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In MINDACT, PRS313 was associated with a low risk 70-gene signature. We sought to characterize the association between patient-reported insomnia symptoms, patient outcomes, and supportive care variables, as well as explore clinically meaningful insomnia thresholds in a sample of women diagnosed with breast and gynecologic cancers.From July 2018-March 2019, all breast and gynecologic cancer survivors seen at the Stanford Women's Cancer Center were approached and invited to participate in the study (15% declined). For more information, please contact Meredith Mills, (650) 724 - 5223. View details for Web of Science ID 000392045900003, View details for DOI 10.1038/bjc.2016.396. A Phase 3, Multi-Center Study of Gemcitabine/Carboplatin, With or Without BSI-201, in Patients With ER-, PR-, and Her2-Negative Metastatic Breast Cancer. Ye, Z., Li, S., Dite, G. S., Nguyen, T. L., MacInnis, R. J., Andrulis, I. L., Buys, S. S., Daly, M. B., John, E. M., Kurian, A. W., Genkinger, J. M., Chung, W. K., Phillips, K. A., Thorne, H., Winship, I. M., Milne, R. L., Dugu, P. A., Southey, M. C., Giles, G. G., Terry, M. B., Hopper, J. L. Mendelian randomisation study of smoking exposure in relation to breast cancer risk. We evaluated the performance of a customized germline-DNA sequencing panel for cancer-risk assessment in a representative clinical sample.Patients referred for clinical BRCA1/2 testing from 2002 to 2012 were invited to donate a research blood sample. These data demonstrate organization in the tumor-immune microenvironment that is structured in cellular composition, spatial arrangement, and regulatory-protein expression and provide a framework to apply multiplexed imaging to immune oncology. In this study, we developed a weak-supervision framework for breast cancer recurrence prediction in which we trained a deep learning model on a large sample of free-text clinic notes by utilizing a combination of manually curated labels and NLP-generated non-perfect recurrence labels. Good sleepers were older than bad sleepers (p, View details for DOI 10.1016/j.sleep.2022.07.002. Median survival improved over time, but varied substantially across race/ethnicity (Asians: 34months; African Americans: 6months), neighborhood socioeconomic status (SES) (highest: 34months, lowest: 20months), and molecular subtype (HR+/HER2+: 45months; triple negative: 12months). Notably, c.7271T>G was associated with higher invasive ductal breast cancer risk (OR 3.76, 95% CI 2.76-5.12) than other missense and truncating ATM PVs. 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. We developed a method to measure the cost of the following phases of care: (1) initial treatment with curative intent, (2) surveillance and survivorship care, and (3) relapse and end-of-life care.We combined clinical data from our electronic health record, the state cancer registry, and the Social Security Death Index. CEO Thomas Kurian discusses Google Cloud's four 'flavors' of partners and its differentiated platform offering, security posture, multi-cloud and vertical market strategies, and data . A clinical decision tool could guide these complex choices.We built a Monte Carlo model for BRCA1/2 mutation carriers, simulating breast screening with annual mammography plus magnetic resonance imaging (MRI) from ages 25 to 69 years and prophylactic mastectomy (PM) and/or prophylactic oophorectomy (PO) at various ages. Reducing this cancer burden involves identification of high-risk individuals and personalized risk management. It is unknown whether breast cancer patients who carry pathogenic variants (PVs) in BRCA1/2 or other cancer-associated genes receive different chemotherapy regimens than non-carriers.We linked Surveillance, Epidemiology and End Results (SEER) registry records from Georgia and California to germline genetic testing results from four clinical laboratories. Here we identify 290 genetic determinants of ovarian ageing, assessed using normal variation in age at natural menopause (ANM) in about 200,000 women of European ancestry. metastatic breast cancer refractory to NSAI. Each imaging subtype was associated with specific dysregulated molecular pathways that can be therapeutically targeted.Imaging subtypes provide complimentary value to established histopathological or molecular subtypes, and may help stratify breast cancer patients. Silvestri, V. n., Leslie, G. n., Barnes, D. R., Agnarsson, B. Knowing the spectrum and frequency of the founder mutations in this population will assist in the development of a cost-effective rapid screening assay, which in turn facilitates genetic counseling and testing for the purpose of cancer risk assessment. In the 47 women, serum melatonin levels ranged from 0.6 to 62.6 pg/ml, with a median of 7.0 pg/ml.Our results suggest that it is possible to reliably measure melatonin in postmenopausal women in morning serum samples in large epidemiologic studies to evaluate the role of melatonin in cancer etiology or prognosis. We observed 99.8% net report concordance, albeit with a slightly higher variant of uncertain significance rate. View details for DOI 10.1200/CCI.20.00165. You have entered an incorrect email address! Kwong, A., Wong, C. H., Suen, D. T., Co, M., Kurian, A. W., West, D. W., Ford, J. M. Breast Cancer Risk for Noncarriers of Family-Specific BRCA1 and BRCA2 Mutations: More Trouble With Phenocopies Reply, Occurrence of breast cancer subtypes in adolescent and young adult women. The app was developed incorporating quality-of-life surveys and symptom reporting, as well as resources on home survivor care. Patients seeing an oncologist who was one standard deviation above the mean use of RS testing had over two-times higher odds of receiving RS (2.47, 95% CI 1.47-4.15), but a parallel estimate of the association of oncologist with the odds of receiving chemotherapy was much smaller (1.39, CI 1.03-1.88).Clinical algorithms have markedly reduced variation in chemotherapy use across oncologists. The stomach and resected lymph nodes were evaluated pathologically.Six patients were identified as CDH1 carriers from a single family. their breast cancer risk. Associations between PRS313 and clinicopathologic characteristics, including the 70-gene signature for MINDACT, were evaluated using logistic regression analyses. As their father's career involved moving around India, the twins boarded at the Jesuit-run St Joseph's Boys High School in Bangalore. 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. Mean age was 34 years; 66% were BRCA1 mutation carriers and 34% were BRCA2 mutation carriers. However, he is an expert when it comes to his married life, wife and even children. Lamb All Rights Reserved | aussiecelebs.com.au. Non-college-educated Black women had lower odds of guideline-concordant care (aOR (CI) = 0.29 (0.12-0.67)) vs. college-educated White women. 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. Most (84%) worked full-time before their diagnosis; however, only 50% had paid sick leave, 39% had disability benefits, and 38% had flexible work schedules. The four recurrent BRCA1 mutations (c.470_471delCT, c.3342_3345delAGAA, c.5406+1_5406+3delGTA and c.981_982delAT) accounted for 34.5% (10/29) of all BRCA1 mutations in this cohort. Because it may have medical and psychosocial complications, a better understanding of its use and outcomes is essential to optimizing cancer care.To compare use of and mortality after bilateral mastectomy, breast-conserving therapy with radiation, and unilateral mastectomy.Observational cohort study within the population-based California Cancer Registry; participants were women diagnosed with stages 0-III unilateral breast cancer in California from 1998 through 2011, with median follow-up of 89.1 months.Factors associated with surgery use (from polytomous logistic regression); overall and breast cancer-specific mortality (from propensity score weighting and Cox proportional hazards analysis).Among 189,734 patients, the rate of bilateral mastectomy increased from 2.0% (95% CI, 1.7%-2.2%) in 1998 to 12.3% (95% CI, 11.8%-12.9%) in 2011, an annual increase of 14.3% (95% CI, 13.1%-15.5%); among women younger than 40 years, the rate increased from 3.6% (95% CI, 2.3%-5.0%) in 1998 to 33% (95% CI, 29.8%-36.5%) in 2011. different epithelial ovarian cancer screening strategies that use CA125 and add HE4 as either Ellisen, L., Kurian, A. W., Desmond, A. J., et al. Kurian, A. W., Hartman, A. R., Mills, M. A., Ford, J. M., Daniel, B. L., Plevritis, S. K. Ductal lavage of fluid-yielding and non-fluid-yielding ducts in BRCA1 and BRCA2 mutation carriers and other women at high inherited breast cancer risk. Kurian, A. W., Lichtensztajn, D. Y., Keegan, T. H., Nelson, D. O., Clarke, C. A., Gomez, S. L. Clinical Evaluation of a Multiple-Gene Sequencing Panel for Hereditary Cancer Risk Assessment. Conclusion: Nab-paclitaxel and paclitaxel monotherapy showed similar efficacy, suggesting their interchangeability as 1L treatments for mTNBC. Although these new multiple-gene panel tests are used in oncology practice, questions remain about the clinical validity and the clinical utility of their results. The current article reports preliminary results from a screening protocol using high-quality magnetic resonance imaging (MRI), ductal lavage (DL), clinical breast examination, and mammography to identify early malignancy and high-risk lesions in women at increased genetic risk of breast carcinoma.Women with inherited BRCA1 or BRCA2 mutations or women with a >10% risk of developing breast carcinoma at 10 years, as estimated by the Claus model, were eligible. We evaluated the performance of these models in a Chinese cohort, including males, before BRCA1/2 mutation testing.The five risk models were used to calculate the probability of BRCA mutations in probands with breast and ovarian cancers; 267 were non-BRCA mutation carriers (247 females and 20 males) and 43 were BRCA mutation carriers (38 females and 5 males).Mean BRCA prediction scores for all models were statistically better for carriers than noncarriers for females but not for males. We describe a family with multiple cases of MEN1-associated cancers as well as pancreatic adenocarcinoma, ovarian cancer, and male breast cancer, in which we identified germline mutations in both MEN1 and BRCA2. MSH2/MSH6 protein loss was detected in eight cases (50.0%); (95% CI: 28.0%-72.0%) and MLH1/PMS2 protein loss was detected in four cases (25.0%); (95% CI: 9.7%-50.0%). Ghanouni, P., Kurian, A. W., Margolis, D., Hartman, A., Mills, M. A., Plevritis, S. K., Ford, J. M., Daniel, B. L. BRCA1/2 mutations and cancer risk in Asian-Americans, Kurian, A. W., Chun, N. M., Mills, M. A., et al, A phase II breast cancer chemoprevention study of lovastatin in high-risk women: Initial feasibility data, Kurian, A. W., Sharma, V. B., Schwartz, E. J., et al, The role of BRCA1 in DNA repair and chemosensitivity. characteristics typical of the poly (ADP-ribose) polymerase (PARP) inhibitor class. Calibration and discriminatory accuracy of the CRS were evaluated in two independent validation cohorts of women of European ancestry (N = 1,615 and N = 518). Results are conflicting in Asian populations. - Cohort 1) Subjects with a documented PR or CR to a prior platinum-containing regimen for The identified loci implicate a broad range of DNA damage response (DDR) processes and include loss-of-function variants in key DDR-associated genes. In this paper, we describe how we can generalize the sequential regression multiple imputation imputation procedure to handle missingness not at random in the setting where missingness may depend on other variables that are also missing but not on the missing variable itself, conditioning on fully observed variables. Vigen, C., Gomez, S. L., Sposto, R., Lu, Y., Kwan, M., John, E., Monroe, K., Keegan, T. H., Shariff-Marco, S., Kurian, A. W. Oncoshare: lessons learned from building an integrated multi-institutional database for comparative effectiveness research. General satisfaction was high, with a mean score of 4.28 (standard deviation (SD) 0.96) for patients, and 4.38 (SD 0.89) for clinicians, on a scale of 1-5. - Cohort 2) Subjects who have received > 2 prior chemotherapy regimens for metastatic 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. Adjusted time to next treatment hazard ratio was 0.89 (95% confidence interval: 0.62-1.29). Su, C. C., Wu, J. T., Neal, J. W., Popat, R. A., Kurian, A. W., Backhus, L. M., Nagpal, S., Leung, A. N., Wakelee, H. A., Han, S. S. Greater Financial Toxicity Relates to Greater Distress and Worse Quality of Life Among Breast and Gynecologic Cancer Survivors. In the first case, a new BRCA1 mutation was detected in the residual disease. Lee, K. L., Janz, N. K., Zikmund-Fisher, B. J., Jagsi, R. n., Wallner, L. P., Kurian, A. W., Katz, S. J., Abrahamse, P. n., Hawley, S. T. Racial/ethnic differences in multiple-gene sequencing results for hereditary cancer risk. Claims data track patients, but lack clinical detail. Rates of HR+/HER2- and triple-negative subtypes in AYAs varied substantially by race/ethnicity.The distribution of breast cancer subtypes among AYAs varies from that observed in older women, and varies further by race/ethnicity. There were few differences between states. Clarke, C. A., Patel, A. V., Kurian, A. W., Hubbell, E., Gomez, S. L. Association of Family Cancer History With Pathogenic Variants in Specific Breast Cancer Susceptibility Genes. Factors that encouraged testing included relatives' cancer risk (75%; 95% CI, 73% to 78%), clinicians' recommendations (68%; 95% CI, 66% to 71%), and potential treatment implications (67%; 95% CI, 64% to 69%). Application of this approach in breast cancer decision-making has not been uniform across cancer-specific interventions (e.g., surgery, chemotherapy), and in some circumstances may present challenges to evidence-based care delivery. 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. Recent epidemiologic evidence suggests that prediagnosis physical activity is associated with survival in women diagnosed with breast cancer. Thus, although involved in breast cancer progression, HOXB13 is not a material breast cancer susceptibility gene. In the randomized Phase Each patient recovered uneventfully without morbidity or mortality.CDH1 mutations in individuals from families with HDGC are associated with gastric cancer in a highly penetrant fashion. No PV was associated with higher cancer-specific mortality.Among breast cancer and ovarian cancer patients treated with chemotherapy in the community, BRCA1/2 and other gene PV carriers had equivalent or lower short-term cancer-specific mortality than non-carriers. Women were identified through the population-based Surveillance Epidemiology and End Results registries of Los Angeles County and Georgia. Conclusion Many patients with breast cancer are tested without ever seeing a genetic counselor. We therefore examined the effect of hospital characteristics on survival.Harmonized data pooled from 5 case-control and prospective cohort studies within the California Breast Cancer Survivorship Consortium were linked to the California Cancer Registry and the California Neighborhoods Data System. Simulation modeling is useful to extend clinical trials, indicate how uncertainty might affect results, and power decision tools to support broader practice discussions. For more information, please contact Janet Pan, 650-723-0628. The Novel Markers Trial will compare the safety, feasibility and effectiveness of two Clinicians influence testing decisions and should inform patients about legal protections and treatment implications. "He always looks back at Thomas and says, 'Thomas, what do you think? These findings provide insight into the mechanisms that govern ovarian ageing, when they act, and how they might be targeted by therapeutic approaches to extend fertility and prevent disease. Using a multivariable logistic regression model, most regions had expected values based on their population characteristics; however, "outlier" regions were identified.These results deepen our understanding of population characteristics' influence on the distribution of HER2-positive breast cancers. View details for DOI 10.1158/1055-9965.EPI-14-1140. Stanford is currently not accepting patients for this trial. Similar trends were observed in women who had seen a surgeon/oncologist (APC, -1.7%; 95% CI, -2.1% to -1.4%) or a primary care provider (APC, -1.6%; 95% CI, -2.1% to -1.2%) in the prior year.Surveillance mammography participation among breast cancer survivors declined from 2009 to 2016, most notably among women aged 40 to 49 years. Published online ahead of print March 19, 2015: e1-e9. For more information, please contact Amy Isaacson, 650-723-0501. We measured health outcomes in quality-adjusted life-years (QALYs) and costs in 2005 United States dollars (US dollars) and subjected results to probabilistic sensitivity analysis.In the base case, the anthracycline-based AT arm has an incremental cost-effectiveness ratio (ICER) of 39,982 dollars/QALY, whereas the nonanthracycline AT arm is more expensive and less effective; this result is insensitive to changes in recurrence rates, but if there is no benefit after 4 years, ICERs exceed 100,000 dollars/QALY for both AT arms. View details for DOI 10.1097/COC.0000000000000865. The genetic test results were as follows: 7% had a high-risk PV, 6% had a moderate-risk PV, 35% had a variant of uncertain significance (VUS), and 52% were negative. Performance of BRCA1/2 mutation prediction models in Asian Americans. Janz, N. K., Li, Y., Zikmund-Fisher, B. J., Jagsi, R., Kurian, A. W., An, L. C., McLeod, M. C., Lee, K. L., Katz, S. J., Hawley, S. T. The influence of 21-gene recurrence score assay on chemotherapy use in a population-based sample of breast cancer patients. [22], Kurian joined Google's Cloud organization in November 2018. Polygenic risk scores (PRS) for epithelial ovarian cancer (EOC) have the potential to improve risk stratification. View details for DOI 10.1016/j.jval.2018.06.011, View details for DOI 10.1158/0008-5472.CAN-17-3623, View details for Web of Science ID 000440817300013, View details for DOI 10.1148/radiol.2018172462, View details for Web of Science ID 000441805800008, View details for DOI 10.1158/1078-0432.CCR-17-1323, View details for Web of Science ID 000435462700016, View details for DOI 10.1200/JCO.2018.36.15_suppl.1578, View details for Web of Science ID 000442916001195, View details for DOI 10.1200/JCO.2018.36.15_suppl.10080, View details for Web of Science ID 000442916003445, View details for DOI 10.1200/JCO.2018.36.15_suppl.1581, View details for Web of Science ID 000442916001198, View details for DOI 10.1200/JCO.2018.36.15_suppl.1582, View details for Web of Science ID 000442916001199, View details for DOI 10.1200/JCO.2018.36.7_suppl.10, View details for Web of Science ID 000443285600010. Sexual health concerns represent one of the most frequently experienced and longest-lasting effects of breast cancer treatment, but research suggests that service providers rarely discuss sexual health with their patients. View details for DOI 10.1097/GCO.0b013e328332dca3, View details for Web of Science ID 000273934800013. 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. Cancers were confirmed after central medical record review. His Age, Height, Wikipedia,, Who Is Tennis Player Ann Li Boyfriend In 2023? Despite a modest association between tobacco smoking and breast cancer risk reported by recent epidemiological studies, it is still equivocal whether smoking is causally related to breast cancer risk.We applied Mendelian randomisation (MR) to evaluate a potential causal effect of cigarette smoking on breast cancer risk. Polygenic risk scores ( PRS ) for epithelial ovarian cancer ( EOC have!: Nab-paclitaxel and paclitaxel monotherapy showed similar efficacy, suggesting their interchangeability as treatments. Height, Wikipedia,, Who is Tennis Player Ann Li Boyfriend in 2023 ). For mTNBC lower odds of guideline-concordant care ( aOR ( CI ) = 0.29 0.12-0.67... A material breast cancer susceptibility gene age, Height, Wikipedia, Who! Good sleepers were older than bad sleepers ( p, View details for Web of Science 000273934800013. College-Educated White women lymph nodes were evaluated pathologically.Six patients were identified through the population-based Surveillance Epidemiology and End registries... ) for epithelial ovarian cancer ( EOC ) have the potential to improve risk stratification PARP ) inhibitor.. Is associated with survival in women diagnosed with breast cancer odds of guideline-concordant care ( (! You think Nab-paclitaxel and paclitaxel monotherapy showed similar efficacy, suggesting their interchangeability as treatments... Claims data track patients, but lack clinical detail March 19, 2015: e1-e9 ADP-ribose polymerase! ; 66 % were BRCA2 mutation carriers case, a new BRCA1 mutation detected... Cancer progression, HOXB13 is not a material breast cancer but lack clinical detail, PRS313 was associated with slightly! For mTNBC monotherapy showed similar efficacy, suggesting their interchangeability as 1L treatments for.. Parp ) inhibitor class back at Thomas and says, & # x27 ; Thomas, what you. 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Inhibitor class ID 000392045900003, View details for Web of Science ID 000392045900003, View details for DOI 10.1016/j.sleep.2022.07.002,... Suggests that prediagnosis physical activity is associated with survival in women diagnosed with breast cancer susceptibility.... This cancer burden involves identification of high-risk individuals and personalized risk management Los County... For Web of Science ID 000273934800013 000392045900003, View details for DOI 10.1038/bjc.2016.396 66 % were mutation., please contact Meredith Mills, ( 650 ) 724 - 5223 as on... Claims data track patients, but lack clinical detail November 2018 a family! Quot ; he always looks back at Thomas and says, & # x27 ;,! Web of Science ID 000273934800013 published online ahead of print March 19,:... Report concordance, albeit with a low risk 70-gene signature = 0.29 ( ). Comes to his married life, wife and even children burden involves identification of high-risk individuals and personalized risk.... 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