Adding annual breast screening provides gains of 2.0 to 9.9 years for BRCA1 and 1.5 to 4.3 years for BRCA2. Our study aimed to investigate the impact of LDCT screening for PLC on the risk of developing BM after PLC diagnosis.We used NLST data to identify 1,502 participants who were diagnosed with PLC in 2002-2009 and have follow-up data for BM. Lin, G. A., Trosman, J. R., Douglas, M. P., Weldon, C. B., Scheuner, M. T., Kurian, A., Phillips, K. A. Results were discounted at 3%. The conference . View details for DOI 10.1016/j.jval.2020.01.018. Gene-based associations were also combined in meta-analysis across individuals with European, Asian, African, and Latin American and Hispanic ancestry.In European ancestry samples, 14 genes were significantly associated (q, View details for DOI 10.1186/s13073-022-01152-5. I have a strong focus on genetic risk assessment and precision oncology. We used newly available population-based data to examine whether the age-specific incidences of breast cancer subtypes vary by race and ethnicity.We classified 91908 invasive breast cancers diagnosed in California between January 1, 2006, and December 31, 2009, by subtype based on tumor expression of estrogen receptor (ER) and progesterone receptor (PR)-together referred to as hormone receptor (HR)-and human epidermal growth factor receptor 2 (HER2). We fitted Cox proportional hazards regression models adjusted for age at diagnosis, demographics, and lifestyle factors. hydrochloride, cyclophosphamide, and paclitaxel are more effective with or without
Participants were queried about communication of their results, as part of a prospective study of multi-gene panel genetic testing. Lonning, P., Nikolaienko, O., Pan, K., Kurian, A. W., Eikesdal, H., Pettinger, M., Anderson, G. L., Prentice, R. L., Chlebowski, R. T., Knappskog, S. A case-control study of healthcare disparities in sex and gender minority patients with breast cancer. A., Troester, M. A., Vachon, C. M., van Veen, E. M., Wang, X. n., Weinberg, C. R., Weltens, C. n., Willett, W. n., Winham, S. J., Wolk, A. n., Yang, X. R., Zheng, W. n., Ziogas, A. n., Dunning, A. M., Pharoah, P. D., Schmidt, M. K., Kraft, P. n., Easton, D. F., Milne, R. L., Garca-Closas, M. n., Chang-Claude, J. n. Association of a Polygenic Risk Score With Breast Cancer Among Women Carriers of High- and Moderate-Risk Breast Cancer Genes. 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. Further studies are needed to better understand the communication process in individuals from diverse racial/ethnic backgrounds. Classifications based on remaining lifetime risk were inferior to 5-year risk estimates. Participants were Black and non-Hispanic White women diagnosed with breast cancer, unselected for family history or age at diagnosis. Thomas Kurian is the CEO of Google Cloud and former president of Oracle Corporation. Previously, Mr. Kurian went toIndian Institute of Technology Madras where he studied for six months. Factors that discouraged testing included insurance concerns (14%; 95% CI, 12% to 16%), cost (14%; 95% CI, 12% to 16%), and discrimination (9%; 95% CI, 7% to 11%). Risk-adapted screening and prevention protocols are underway, with ongoing refinement as genetic knowledge grows. Bevers, T. B., Ward, J. H., Arun, B. K., Colditz, G. A., Cowan, K. H., Daly, M. B., Garber, J. E., Gemignani, M. L., Gradishar, W. J., Jordan, J. veliparib plus carboplatin versus the addition of carboplatin to standard neoadjuvant
For women aged 40years or more, receiver-operating characteristic curves were similar for 5-year and lifetime IBIS risk from birth. is a Professor of Medicine and of Epidemiology and Population Health at Stanford University School of Medicine. Comparative effectiveness research (CER) using observational data requires informatics methods for the extraction, standardization, sharing, and integration of data derived from a variety of electronic sources. Use of and mortality after bilateral mastectomy compared with other surgical treatments for breast cancer in California, 1998-2011. 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. We describe our findings and discuss them in the context of PMI priorities. trastuzumab or endocrine therapy) of particular subtypes of breast cancer among African-American patients. For more information, please contact Pei Jen Chang, 650-725-0866. It's necessary to re-evaluate these variants in large GWAS datasets.Of these 279 variants, data were obtained for 228 from GWAS conducted within the Asian Breast Cancer Consortium (24,206 cases and 24,775 controls) and the Breast Cancer Association Consortium (122,977 cases and 105,974 controls of European ancestry). We investigated BRCA1/2 mutations and cancer risk factors in a clinic-based sample. We analyzed data using descriptive statistics, chi2 and t tests.RESULTS: Three hundred twelve people with cancer participated and represented 38 states. We examined oncologists' influence on use of recurrence score (RS) testing and chemotherapy in the community.We identified 7810 women with stages 0-II breast cancer treated in 2013-15 through the SEER registries of Georgia and Los Angeles County. Afghahi, A., Purington, N., Han, S. S., Desai, M., Pierson, E., Mathur, M. B., Seto, T., Thompson, C. A., Rigdon, J., Telli, M. L., Badve, S. S., Curtis, C. N., West, R. B., Horst, K., Gomez, S. L., Ford, J. M., Sledge, G. W., Kurian, A. W. Genetic testing and results in population-based breast cancer patients and ovarian cancer patients. 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. Breast cancer comprises clinically distinct subtypes, but most risk statistics consider breast cancer only as a single entity. Advances in bioinformatics also facilitate the interpretation of large amounts of genomic data. Larger studies are needed to identify risk factors and prognostic significance associated with atypia and non-fluid-yielding ducts in high-risk populations, and define their role as biomarkers. Women's perceived risk of distant recurrence (0-100%) was categorized into subgroups: overestimation, reasonably accurate, and zero risk. Wapnir, I., Kurian, A. W., Lichtensztajn, D., Clarke, C. A., Gomez, S. Higher peripheral lymphocyte count to predict survival in triple-negative breast cancer (TNBC). Little is known about neighborhood attributes that may influence opportunities for healthy eating and physical activity in relation to breast cancer mortality. The primary outcome for this study is the type and timing of risk management options (surveillance, chemoprevention, surgery) taken up over the course of the study (i.e., 12 months). paclitaxel to see how well they work with or without bevacizumab in treating patients with
RS was less often used for patients with involved lymph nodes, higher tumor grade, and age < 40 or 65 years. Diane Greene will alsoremain a Director on the board of Alphabet which is aGoogles parent company. A., Ikeda, D. M., McPherson, L., Sharma, B., Kardashian, A., Schackmann, E., Kingham, K. E., Mills, M. A., West, D. W., Ford, J. M., Kurian, A. W. A Simulation Model to Predict the Impact of Prophylactic Surgery and Screening on the Life Expectancy of BRCA1 and BRCA2 Mutation Carriers. To estimate the value of cancer care and to compare value among episodes of care, a transparent, reproducible, and standardized cost computation methodology is needed. Outcomes included life years (LYs), quality-adjusted life years (QALYs), and breast cancer mortality. Wang, A., Aragaki, A. K., Tang, J. Y., Kurian, A. W., Manson, J. E., Chlebowski, R. T., Simon, M. S., Desai, P. M., Wassertheil-Smoller, S., Liu, S., Kritchevsky, S., Wakelee, H. A., Stefanick, M. L. Clinical impact of multi-gene panel testing for hereditary breast and ovarian cancer risk assessment. COMMUNICATING COMPLEXITY: ANALYSIS OF THE COMMUNICATION OF CANCER GENETIC TEST RESULTS THREE MONTHS POST DISCLOSURE. Banerjee, I. n., Bozkurt, S. n., Caswell-Jin, J. L., Kurian, A. W., Rubin, D. L. Patient-clinician interactions and disparities in breast cancer care: the equality in breast cancer care study. We used Cox regression to estimate risk associations with log-transformed weight and BMI after adjusting for underlying familial risk. In the setting of MRI screening, mammography prior to 40 years may offer little additional benefit. View details for DOI 10.2105/AJPH.2014.302406, View details for Web of Science ID 000358295600037, View details for Web of Science ID 000356730202263. This study will also assess the acceptability, feasibility and cost-effectiveness of using personalised risk estimates in clinical care. However, valid analytical approaches to examining care trajectories must be longitudinal and account for the dynamic nature of what is "seen" in the EHR.The Oncoshare database combines clinical detail from the California Cancer Registry and EHR data from two large health care organizations in the same catchment area-a multisite community practice and an academic medical center-for all women treated in either organization for breast cancer from 2000 to 2012. Logistic and linear regression models were used to evaluate for association of clinical trial engagement and patient portal message rates with primary language group.Patients with LEP had significantly lower rates of clinical trial engagement compared with their English-speaking counterparts (adjusted odds ratio [OR], 0.29; 95% CI, 0.16 to 0.51). These 750 variants included technically challenging classes of sequence and copy number variation that together represent a significant fraction (13.4%) of the pathogenic variants observed. mechanism has not yet been fully elucidated, however based on experiments on tumor cells
View details for DOI 10.1007/s10549-016-4076-5, View details for Web of Science ID 000393023500014. Domchek, S. M., Yao, S., Chen, F., Hu, C., Hart, S. N., Goldgar, D. E., Nathanson, K. L., Ambrosone, C. B., Haiman, C. A., Couch, F. J., Polley, E. C., Palmer, J. R. Polygenic risk scores for prediction of breast cancer risk in Asian populations. View details for DOI 10.1038/bjc.2016.149. Major discussion topics this year included multigene testing, risk management recommendations for less common genetic mutations, and salpingectomy for ovarian cancer risk reduction. All patients underwent comprehensive BRCA1/2 genotyping, and homologous recombination deficiency was assessed by loss of heterozygosity (HRD-LOH) in pretreatment core breast biopsies.Among 80 patients, median age was 48 years; 19 patients (24%) had germline BRCA1 or BRCA2 mutations; clinical stage was I (13%), IIA (36%), IIB (36%), and IIIA (15%). For more information, please contact Karen Lau, 650-723-0658. View details for DOI 10.1001/jama.2014.10707. Oncologists were much more likely to order RS if patient preferences were discordant with their recommendations (67.4%, 95% CI=61.7% to 73.0%, vs 17.5%, 95% CI=13.1% to 22.0%, concordant), and they adjusted recommendations based on patient preferences and RS results.For both node-negative/micrometastasis and node-positive patients, chemotherapy receipt and oncologists' recommendations for chemotherapy declined markedly over time, without substantial change in practice guidelines. not yet known whether letrozole is more effective than a placebo in treating patients with
Now you may have guessed thatThomas Kurian net worth is not less than millions of dollars. Among metastatic tumors, those that were HER2+ had better survival than other subtypes. Temporal analyses revealed important trends: the possible contribution of the CMS NCD to a faster pace of coverage adoption, the interdependence in coverage timing among BlueCross BlueShield members, the impact of using a third-party policy on coverage timing, and the importance of small payers in early adoption. Prevalence of Pathogenic Variants in Cancer Susceptibility Genes Among Women With Postmenopausal Breast Cancer. DeRouen, M. C., Gomez, S. L., Press, D. J., Tao, L., Kurian, A. W., Keegan, T. H. PrECOG 0105: Final efficacy results from a phase II study of gemcitabine (G) and carboplatin (C) plus iniparib (BSI-201) as neoadjuvant therapy for triple-negative (TN) and BRCA1/2 mutation-associated breast cancer. This study aimed to examine the association between mindsets-established, but mutable beliefs that a person holds-and health-related quality of life in survivors of breast and gynecologic cancer.A cross-sectional survey study was conducted with breast and gynecologic cancer survivors. More widespread adoption of active lifestyles may reduce the burden from the most common cancer in women. However, little is known about the translation of trial results and guidelines to clinical practice. View details for DOI 10.1371/journal.pone.0043994, View details for Web of Science ID 000308462000010, View details for PubMedCentralID PMC3436879, The prevalence and penetrance of BRCA1 and BRCA2 (BRCA1/2) mutations may differ between Asians and whites. Combined Asian and European PRSs (333 single-nucleotide variations) had a hazard ratio per SD of 1.53 (95% CI= 1.37-1.71) and an area under the receiver operating curve of 0.621 (95% CI= 0.608-0.635). View details for DOI 10.1200/JCO.2013.53.6607, View details for Web of Science ID 000337925500007. If results are promising, they may justify a randomized trial of statins for breast cancer chemoprevention, with a focus on HR-negative disease.
In females, BRCAPRO showed similar discrimination, as measured by the area under the receiver operator characteristic curve (AUC) for BRCA1/2 combined mutation prediction to BOADICEA, but performed better than BOADICEA in BRCA1 mutation prediction (AUC 93% vs. 87%). View details for DOI 10.1016/j.jbi.2017.02.012. Through recursive partitioning, the highest mastectomy subgroups were defined by tumor characteristics such as size and anatomic location, in combination with diagnosis year and nativity.Tumor characteristics and, secondarily, patient, hospital, and neighborhood factors are predictors of mastectomy and omission of radiation following BCS among Asian Americans.By focusing on interactions among patient, hospital, and neighborhood factors in the differential receipt of breast cancer treatment, our study identifies subgroups of interest for further study and translation into public health and patient-focused initiatives to ensure that all women are fully informed about treatment options. Wang, A., Aragaki, A. K., Tang, J. Y., Kurian, A. W., Manson, J. E., Chlebowski, R. T., Simon, M., Desai, P., Wassertheil-Smoller, S., Liu, S., Kritchevsky, S., Wakelee, H. A., Stefanick, M. L. Synergistic drug combinations from electronic health records and gene expression. She was loving but tough. Gupta, T., Purington, N., Liu, M., Han, S., Sledge, G., Schapira, L., Kurian, A. Among 146326 participants with median 14.6 follow-up years, 23067 incident cancers and 3152 cancer deaths were observed. We compared breast cancer incidence and proportion of newly diagnosed patients receiving pre-operative systemic therapy pre-COVID, in the first 2 months of the COVID pandemic and in the later part of the COVID pandemic.Average monthly breast cancer incidence was 19.3 (95% CI 19.1-19.5) cases per 100,000 women and men pre-COVID, 11.6 (95% CI 10.8-12.4) per 100,000 in April-May 2020, and 19.7 (95% CI 19.3-20.1) per 100,000 in June 2020-February 2021. Assuming one-third of metastatic cancers were diagnosed at each earlier stage (I, II, and III), 52-126 fewer cancer-related deaths would be expected across subgroups, a relative reduction of 21-23%.Across population subgroups, non-Hispanic Black males have the highest burden of stage IV cancer and would have the most deaths averted from improved detection of cancer before metastasis.Detecting cancer before metastasis could meaningfully reduce deaths in all populations, but especially in non-Hispanic Black populations. steroidal aromatase inhibitors (NSAI). Both individual-level data as well as summary statistics for 164 single-nucleotide polymorphisms (SNPs) reported in genome-wide association studies of lifetime smoking index (LSI) or cigarette per day (CPD) were used to obtain MR effect estimates. Reproductive longevity is essential for fertility and influences healthy ageing in women1,2, but insights into its underlying biological mechanisms and treatments to preserve it are limited. View details for DOI 10.6004/jnccn.2020.0017. Most PVs were in 20 breast cancer-associated genes or ovarian cancer-associated genes; testing other genes yielded mostly VUS. For more information, please contact Naheed Mangi, 650-723-0658. This approach may be adaptable to other cancer sites and could help to unlock the potential of EMRs for research on real-world cancer outcomes. Daly, M. B., Pal, T. n., Berry, M. P., Buys, S. S., Dickson, P. n., Domchek, S. M., Elkhanany, A. n., Friedman, S. n., Goggins, M. n., Hutton, M. L., Karlan, B. Y., Khan, S. n., Klein, C. n., Kohlmann, W. n., Kurian, A. W., Laronga, C. n., Litton, J. K., Mak, J. S., Menendez, C. S., Merajver, S. D., Norquist, B. S., Offit, K. n., Pederson, H. J., Reiser, G. n., Senter-Jamieson, L. n., Shannon, K. M., Shatsky, R. n., Visvanathan, K. n., Weitzel, J. N., Wick, M. J., Wisinski, K. B., Yurgelun, M. B., Darlow, S. D., Dwyer, M. A. Clinical use of the 21-gene assay and patient experiences in early-stage breast cancer. We studied the associations between HLA alleles and breast cancer risk using logistic regression, adjusting for population structure and age. Caswell-Jin, J., Callahan, A., Purington, N., Han, S. S., Itakura, H., Sledge, G. W., Shah, N., Kurian, A. W. Comprehensive breast cancer (BC) risk assessment for CHEK2 carriers incorporating a polygenic risk score (PRS) and the Tyrer-Cuzick (TC) model. Relative to high-socioeconomic status (SES) non-Hispanic Whites, we observed less anthracycline and taxane use by SES non-Hispanic Whites (OR 0.63, 95 % CI 0.49-0.82) and American Indians (OR 0.23, 95 % CI 0.06-0.93), and more anthracycline use by high-SES Asians/Pacific Islanders (OR 1.72, 95 % CI 1.02-2.90). He has reorganized the sales team to align with Sales practices of enterprise clients.[24]. Difficulty of access to cascade testing, particularly for family members that do not live in the United States, was also of concern. On multivariable analysis with conventional clinicopathologic features, the copy number gains were significantly associated with concurrent IBC. 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. Thomas has made over 39 trades of the Oracle stock since 2009, according to the Form 4 filled with the SEC. Previously unseen variants requiring interpretation accumulated rapidly, even after 1000 individuals had been tested. 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. View details for DOI 10.1007/s10549-022-06716-y. The NCCN Guidelines for Genetic/Familial High-Risk Assessment: Breast and Ovarian provide recommendations for genetic testing and counseling and risk assessment and management for hereditary cancer syndromes. We prospectively enrolled 1046 individuals who were appropriate candidates for HBOC evaluation and who lacked BRCA1/2 mutations.We carried out multigene panel testing on all participants, then determined the clinical actionability, if any, of finding non-BRCA1/2 mutations in these and additional comparable individuals.We evaluated the likelihood of (1) a posttest management change and (2) an indication for additional familial testing, considering gene-specific consensus management guidelines, gene-associated cancer risks, and personal and family history.Among 1046 study participants, 40 BRCA1/2-negative patients (3.8%; 95% CI, 2.8%-5.2%) harbored deleterious mutations, most commonly in moderate-risk breast and ovarian cancer genes (CHEK2, ATM, and PALB2) and Lynch syndrome genes. Residential addresses were linked to the CNDS to characterize neighborhoods. The mean age was 54 years (range, 51-57 years). In this role, she continued to research on the identification of women with elevated breast and gynecologic cancer risk and the development of new techniques for early cancer detection and risk reduction. After testing, few patients (4%) had prophylactic surgery, most (92%) never regretted testing, and most (80%) wanted to know all results, even those of uncertain significance. Escala-Garcia, M., Canisius, S., Keeman, R., Beesley, J., Anton-Culver, H., Arndt, V., Augustinsson, A., Becher, H., Beckmann, M. W., Behrens, S., Bermisheva, M., Bojesen, S. E., Bolla, M. K., Brenner, H., Canzian, F., Castelao, J. E., Chang-Claude, J., Chanock, S. J., Couch, F. J., Czene, K., Daly, M. B., Dennis, J., Devilee, P., Drk, T., Dunning, A. M., Easton, D. F., Ekici, A.