien, K. M., Olshan, A. F., Olson, J. E., Olsson, H. n., Orr, N. n., Perou, C. M., Pita, G. n., Polley, E. C., Prentice, R. L., Rennert, G. n., Rennert, H. S., Ruddy, K. J., Sandler, D. P., Saunders, C. n., Schoemaker, M. J., Schttker, B. n., Schumacher, F. n., Scott, C. n., Scott, R. J., Shu, X. O., Smeets, A. n., Southey, M. C., Spinelli, J. J., Stone, J. n., Swerdlow, A. J., Tamimi, R. M., Taylor, J. The study evaluates if a 6-month course of oral lovastatin at 80 mg/day would decrease
Patients who had genetic counseling were twice as likely to recall clinicians informing them about all queried topics. View details for DOI 10.1007/s10900-015-0052-y, View details for DOI 10.1016/j.stamet.2015.06.001, View details for Web of Science ID 000361262400006. Later on, he earneda BS in electrical engineering, graduatingSumma Cum Laude. Results One image feature measuring heterogeneity (ie, information measure of correlation) was significantly associated with prognosis (false-discovery rate < 0.1), and at a cutoff of 0.57 stratified patients into two groups with different recurrence-free survival rates (log-rank P = .024). The Effect of Patient and Contextual Characteristics on Racial/Ethnic Disparity in Breast Cancer Mortality. The identified loci implicate a broad range of DNA damage response (DDR) processes and include loss-of-function variants in key DDR-associated genes. We studied the associations between HLA alleles and breast cancer risk using logistic regression, adjusting for population structure and age. View details for DOI 10.6004/jnccn.2018.7266 Breast cancer and ovarian cancer patients increasingly undergo germline genetic testing. Archer, S., Fennell, N., Colvin, E., Laquindanum, R., Mills, M., Dennis, R., Stutzin Donoso, F., Gold, R., Fan, A., Downes, K., Ford, J., Antoniou, A. C., Kurian, A. W., Evans, D. G., Tischkowitz, M. Breast cancer diagnosis and treatment during the COVID-19 pandemic in a nationwide, insured population. His father was self-educated and became a successful executive in the manufacturing industry. The rate of final lumpectomy increased by 13% from 2013 to 2015, accompanied by a decrease in unilateral and bilateral mastectomy (P=.002). Respondents often recalled clinicians informing them about inheritance patterns (65%; 95% CI, 62% to 67%), surgical implications (65%; 95% CI, 63% to 68%), and other cancer risks (66%; 95% CI, 63% to 68%) but less often that results could have potential implications for clinical trial eligibility (38%; 95% CI, 36% to 42%) or targeted therapies (14%; 95% CI, 12% to 16%). He said . We classified EHR encounters data according to typical periods of the cancer care episode (screening, diagnosis, treatment) and posttreatment surveillance, as well as by facility used to better characterize patterns of care for patients seen at both organizations.We identified a "treated" cohort consisting of women receiving interventions for their initial cancer diagnosis, and classified their encounters over time across multiple dimensions (type of care, provider of care, and timing of care with respect to their cancer diagnosis). A., Trentham-Dietz, A. n., Vachon, C. M., Weinberg, C. n., Yao, S. n., Ziogas, A. n., Weitzel, J. N., Goldgar, D. E., Domchek, S. M., Nathanson, K. L., Kraft, P. n., Polley, E. C., Couch, F. J. Karimi, Y. H., Kurian, A. W., Blayney, D. W., Banerjee, I. Women's health clinicians are poised to evaluate risk, promote breast cancer risk reduction, and manage overall health. One patient who was a BRCA1 carrier had high-grade ductal carcinoma in situ (DCIS) that was screen detected by MRI but that was missed on mammography. Breast Cancer Diagnosis, Treatment, and Outcomes of Patients From Sex and Gender Minority Groups. Now you may have guessed thatThomas Kurian net worth is not less than millions of dollars. The AIC for the weight-only model was 6.22 units lower than for the BMI-only model, and the log risk gradient was 23% greater. Heidi Berger and Daniel Ricciardo Are They Still Together? This phase II study will test cancer to see if it has a HER2 mutation and, if so, see how
Data on screening performance for mammography and MRI were estimated from published literature. Bilateral mastectomy was more often used by non-Hispanic white women, those with private insurance, and those who received care at a National Cancer Institute (NCI)-designated cancer center (8.6% [95% CI, 8.1%-9.2%] among NCI cancer center patients vs 6.0% [95% CI, 5.9%-6.1%] among non-NCI cancer center patients; odds ratio [OR], 1.13 [95% CI, 1.04-1.22]); in contrast, unilateral mastectomy was more often used by racial/ethnic minorities (Filipina, 52.8% [95% CI, 51.6%-54.0%]; OR, 2.00 [95% CI, 1.90-2.11] and Hispanic, 45.6% [95% CI, 45.0%-46.2%]; OR, 1.16 [95% CI, 1.13-1.20] vs non-Hispanic white, 35.2% [95% CI, 34.9%-35.5%]) and those with public/Medicaid insurance (48.4% [95% CI, 47.8%-48.9%]; OR, 1.08 [95% CI, 1.05-1.11] vs private insurance, 36.6% [95% CI, 36.3%-36.8%]). 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. The proportion of mastectomies that were nipple-sparing increased over time (1988, 0.2%; 2013, 5.1%) and with neighborhood socioeconomic status, and decreased with age and stage. A second NLP model was trained and validated to identify sites of recurrence. We identified differentially expressed genes from 14 case-control human breast cancer gene expression datasets and integrated them with drug-protein networks. A., Terry, M. B., Teul, A. n., Thull, D. L., Tischkowitz, M. n., Toland, A. E., Torres, D. n., Trainer, A. H., Truong, T. n., Tung, N. n., Vachon, C. M., Vega, A. n., Vijai, J. n., Wang, Q. n., Wappenschmidt, B. n., Weinberg, C. R., Weitzel, J. N., Wendt, C. n., Wolk, A. n., Yadav, S. n., Yang, X. R., Yannoukakos, D. n., Zheng, W. n., Ziogas, A. n., Zorn, K. K., Park, S. K., Thomassen, M. n., Offit, K. n., Schmutzler, R. K., Couch, F. J., Simard, J. n., Chenevix-Trench, G. n., Easton, D. F., Andrieu, N. n., Antoniou, A. C. Tobacco Smoking and Risk of Second Primary Lung Cancer. Data on surgical decisions, motivations for those decisions, and knowledge were included in the analysis. However, little is known about cancer-specific mortality among carriers of a pathogenic variant (PV) in BRCA1/2 or other genes in a population-based setting.Georgia and California Surveillance Epidemiology and End Results (SEER) registry records were linked to clinical genetic testing results. Their application to women of non-European ancestry has lagged because of the lack of a formal approach to incorporate genetic ancestry and ancestry-dependent variant frequencies and effect sizes. The purpose of this 2-stage, 2-cohort Phase 2 trial is to evaluate the safety and efficacy of
Kurian, A. W., Abrahamse, P., Ward, K. C., Hamilton, A. S., Deapen, D., Berek, J. S., Hoang, L., Yussuf, A., Dolinsky, J., Brown, K., Slavin, T., Hofer, T. P., Katz, S. J. To quantify the potential benefit, we estimated reductions in absolute cancer-related deaths that could occur if cancers diagnosed after metastasis (stage IV) were instead diagnosed at earlier stages.We obtained stage-specific incidence and survival data from the Surveillance, Epidemiology, and End Results Program for 17 cancer types for all persons diagnosed ages 50 to 79 years in 18 geographic regions between 2006 and 2015. Notably, failing to impute cases with missing receptor status leads to overestimation of survival because those with missing receptor status tend to have worse prognostic features. Lin, G. A., Trosman, J. R., Douglas, M. P., Weldon, C. B., Scheuner, M. T., Kurian, A., Phillips, K. A. Associations between HLA alleles and breast cancer and ovarian cancer patients increasingly germline... 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