Data were analyzed from August 2019 to November 2020.Risk-reducing salpingo-oophorectomy.In all analyses, the primary end point was the time to a first primary breast cancer.A total of 876 families were evaluated, including 498 with BRCA1 (2650 individuals; mean [SD] event age, 55.8 [19.1] years; 437 White probands [87.8%]) and 378 with BRCA2 (1925 individuals; mean [SD] event age, 57.0 [18.6] years; 299 White probands [79.1%]). While constitutional BRCA1 promoter methylation has been observed in normal tissues of some individuals, the potential role of normal tissue methylation as a risk factor for incident TNBC or HGSOC is unknown.To assess the potential association between white blood cell BRCA1 promoter methylation and subsequent risk of incident TNBC and HGSOC.This case-control study included women who were participating in the Women's Health Initiative study who had not received a diagnosis of either breast or ovarian cancer before study entrance. More Asians had breast cancer (76 vs. 53%, p=0.03); more whites had relatives with breast cancer (86 vs. 50%, p=0.0003). We studied 6,761 women post-menopausal at baseline with a wide range of familial risk from 2,364 families in the Prospective Family Study Cohort (ProF-SC). We developed an online tool to guide decisions about cancer risk reduction (available at: http://brcatool.stanford.edu ), and recruited patients and clinicians to test its feasibility. Reply to S.M. [13] In 2020, she was elected to the American Society for Clinical Investigation.[14]. A., O'Neill, S., Chandler, Y., Isaacs, C., Kurian, A. W., Kushi, L., Schechter, C. B., Mandelblatt, J. For more information, please contact Meredith Mills, (650) 724 - 5223. Non-melanoma skin cancer (NMSC), the most prevalent cancer in the US,(1) has been associated with increased risk of non-cutaneous malignancies, including breast cancer, lung cancer, and lymphoma. 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. The long-term goal is to enhance standard clinicopathologic measures of low- versus high-risk DCIS and to enable risk-appropriate treatment.We studied three common chromosomal copy number alterations (CNA) in IBC and designed fluorescence in situ hybridization-based assay to measure copy number at these loci in DCIS samples. To determine the contribution of germline pathogenic variants (PVs) in hereditary cancer testing panel genes to invasive lobular carcinoma (ILC) of the breast.The study included 2,999 women with ILC from a population-based cohort and 3,796 women with ILC undergoing clinical multigene panel testing (clinical cohort). Statin use and all-cancer mortality: Prospective results from the Womens Health Initiative. Patients identified their oncologists (n=504) of whom 304 responded to surveys (60%). We estimate the impact of different risk-reducing options at various ages on life expectancy.We apply our previously developed Monte Carlo simulation model of screening and prophylactic surgery in BRCA1/2 mutation carriers. Pathogenic variants (PVs) in ATM are relatively common, but the scope and magnitude of risk remains uncertain. Luhn, P. n., Chui, S. Y., Hsieh, A. F., Yi, J. n., Mecke, A. n., Bajaj, P. S., Hasnain, W. n., Falgas, A. n., Ton, T. G., Kurian, A. W. Re-evaluating genetic variants identified in candidate gene studies of breast cancer risk using data from nearly 280,000 women of Asian and European ancestry. His first executive role was as Vice President of Oracle's e-Business division. MacInnis, R. J., Knight, J. The NLP model for recurrence identified a larger proportion of patients with distant recurrence in a breast cancer database (11.1%) compared with International Classification of Diseases coding (2.31%).We developed two NLP models to identify distant cancer recurrence, timing of recurrence, and sites of recurrence based on unstructured electronic health record data. A., Terry, M. B., Tomlinson, I., Troester, M. A., Truong, T., Vachon, C. M., van Veen, E. M., Vijai, J., Wang, S., Wendt, C., Winqvist, R., Wolk, A., Ziogas, A., Dunning, A. M., Pharoah, P. D., Easton, D. F., Zheng, W., Kraft, P., Chang-Claude, J. Simulation modeling of breast cancer endocrine therapy duration by patient and tumor characteristics. This regulatory element increases cell-type-specific expression of the tumor suppressor gene IGFBP5 and, thereby, reduces risk of estrogen receptor-positive breast cancer (odds ratio = 0.77, 95% CI 0.74-0.81, p = 3.1 10-31). When starting MRI at 30 years, initiating annual mammography starting at 30 vs 40 years did not meaningfully reduce mean mortality rates (0.1% [0.1%-0.2%] to 0.3% [0.2%-0.3%]) but was estimated to add 649 (602-695) to 650 (603-696) false-positive screenings and 58 (41-76) to 59 (41-76) benign biopsies per 1000 women.This analysis suggests that annual MRI screening starting at 30 to 35 years followed by annual MRI and mammography at 40 years may reduce breast cancer mortality by more than 50% for women with ATM, CHEK2, and PALB2 pathogenic variants. A., Gaudet, M. M., Giles, G. G., Glendon, G., Goldberg, M. S., Goldgar, D. E., Gonzlez-Neira, A., Grip, M., Gunel, P., Hahnen, E., Haiman, C. A., Hkansson, N., Hall, P., Hamann, U., Han, S., Harkness, E. F., Hart, S. N., He, W., Heemskerk-Gerritsen, B. African American PV carriers had similarly elevated risks of CBC as non-Hispanic White PV carriers. Frey, M. K., Ahsan, M. D., Bergeron, H., Lin, J., Li, X., Fowlkes, R. K., Narayan, P., Nitecki, R., Rauh-Hain, J. Participants were queried about communication of their results, as part of a prospective study of multi-gene panel genetic testing. 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). We conducted multi-level analyses on patients with ER-positive HER2-negative invasive disease (N=2973) to examine oncologists' influence on variation in RS testing and chemotherapy receipt, using patient and oncologist survey responses merged to SEER data.Half of patients (52.8%) received RS testing and 27.7% chemotherapy. 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. 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. We conducted validation studies using the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO, N=3,423 IPLC cases) and European Prospective Investigation into Cancer and Nutrition (EPIC, N=4,731 IPLC cases) cohorts and pooled the SPLC risk estimates using random effects meta-analysis.Overall, 163 (2.3%) MEC cases developed a SPLC. Unmet patient needs for engagement with physicians about financial concerns were common. Afghahi, A., Mathur, M., Seto, T., Desai, M., Kenkare, P., Horst, K., Das, A., Thompson, C., Luft, H., Yu, P., Sledge, G., Kurian, A. W. Technical evaluation of multigene testing for hereditary breast and ovarian cancer, Lincoln, S. E., Kurian, A. W., Desmond, A., et al, Concerns about cancer risk and experiences with genetic testing in a diverse population of patients with breast cancer, Jagsi, R., Griffith, K., Kurian, A. W., et al, Percent of Breast Cancers Positive for HER2 Varies By Ethnicity and Social Determinants of Health in California-Implications of Patient Demographics on Laboratory Benchmarks. The changes did wonders and Google Cloud made a smashing comeback under Thomas Kurian's leadership. Two-fold increased risks were associated with migration at age 40 years and longer U.S. residence (30 years or 75% of life). High-risk lesions that were screen detected by MRI in three women included radial scars and atypical lobular hyperplasia. The primary analyses focused on the overall cohort and on women from the general population. This study was designed to assess efficacy, safety, and predictors of response to iniparib in combination with gemcitabine and carboplatin in early-stage triple-negative and BRCA1/2 mutation-associated breast cancer.This single-arm phase II study enrolled patients with stage I to IIIA (T 1 cm) estrogen receptor-negative ( 5%), progesterone receptor-negative ( 5%), and human epidermal growth factor receptor 2-negative or BRCA1/2 mutation-associated breast cancer. Impact of Low-Dose CT Screening for Primary Lung Cancer on Subsequent Risk of Brain Metastasis. Wu, J. n., Li, B. n., Sun, X. n., Cao, G. n., Rubin, D. L., Napel, S. n., Ikeda, D. M., Kurian, A. W., Li, R. n. Trends in Reoperation After Initial Lumpectomy for Breast Cancer: Addressing Overtreatment in Surgical Management. 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. Coignard, J. n., Lush, M. n., Beesley, J. n., O'Mara, T. A., Dennis, J. n., Tyrer, J. P., Barnes, D. R., McGuffog, L. n., Leslie, G. n., Bolla, M. K., Adank, M. A., Agata, S. n., Ahearn, T. n., Aittomki, K. n., Andrulis, I. L., Anton-Culver, H. n., Arndt, V. n., Arnold, N. n., Aronson, K. J., Arun, B. K., Augustinsson, A. n., Azzollini, J. n., Barrowdale, D. n., Baynes, C. n., Becher, H. n., Bermisheva, M. n., Bernstein, L. n., Biakowska, K. n., Blomqvist, C. n., Bojesen, S. E., Bonanni, B. n., Borg, A. n., Brauch, H. n., Brenner, H. n., Burwinkel, B. n., Buys, S. S., Calds, T. n., Caligo, M. A., Campa, D. n., Carter, B. D., Castelao, J. E., Chang-Claude, J. n., Chanock, S. J., Chung, W. K., Claes, K. B., Clarke, C. L., Colle, J. M., Conroy, D. M., Czene, K. n., Daly, M. B., Devilee, P. n., Diez, O. n., Ding, Y. C., Domchek, S. M., Drk, T. n., Dos-Santos-Silva, I. n., Dunning, A. M., Dwek, M. n., Eccles, D. M., Eliassen, A. H., Engel, C. n., Eriksson, M. n., Evans, D. G., Fasching, P. A., Flyger, H. n., Fostira, F. n., Friedman, E. n., Fritschi, L. n., Frost, D. n., Gago-Dominguez, M. n., Gapstur, S. M., Garber, J. n., Garcia-Barberan, V. n., Garca-Closas, M. n., Garca-Senz, J. Pollom, E. L., Qian, Y., Chin, A. L., Dirbas, F. M., Asch, S. M., Kurian, A. W., Horst, K. C., Tsai, C. Cancer Risk Estimates for Study of Multiple-Gene Testing After Diagnosis of Breast Cancer Reply, Can We Use Survival Data from Cancer Registries to Learn about Disease Recurrence? A., Domchek, S. M., Drk, T., du Bois, A., Drst, M., Eccles, D. M., Eliassen, H. A., Engel, C., Evans, G. D., Fasching, P. A., Flanagan, J. M., Fortner, R. T., Machackova, E., Friedman, E., Ganz, P. A., Garber, J., Gensini, F., Giles, G. G., Glendon, G., Godwin, A. K., Goodman, M. T., Greene, M. H., Gronwald, J., Hahnen, E., Haiman, C. A., Hkansson, N., Hamann, U., Hansen, T. V., Harris, H. R., Hartman, M., Heitz, F., Hildebrandt, M. A., Hgdall, E., Hgdall, C. K., Hopper, J. L., Huang, R. Y., Huff, C., Hulick, P. J., Huntsman, D. G., Imyanitov, E. N., Isaacs, C., Jakubowska, A., James, P. A., Janavicius, R., Jensen, A., Johannsson, O. T., John, E. M., Jones, M. E., Kang, D., Karlan, B. Y., Karnezis, A., Kelemen, L. E., Khusnutdinova, E., Kiemeney, L. A., Kim, B. G., Kjaer, S. K., Komenaka, I., Kupryjanczyk, J., Kurian, A. W., Kwong, A., Lambrechts, D., Larson, M. C., Lazaro, C., Le, N. D., Leslie, G., Lester, J., Lesueur, F., Levine, D. A., Li, L., Li, J., Loud, J. T., Lu, K. H., Lubiski, J., Mai, P. L., Manoukian, S., Marks, J. R., Matsuno, R. K., Matsuo, K., May, T., McGuffog, L., McLaughlin, J. R., McNeish, I. There was no significant mortality difference compared with bilateral mastectomy (HR, 1.02 [95% CI, 0.94-1.11]; 10-year mortality, 18.8% [95% CI, 18.6%-19.0%]). Eligible trials were subjected to meta-analysis.Eighty-seven studies met inclusion criteria. Associations between PRS313 and clinicopathologic characteristics, including the 70-gene signature for MINDACT, were evaluated using logistic regression analyses. profile of this PM01183 to analyze the pharmacokinetics (PK) and PK/PD In Hong Kong and China, genetic testing and counseling are not as common as in the West. The reduction was much greater for women with positive nodes (31%; CI 21-41%), larger tumor (30% for tumor size >2cm; CI 22-38%), or younger age (22% for <50years; CI 9-35%).RS substantially changed chemotherapy treatment selections with the largest influence among patients with less favorable pre-test prognosis. Exhaustive preoperative stomach evaluation was normal in each case, and the stomach and adjacent lymph nodes appeared normal at surgery. 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). 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. View details for DOI 10.1002/cncr.31731 Yadav, S., Boddicker, N. J., Na, J., Polley, E. C., Hu, C., Hart, S. N., Gnanaolivu, R. D., Larson, N., Holtegaard, S., Huang, H., Dunn, C. A., Teras, L. R., Patel, A. V., Lacey, J. V., Neuhausen, S. L., Martinez, E., Haiman, C., Chen, F., Ruddy, K. J., Olson, J. E., John, E. M., Kurian, A. W., Sandler, D. P., O'Brien, K. M., Taylor, J. 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). Katz, S., Friese, C., Li, Y., Deapen, D., Hamilton, A., Ward, K., Kurian, A. W. Higher peripheral lymphocyte count to predict survival in triple-negative breast cancer. View details for Web of Science ID 000318174800096. Powell, A. To examine the association between prediagnosis recreational physical activity and mortality by race/ethnicity, we pooled data from the California Breast Cancer Survivorship Consortium for 3 population-based case-control studies of breast cancer patients (n = 4,608) diagnosed from 1994 to 2002 and followed up through 2010. 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. Gomez, S. L., Press, D. J., Lichtensztajn, D., Keegan, T. H., Shema, S. J., Le, G. M., Kurian, A. W. Accuracy of BRCA1/2 Mutation Prediction Models for Different Ethnicities and Genders: Experience in a Southern Chinese Cohort. In 1996, the brothers switched companies when George was hired by McKinsey, and Thomas, by Oracle [7]. Patients' assessments of the amount of information they received about whether to get tested were similarly high whether they were counseled by a genetics expert or by a physician only (80.8% v 79.4% stated information was just right, P = .59). Data from 108,420 invasive breast cancer cases and 87,681 controls were used for the LSI analysis and for the CPD analysis conducted among ever-smokers from 26,147 cancer cases and 26,072 controls. We compared the ability of each NLP model to identify the presence, timing, and site of recurrence, when compared against manual chart review and International Classification of Diseases coding.A total of 1,273 patients were included in the development and validation of the two models. Women with inherited BRCA1/2 mutations are at high risk for breast cancer, which mammography often misses. Breast cancer is the most common cancer diagnosed in women, accounting for an estimated 30% of all new women cancer diagnoses in 2022. A., Giles, G. G., Grip, M., Gunel, P., Gndert, M., Hahnen, E., Haiman, C. A., Hkansson, N., Hall, P., Hamann, U., Hart, S. N., Hartikainen, J. M., Hartmann, A., He, W., Hooning, M. J., Hoppe, R., Hopper, J. L., Howell, A., Hunter, D. J., Jager, A., Jakubowska, A., Janni, W., John, E. M., Jung, A. Y., Kaaks, R., Keupers, M., Kitahara, C. M., Koutros, S., Kraft, P., Kristensen, V. N., Kurian, A. W., Lacey, J. V., Lambrechts, D., Le Marchand, L., Lindblom, A., Linet, M., Luben, R. N., Lubiski, J., Lush, M., Mannermaa, A., Manoochehri, M., Margolin, S., Martens, J. W., Martinez, M. E., Mavroudis, D., Michailidou, K., Milne, R. L., Mulligan, A. M., Muranen, T. A., Nevanlinna, H., Newman, W. G., Nielsen, S. F., Nordestgaard, B. G., Olshan, A. F., Olsson, H., Orr, N., Park-Simon, T. W., Patel, A. V., Peissel, B., Peterlongo, P., Plaseska-Karanfilska, D., Prajzendanc, K., Prentice, R., Presneau, N., Rack, B., Rennert, G., Rennert, H. S., Rhenius, V., Romero, A., Roylance, R., Ruebner, M., Saloustros, E., Sawyer, E. J., Schmutzler, R. K., Schneeweiss, A., Scott, C., Shah, M., Smichkoska, S., Southey, M. C., Stone, J., Surowy, H., Swerdlow, A. J., Tamimi, R. M., Tapper, W. J., Teras, L. R., Terry, M. B., Tollenaar, R. A., Tomlinson, I., Troester, M. A., Truong, T., Vachon, C. M., Wang, Q., Hurson, A. N., Winqvist, R., Wolk, A., Ziogas, A., Brauch, H., Garca-Closas, M., Pharoah, P. D., Easton, D. F., Chenevix-Trench, G., Schmidt, M. K. Recreational Physical Activity and Outcomes After Breast Cancer in Women at High Familial Risk. She is a Professor of Medicine and Epidemiology & Population Health at Stanford University and an oncologist at the Stanford Cancer Institute. Thompson, C. A., Kurian, A. W., Luft, H. S. Diabetes and Other Comorbidities in Breast Cancer Survival by Race/Ethnicity: The California Breast Cancer Survivorship Consortium (CBCSC). Jayasekera, J., Sparano, J. (7) We sought to replicate these prospective findings in the large WHI cohort, for which important potential confounders, e.g. Telli, M. L., Jensen, K. C., Vinayak, S., Kurian, A. W., Lipson, J. [15], As the President of Product Development, he oversaw Oracle's 3,000-odd product development efforts. He has an identical twin, George also a Silicon Valley executive. Schackmann, E. A., Vinayak, S., Kurian, A. W., et al. The increase in statistical power associated with larger sample sizes in cross-disease analysis allows for the identification of novel susceptibility regions. Ransohoff, K. J., Stefanick, M. L., Li, S. n., Kurian, A. W., Wakelee, H. n., Wang, A. n., Paskett, E. n., Han, J. n., Tang, J. Y. Sharma, V. B., Kurian, A. W., Feldman, A., Ford, J. M. Cost-effectiveness of screening BRCA1/2 mutation carriers with breast magnetic resonance imaging. View details for DOI 10.1097/01.sla.0000254370.29893.e4. Thirty-nine percent (95% CI, 36% to 41%) recalled hearing from a clinician that genetic discrimination is illegal. Linking routine electronic health record (EHR) data with clinical registry data allows one to gain a more complete picture of the patient journey through a cancer care episode. We simulated outcomes for 1,512 unique patient subgroups based on all possible combinations of age, tumor size, grade, and comorbidity level; simulations were performed with and without 21-gene recurrence scores (RSs). View details for DOI 10.1007/s10689-007-9171-7, View details for Web of Science ID 000253712200022. Alison Wagonfeld. Purpose Genetic testing for breast cancer risk is evolving rapidly, with growing use of multiple-gene panels that can yield uncertain results. Clarke, C. A., Keegan, T. H., Yang, J., Press, D. J., Kurian, A. W., Patel, A. H., Lacey, J. V. Single Cell Profiling of Circulating Tumor Cells: Transcriptional Heterogeneity and Diversity from Breast Cancer Cell Lines. Hu, C. n., Hart, S. N., Gnanaolivu, R. n., Huang, H. n., Lee, K. Y., Na, J. n., Gao, C. n., Lilyquist, J. n., Yadav, S. n., Boddicker, N. J., Samara, R. n., Klebba, J. n., Ambrosone, C. B., Anton-Culver, H. n., Auer, P. n., Bandera, E. V., Bernstein, L. n., Bertrand, K. A., Burnside, E. S., Carter, B. D., Eliassen, H. n., Gapstur, S. M., Gaudet, M. n., Haiman, C. n., Hodge, J. M., Hunter, D. J., Jacobs, E. J., John, E. M., Kooperberg, C. n., Kurian, A. W., Le Marchand, L. n., Lindstroem, S. n., Lindstrom, T. n., Ma, H. n., Neuhausen, S. n., Newcomb, P. A., O'Brien, K. M., Olson, J. E., Ong, I. M., Pal, T. n., Palmer, J. R., Patel, A. V., Reid, S. n., Rosenberg, L. n., Sandler, D. P., Scott, C. n., Tamimi, R. n., Taylor, J. Integration of polygenic risk into clinical breast cancer risk estimators can improve discrimination. Ellisen, L., Kurian, A. W., Desmond, A. J., et al. Stanford is currently not accepting patients for this trial. Furthermore, we discuss recent the advances in targeted therapies for TNBC patients with a hereditary predisposition, including the role of poly (ADP-ribose) polymerase (PARP) inhibitors in BRCA1/2 mutation-associated breast cancers. These common alleles were associated with clinical extremes of ANM; women in the top 1% of genetic susceptibility have an equivalent risk of premature ovarian insufficiency to those carrying monogenic FMR1 premutations3. Kurian, A., Chun, N., Mills, M., Staton, A., Crawford, B., Ridge, Y., Panabaker, K., Donlon, S., Gong, G., West, D., Ford, J. CDH1 truncating mutations in the E-cadherin gene - An indication for total gastrectomy to treat hereditary diffuse gastric cancer. A., Ham, C. M., Van Dam, J., Jeffrey, R. B., Longacre, T. A., Huntsman, D. G., Chun, N., Kurian, A. W., Ford, J. M. Ductal pattern enhancement on magnetic resonance imaging of the breast due to ductal lavage. 3-Hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, known as "statins," are appealing candidate agents for breast cancer chemoprevention because of their demonstrated safety after decades of widespread use. Conclusion Many patients with breast cancer are tested without ever seeing a genetic counselor. Lowry, K. P., Geuzinge, H. A., Stout, N. K., Alagoz, O., Hampton, J., Kerlikowske, K., de Koning, H. J., Miglioretti, D. L., van Ravesteyn, N. T., Schechter, C., Sprague, B. L., Tosteson, A. N., Trentham-Dietz, A., Weaver, D., Yaffe, M. J., Yeh, J. M., Couch, F. J., Hu, C., Kraft, P., Polley, E. C., Mandelblatt, J. S., Kurian, A. W., Robson, M. E. Time Trends in Receipt of Germline Genetic Testing and Results for Women Diagnosed With Breast Cancer or Ovarian Cancer, 2012-2019. Treatment decisions and employment of breast cancer patients: Results of a population-based survey. Haplotype analysis was performed to confirm 1 BRCA1 and 3 BRCA2 mutations are putative founder mutations. Stanford is currently not accepting patients for this trial. Gupta, T., Purington, N., Liu, M., Han, S., Sledge, G., Schapira, L., Kurian, A. 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. Clinicopathologic data were extracted from the electronic medical records of Stanford Cancer Institute and linked to demographic data from the population-based California Cancer Registry; results were integrated with data from tissue microarrays of specimens containing DCIS that did not develop IBC versus DCIS with concurrent IBC. Absolute excess risks were higher after BCT and ULM (5.0 and 13.6 more cases, respectively) compared with BLM (28.6 fewer cases). Approximately 6.1 million adults in the United States serve as care partners for cancer survivors. Cox regression was used to assess associations of common germline variants with 15-year and 5-year breast cancer-specific survival. Thomas Kurian CEO at Google Cloud Atherton, California, United States 73K followers 500+ connections Join to view profile Google Stanford University Graduate School of Business Activity As a 26. This portion of the NCCN Guidelines includes recommendations regarding diagnostic criteria and management of patients with Cowden Syndrome/PTEN hamartoma tumor syndrome. In total, 2,187 deaths (1,122 from breast cancer) were observed through December 31, 2010. Women receive broad cancer risk figures that are not personalised (e.g., 44-63% lifetime risk of breast cancer for those with PALB2). John, E. M., McGuire, V. n., Kurian, A. W., Koo, J. n., Shariff-Marco, S. n., Gomez, S. L., Cheng, I. n., Keegan, T. H., Kwan, M. L., Bernstein, L. n., Vigen, C. n., Wu, A. H. Development and Validation of a Clinical Polygenic Risk Score to Predict Breast Cancer Risk. Jayasekera, J., Sparano, J. Genomic landscape of ductal carcinoma in situ and association with progression. Of those who consented, 273 survivors completed an online survey related to their sleep (ISI), quality of life (FACT-G), distress (PHQ-4), supportive care needs (SCNS-SF34), and symptom severity (MDASI). Compared with patient-mediated contact, direct relative contact increased rates of cascade genetic counseling and testing, arguing for a shift in the care delivery paradigm, to be confirmed by randomized controlled trials. bevacizumab. The women underwent genetic testing within 3 months after diagnosis and were reported to the Georgia and California SEER registries by December 1, 2017.Pathogenic variant status based on linked results of clinical germline genetic testing by 4 laboratories that did most such testing in the studied regions.Potential deviation of treatment from practice guidelines was assessed in the following clinical scenarios: (1) surgery: receipt of bilateral mastectomy by women eligible for less extensive unilateral surgery (unilateral breast tumor); (2) radiotherapy: omission in women indicated for postlumpectomy radiotherapy (all lumpectomy recipients except age 70 with stage I, estrogen and/or progesterone receptor [ER/PR] positive, ERBB2 [formerly HER2]-negative disease); and (3) chemotherapy: receipt by women eligible to consider chemotherapy omission (stages I-II, ER/PR-positive, ERBB2-negative, and 21-gene recurrence score of 0-30, which was the upper limit of the intermediate risk range during the study years). Multivariable logistic regression models were fit to the outcome of DCIS progression to IBC as functions of demographic and clinical features.We observed recurrent variants of known IBC-related mutations, and the most commonly mutated genes in DCIS were PIK3CA (34.4%) and TP53 (18.4%). Recent advances in genomic technology have enabled far more rapid, less expensive sequencing of multiple genes than was possible only a few years ago. The impact of significant others on breast cancer patients treatment decision making. Also surveyed were 488 attending surgeons identified by the patients.The study examined the association of surgeon with variation in the receipt of genetic testing using information from patient and surgeon surveys merged to Surveillance, Epidemiology, and End Results and genetic testing data obtained from 4 laboratories.In total, 5080 women (69.6%) of 7303 who were eligible (mean [SD] age, 61.4 [0.8] years) and 377 surgeons (77.3%) of 488 (mean [SD] age, 53.8 [10.7] years) responded to the survey. Cancer incidence has been more extensively studied than cancer survival, though results are inconsistent as some large meta-analyses have not found an association, while other studies have reported improved cancer outcomes with the use of statins. Nevertheless, breast cancer mortality rates will be higher for women with higher PRS313 as increasing PRS313 is associated with an increased risk of disease. She is also a clinically active oncologist, treating patients diagnosed with breast cancer. Women are more likely to experience worse cancer-related financial outcomes than men. () RSNA, 2017 Online supplemental material is available for this article. For more information, please contact Janet Pan, 650-723-0628. 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.
Ben Napier Political Views,
Party Down South Cast Member Dies,
Beam Sword Terraria,
Articles T