Our database consisted of structured fields and unstructured free-text clinical notes from EMR, linked to CCR, a component of the Surveillance, Epidemiology and End Results Program (SEER). Telli, M. L., Jensen, K. C., Kurian, A. W., Vinayak, S., Lipson, J. Most patients (82%; 95% CI, 70% to 90%) recalled that a risk-reducing intervention (screening, medication, or surgery) was recommended, and most patients (85%; 95% CI, 72% to 93%) adhered to the recommendation. Gaps in integrating genetic testing into management of breast cancer. View details for DOI 10.1002/pon.5763 Advances in genetic testing have enabled more rapid and less expensive commercial sequencing than could be imagined only a few years ago. Sensitivity analyses were performed to determine the effect of key model parameters, including the duration of the pandemic impact.By 2030, the models project 950 (model range = 860-1297) cumulative excess breast cancer deaths related to reduced screening, 1314 (model range = 266-1325) associated with delayed diagnosis of symptomatic cases, and 151 (model range = 146-207) associated with reduced chemotherapy use in women with hormone positive, early-stage cancer. Age-specific breast cancer risks were estimated using aggregated data from the Cancer Risk Estimates Related to Susceptibility (CARRIERS) Consortium for 32247 cases and 32544 controls in 12 population-based studies. We examined the combined influence of race/ethnicity and neighborhood socioeconomic status (SES) on short-term survival among women with uniform access to health care and treatment.Using electronic medical records data from Kaiser Permanente Northern California linked to data from the California Cancer Registry, we included 6262 women newly diagnosed with invasive breast cancer. Women are more likely to experience worse cancer-related financial outcomes than men. However, each patient (6 of 6, 100%) was found to have multiple foci of T1 invasive diffuse gastric adenocarcinoma (pure signet-ring cell type). Primary outcomes included knowledge regarding the probability of carrying a BRCA1 and/or BRCA2 pathogenic variant and genetic testing after diagnosis.Overall knowledge regarding the probability of having a BRCA1 and/or BRCA2 pathogenic variant was low (29.8%). Being affected by any cancer was associated with a higher probability of being a BRCA2, rather than a BRCA1, PV carrier (OR, 3.23; 95% CI, 2.81-3.70; P, View details for DOI 10.1001/jamaoncol.2020.2134. Drugs used in chemotherapy, such as doxorubicin hydrochloride, cyclophosphamide, and Women's health clinicians are poised to evaluate risk, promote breast cancer risk reduction, and manage overall health. Clinical use of the 21-gene assay and patient experiences in early-stage breast cancer. For more information, please contact Mary Chen, (650) 723 - 8686. Prevalence and penetrance of breast cancer-associated mutations identified by multiple-gene sequencing in the Women's Health Initiative. In subgroup analyses, risk of breast cancer-specific mortality was significantly elevated among cases with diabetes who received neither radiation nor chemotherapy (HR=2.11, 95% CI=1.32-3.36); no increased risk was observed among those who received both treatments (HR=1.13, 95% CI= 0.70-1.84) (P interaction= 0.03). Early life and education [ edit] Kurian was born to two academic parents; Diana Chapman Walsh, the former President of Wellesley College, and Christopher T. Walsh, a biochemist at Harvard University. However, epidemiologic studies on circulating melatonin are limited because melatonin is secreted at night, yet most epidemiologic studies collect blood during the day when melatonin levels are very low, and assays are lacking that are ultrasensitive to detect low levels of melatonin reliably.To assess the performance of a refined radioimmunoassay in measuring morning melatonin among women.We used morning serum samples from 47 postmenopausal women ages 48-80 years without a history of breast cancer who participated in the San Francisco Bay Area Breast Cancer Study, including 19 women who had duplicate measurements. For more information, please contact Pei-Jen Chang, (650) 725 - 0866. We examined the performances of the IBIS and BOADICEA risk models when using alternative thresholds by comparing predictions based on 5-year risk with those based on lifetime risk from birth and remaining lifetime risk. To search for additional genetic susceptibility loci for breast cancer, here we perform a meta-analysis of data from genome-wide association studies (GWAS) conducted in Asians (24,206 cases and 24,775 controls) and European descendants (122,977 cases and 105,974 controls). 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. Next-generation sequencing promises major advancements in precision medicine but faces considerable challenges with insurance coverage. Surprisingly, Thomas has a twin brother by the nameGeorge Kurian who is just seconds older than him. Kurian, A. W., Canchola, A. J., Gomez, S. L., Clarke, C. A. Many patients desired to talk to providers about the financial impact of cancer (15.2% of whites, 31.1% of blacks, 30.3% of Latinas, and 25.4% of Asians). No patient had any signs or symptoms of gastric cancer. Trends in genetic testing and results for women diagnosed with breast cancer or ovarian cancer, 2013-2017, Development of a breast cancer risk assessment model for ATM mutation carriers incorporating tyrer-cuzick and a polygenic risk score (PRS). Potentially actionable results were disclosed to participants.In total, 198 women participated in the study: 174 had breast cancer and 57 carried germline BRCA1/2 mutations. SM users indicated using SM for social support (34.3%) and loneliness (24.6%) more than for information-seeking (15.9%), coping (18.8%), or self-disclosure (14%). Molecular subtypes were categorized according to tumor expression of hormone receptor (HR, based on estrogen and progesterone receptors) and human epidermal growth factor receptor 2 (HER2). A., Moss, H. A., Baltich Nelson, B., Thomas, C., Christos, P. J., Hamilton, J. G., Chapman-Davis, E., Cantillo, E., Holcomb, K., Kurian, A. W., Lipkin, S., Offit, K., Sharaf, R. N. What are the considerations in patient selection and timing of risk-reducing mastectomy? for metastatic breast cancer (mBC). View details for DOI 10.1200/JCO.22.00303, View details for DOI 10.3949/ccjm.89a.21114, Multi-cancer gene panels for hereditary cancer syndromes (hereditary cancer panels, HCPs) are widely available, and some laboratories have programs that limit patients' out-of-pocket (OOP) cost share. RATIONALE: Estrogen can cause the growth of breast cancer cells. Use of the 21-gene recurrence score assay (RS) and chemotherapy (CT) across health care (HC) systems. 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. "Spirituality, religion, and faith" was associated with an underestimation of risk (63% v. 20%, P < 0.001).The quantification of our qualitative results is subject to any biases that may have occurred during the coding process despite rigorous methodology.Patient-clinician communication is important for breast cancer patients' understanding of their numeric risk of systemic recurrence. George Kurian was appointed CEO of $5.5 billion storage company NetApp about a year ago after a fast, meteoric rise at the company. pharmacokinetic (PK) cohort of the study (cohort A) in postmenopausal women with metastatic Benchmark Method for Cost Computations Across Health Care Systems: Cost of Care per Patient per Day in Breast Cancer Care. However, significant controversy remains as to the timing, causes, generalizability, and longevity of this reported decline in incidence. View details for PubMedID 35723570, View details for DOI 10.1093/jncics/pkac045. In a fragmented health care system, research can be challenging when one seeks to follow cancer patients as they seek care which can continue for months or years and may reflect many physician and patient decisions. 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. Broad clinical experience with such follow-up testing has not yet been thoroughly described.To examine the yield and utility of germline testing following tumor DNA sequencing in a large, diverse patient population.A retrospective cohort study examined germline testing through a laboratory supporting multiple academic and community clinics. The prevalence of PVs in CHEK2 was higher in non-Hispanic White than Black patients (1.29% vs 0.38%; P, View details for DOI 10.1001/jamaoncol.2021.1492. Wallner, L. P., Li, Y., McLeod, M., Gargaro, J., Kurian, A. W., Jagsi, R., Radhakrishnan, A., Hamilton, A. S., Ward, K. C., Hawley, S. T., Katz, S. J. Lin, G. A., Trosman, J. R., Douglas, M. P., Weldon, C. B., Scheuner, M. T., Kurian, A., Phillips, K. A. The median age at diagnosis for all patients was 49 years (IQR, 43-56 years); 74 were lesbian (80%), 12 were bisexual (13%), and 6 were transgender (6%). 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. There he met his wife just like his brother. View details for DOI 10.1002/cncr.31731 In the external validation data, the model with the strongest association for non-mucinous EOC risk derived from the OCAC model development data was the S4 model (27,240 SNPs) with odds ratios (OR) of 1.38 (95% CI: 1.28-1.48, AUC: 0.588) per unit standard deviation, in women of European ancestries; 1.14 (95% CI: 1.08-1.19, AUC: 0.538) in women of East Asian ancestries; 1.38 (95% CI: 1.21-1.58, AUC: 0.593) in women of African ancestries; hazard ratios of 1.36 (95% CI: 1.29-1.43, AUC: 0.592) in BRCA1 pathogenic variant carriers and 1.49 (95% CI: 1.35-1.64, AUC: 0.624) in BRCA2 pathogenic variant carriers. Satisfaction with chemotherapy decisions was high and did not differ between those who did (mean [SD], 4.3 [0.08] on a 1- to 5-point scale) or did not (4.4 [0.03]) obtain a second opinion (P=.29). Thematic analysis was done to identify themes related to the impact of reimbursement and out-of-pocket expenses on test ordering. RPA was not associated with risk of second BC events.Findings support that RPA is associated with lower all-cause mortality in women with BC, particularly in women with BRCA1/2 PVs. Genetic testing after diagnosis of breast cancer is common, but little is known about the influence of the surgeon on the variation in testing.To quantify and explain the association of attending surgeon with rates of genetic testing after diagnosis of breast cancer.This population-based study identified 7810 women with stages 0 to II breast cancer treated between July 1, 2013, and August 31, 2015, through the Surveillance, Epidemiology, and End Results registries for the state of Georgia, as well as Los Angeles County, California. Variation in surgeon attitudes about genetic testing and counseling may explain a substantial amount of this association. Most (86%; 95% CI, 84% to 88%) tested respondents were very satisfied with their testing decision, versus 34% (95% CI, 27% to 41%) of untested respondents. Google Cloud CEO Thomas Kurian was hired to make the unit a promising revenue source for Alphabet. participants with metastatic or locally advanced HER2-positive breast cancer. He was coeditor of the World Christian Encyclopedia, The Encyclopedia of Christian Civilizations, the Dictionary of . Patients' report of oncologists' recommendations for chemotherapy declined from 44.9% (95% CI=40.2% to 49.7%) to 31.6% (95% CI=25.9% to 37.9%), controlling for other factors. Use of and mortality after bilateral mastectomy compared with other surgical treatments for breast cancer in California, 1998-2011. Daly, M. B., Axilbund, J. E., Buys, S., Crawford, B., Farrell, C. D., Friedman, S., Garber, J. E., Goorha, S., Gruber, S. B., Hampel, H., Kaklamani, V., Kohlmann, W., Kurian, A., Litton, J., Marcom, P. K., Nussbaum, R., Offit, K., Pal, T., Pasche, B., Pilarski, R., Reiser, G., Shannon, K. M., Smith, J. R., Swisher, E., Weitzel, J. N. Increasing Mastectomy Rates for Early-Stage Breast Cancer? For more information, please contact Meredith Mills, (650) 724 - 5223. B., Eliassen, A. H., Engel, C., Fasching, P. A., Figueroa, J., Flyger, H., Gago-Dominguez, M., Gao, C., Garca-Closas, M., Garca-Senz, J. Receipt of guideline-concordant care among young adult women with breast cancer. Martinez, K. A., Kurian, A. W., Hawley, S. T., Jagsi, R. Clinical actionability of multi-gene panel tests for hereditary breast and ovarian cancer, Ellisen, L., Lincoln, S., Kurian, A. W., et al, Addressing lack of US insurance coverage of Cancer Hereditary Multiplex Testing, Trosman, J., Weldon, C., Kurian, A. W., Douglas, M., et al. Hall, E., Parikh, D., Gupta, T., Caswell, J., Mills, M., Kingham, K., Koff, R., Ford, J. M., Kurian, A. W. Recent time trends in chemotherapy use and oncologists' chemotherapy recommendations for early-stage, hormone receptor-positive breast cancer. The intent of vaccination is to induce a combined antibody and T-cell anti-HER-2 immune Results are moderately sensitive to variation in breast cancer survival rates and trastuzumab cost, and less sensitive to variations in cardiac toxicity.AT has an ICER comparable to those for other widely used interventions. We present the current pathogenic mutation spectrum of BRCA1/BRCA2 genes in patients with breast cancer in various Asian populations. The most influential variables were related to disease characteristics, neighborhood socioeconomic status, and smoking status at diagnosis. He retired from the Defense Finance and Accounting Service in Columbus, Ohio in 2004. Moderate-to-high risks for pancreatic (OR 4.21; 95% CI 3.24-5.47), prostate (OR 2.58; 95% CI 1.93-3.44), gastric (OR 2.97; 95% CI 1.66-5.31) and invasive ductal breast (OR 2.03; 95% CI 1.89-2.19) cancers were estimated for ATM PV carriers. The MA-PRS is a combination of three ancestry-specific PRSs on the basis of genetic ancestral composition. The prevalence of test results by gene category for breast cancer cases in 2017 were BRCA1/2, PVs 5.2%, and VUS 0.8%; breast cancer-associated genes or ovarian cancer-associated genes (ATM, BARD1, BRIP1, CDH1, CHEK2, EPCAM, MLH1, MSH2, MSH6, NBN, NF1, PALB2, PMS2, PTEN, RAD51C, RAD51D, STK11, and TP53), PVs 3.7%, and VUS 12.0%; other actionable genes (APC, BMPR1A, MEN1, MUTYH, NF2, RB1, RET, SDHAF2, SDHB, SDHC, SDHD, SMAD4, TSC1, TSC2, and VHL) PVs 0.6%, and VUS 0.5%; and other genes, PVs 0.3%, and VUS 2.6%. Among RS recipients, chemotherapy receipt was associated with a higher score (intermediate v low: odds ratio, 3.66; 95% CI, 1.94 to 6.91). A recent fine-scale mapping analysis to refine these associations resulted in 1 (signal 1), 5 (signal 2), and 42 (signal 3) credible causal variants at these loci. Chu, L. W., John, E. M., Yang, B. n., Kurian, A. W., Zia, Y. n., Yu, K. n., Ingles, S. A., Stanczyk, F. Z., Hsing, A. W. Differences in Breast Cancer Survival by Molecular Subtypes in the United States. Jayasekera, J., Lowry, K. P., Yeh, J. M., Schwartz, M. D., Wernli, K. J., Isaacs, C., Kurian, A. W., Stout, N. K. A pilot study to increase cascade genetic testing in families with hereditary cancer syndromes. Toxicity differences observed by treatment modality may inform decision making. AYAs also were more likely to be diagnosed with stage III/IV disease and high-grade tumors than were older women. Half (54.7%) used AIs only, 27.6% used tamoxifen only and 17.7% used both tamoxifen and AIs sequentially. We evaluated the benefits and harms of the five additional years of therapy.An established Cancer Intervention and Surveillance Network (CISNET) model used a lifetime horizon with national and clinical trial data on treatment efficacy and adverse events and other-cause mortality among multiple birth cohorts of U.S. women ages 25-79 newly diagnosed with ER+, non-metastatic breast cancer. 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. View details for PubMedID 34224603. View details for DOI 10.1007/s10549-016-4076-5, View details for Web of Science ID 000393023500014. In this approach, we impute missing values using regression models for each variable, conditional on the other variables in the data. All three mindsets were independent correlates of HRQOL, explaining 6-15% unique variance in HRQOL, even after accounting for demographic and medical factors.Mindsets about illness are significantly associated with HRQOL in cancer survivors. 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. Breast cancer risk was marginally increased among foreign-born women (OR=1.40, 95% CI=0.97-2.03) and two-fold among foreign-born Chinese women (OR=2.16, 95% CI=1.21-3.88). Breast Cancer Risk Reduction, Version 2.2015. Kurian, A. W., Hughes, E., Handorf, E., Gutin, A., Allen, B., Hartman, A., Hall, M. J. Our objective was to characterize trends in annual surveillance mammography participation among women with a personal history of breast cancer over a 13-year period.We examined annual surveillance mammography participation from 2004 to 2016 in a nationwide sample of commercially insured women with prior breast cancer. Second breast cancers are rare, and their reduction should be weighed against the harms associated with BLM. 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. We examined patterns and correlates of genetic counseling and testing and the impact of results on bilateral mastectomy (BLM) use. 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. 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%). HER2 mutated cancer responds to treatment with neratinib. Cancer 2018;000:000-000. 1. Approximately one-third (34.1%) of the surgeon variation was explained by patient volume and surgeon attitudes about genetic testing and counseling. Her research focus was on identifying risk for breast and ovarian cancer. The authors assessed the frequency and severity of toxicities; correlated toxicity severity with unscheduled health care use (clinic visits, emergency department visits/hospitalizations) and physical health; and examined patient, tumor, and treatment factors associated with reporting increased toxicity severity.The overall survey response rate was 71%. The majority (99.0%, n = 135) had shared their results with someone and 96% had told a family member (n = 130). Know All About Adin Ross Girlfriend Pamibaby, Are They Still Together. Annual MRI starting at 30 years followed by mammography and MRI at 40 years was estimated to reduce mortality by 55.4% (55.3%-55.4%) to 59.5% (58.5%-60.4%), with 5075 (5057-5093) to 5415 (5393-5437) false-positive screenings and 1439 (1429-1449) to 1528 (1517-1538) benign biopsies per 1000 women. View details for PubMedCentralID PMC8260917. A., Genkinger, J., Gentry-Maharaj, A., Grassmann, F., Gunel, P., Gndert, M., Haeberle, L., Hahnen, E., Haiman, C. A., Hkansson, N., Hall, P., Harkness, E. F., Harrington, P. A., Hartikainen, J. M., Hartman, M., Hein, A., Ho, W. K., Hooning, M. J., Hoppe, R., Hopper, J. L., Houlston, R. S., Howell, A., Hunter, D. J., Huo, D., Ito, H., Iwasaki, M., Jakubowska, A., Janni, W., John, E. M., Jones, M. E., Jung, A., Kaaks, R., Kang, D., Khusnutdinova, E. K., Kim, S. W., Kitahara, C. M., Koutros, S., Kraft, P., Kristensen, V. N., Kubelka-Sabit, K., Kurian, A. W., Kwong, A., Lacey, J. V., Lambrechts, D., Le Marchand, L., Li, J., Linet, M., Lo, W. Y., Long, J., Lophatananon, A., Mannermaa, A., Manoochehri, M., Margolin, S., Matsuo, K., Mavroudis, D., Menon, U., Muir, K., Murphy, R. A., Nevanlinna, H., Newman, W. G., Niederacher, D., O'Brien, K. M., Obi, N., Offit, K., Olopade, O. I., Olshan, A. F., Olsson, H., Park, S. K., Patel, A. V., Patel, A., Perou, C. M., Peto, J., Pharoah, P. D., Plaseska-Karanfilska, D., Presneau, N., Rack, B., Radice, P., Ramachandran, D., Rashid, M. U., Rennert, G., Romero, A., Ruddy, K. J., Ruebner, M., Saloustros, E., Sandler, D. P., Sawyer, E. J., Schmidt, M. K., Schmutzler, R. K., Schneider, M. O., Scott, C., Shah, M., Sharma, P., Shen, C. Y., Shu, X. O., Simard, J., Surowy, H., Tamimi, R. M., Tapper, W. J., Taylor, J. Lin, G., Scheuner, M., Trosman, J., Sales, P., Ackerman, S., Douglas, M., Weldon, C., Kurian, A., Phillips, K. Multi-gene panel testing results prompt frequent and guideline adherent changes to cancer risk management recommendations based on clinician report. Complete IHC data were available for 8,140 Asian women. Studies on specific cancer types in relation to cancer use have also been mixed, though the most promising results appear to be found in gastrointestinal cancers. We assessed model calibration by evaluating observed versus predicted mutations and attribute diagrams, and model discrimination using areas under the receiver operating characteristic curves.Both models were well-calibrated within each racial/ethnic group, with some exceptions. Positive patients were twice as likely as negative/VUS patients (83% v 41%; P < .001) to encourage their relatives to be tested.In a racially/ethnically and socioeconomically diverse cohort, MGPT increased diagnostic yield. Genetic counseling and testing and the impact of results on bilateral mastectomy compared with other surgical for. And AIs sequentially like his brother women are more likely to experience worse cancer-related financial outcomes men... 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