Surveys were sent approximately 2 months after surgery. In the setting of MRI screening, mammography prior to 40 years may offer little additional benefit. 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. Higher PV prevalence with increasing family history extent (P < .001) was observed only with BRCA1 (3.04% with none, 3.22% with moderate, and 4.06% with strong history) and in triple-negative breast cancer with PALB2 (0.75% with none, 2.23% with moderate, and 2.63% with strong history). Kurian, A. W., Ward, K. C., Hamilton, A. S., Deapen, D. M., Abrahamse, P., Bondarenko, I., Li, Y., Hawley, S. T., Morrow, M., Jagsi, R., Katz, S. J. Considering the joint impacts of these social factors may offer insights to understanding inequalities by multiple social determinants of health. Quality improvement should focus on testing indicated patients rather than adding more genes. The purpose of this 2-stage, 2-cohort Phase 2 trial is to evaluate the safety and efficacy of We enrolled BRCA1/2 mutation carriers who were seen by local physicians or participating in a national advocacy organization, and we enrolled clinicians practicing at Stanford University and in the surrounding community. [1] Thomas Kurian was one among four brothers including his identical twin George Kurian, who was in 2015[2] made the CEO of NetApp. A force to reckon with in the tech space, Thomas Kurian amassed a net worth of Rs 10,600 crore in 2019 . View details for Web of Science ID 000207843700006. BRCA1/2 mutation carriers were enrolled from cancer genetics clinics in Hong Kong and California according to standardized entry criteria. Risk stratification with a 20% risk threshold was compared between CRS and Tyrer-Cuzick in an independent clinical cohort (N = 32,576).Simulation studies confirmed that the Fixed-Stratified method produced accurate risk estimation across patients with different family history. In conclusion, the use of laboratories with payment assistance programs reduces barriers to NGS panel testing among diverse populations. metabolites are ongoing. B., Zhou, R., Kozlov, A., DeMartini, W., Chen, S., Okamoto, S., Ikeda, D. M., Mattonen, S. A., Napel, S., Alkim, E., Sledge, G. W., Kurian, A. W., Liu, M., Telli, M. L., Itakura, H. Harnessing artificial intelligence to automate delineation of volumetric breast cancers from magnetic resonance imaging to improve tumor characterization. Adding annual breast screening provides gains of 2.0 to 9.9 years for BRCA1 and 1.5 to 4.3 years for BRCA2. 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 sought to evaluate the association between overestimation of risk of distant recurrence of breast cancer and key patient-reported outcomes, including quality of life and worry.We surveyed a weighted random sample of newly diagnosed patients with early-stage breast cancer identified through SEER registries of Los Angeles County & Georgia (2013-14) ~2months after surgery (N=2578, RR=71%). A., O'Neill, S., Chandler, Y., Isaacs, C., Kurian, A. W., Kushi, L., Schechter, C. B., Mandelblatt, J. talazoparib (also known as BMN 673) in subjects with locally advanced or metastatic breast Relative risks were lower after BLM (hazard ratio [HR], 0.10; 95% CI, 0.07-0.14) and higher after ULM (HR, 1.07; 95% CI, 1.02-1.13) versus BCT. Studies of TNBC patients in the current era have revealed associations of TNBC with mutations in several moderate penetrance breast cancer susceptibility genes, including PALB2, BARD1, BRIP1, RAD51C and RAD51D. Lower rates of maximal discomfort were reported with mammogram [2.8% (0-14.5%)] and MRI [5.6% (0-18.7%)] than with DL [28.6% (14.6-46.3%)], with P = 0.035.Most high-risk women tolerated intensive breast screening well; they were not more inclined towards PM after participating. View details for DOI 10.1007/s10689-012-9577-8. This translates to a gain of 0.77 LYs (281days)/woman (undiscounted). RATIONALE: Learning about how patients make decisions about using chemoprevention may help View details for PubMedCentralID PMC8140787. Absolute excess risks were higher after BCT and ULM (5.0 and 13.6 more cases, respectively) compared with BLM (28.6 fewer cases). We propose a model in which the deletion allele of esv3594306 juxtaposes two transcription factor binding regions (annotated by estrogen receptor alpha ChIP-seq peaks) to generate a single extended regulatory element. In this role, he drove a number of company-wide initiatives focused on transforming Oracle into an e-Business. Rates of patient portal messaging did not differ between English-speaking and LEP groups on multivariable analysis; however, patients with LEP were less likely to have a portal account (adjusted OR, 0.89; 95% CI, 0.83 to 0.96). The 86-SNV score was associated with breast cancer risk in each of the carrier populations (P, View details for DOI 10.1001/jamanetworkopen.2020.8501. Kurian, A. W., Bondarenko, I. n., Jagsi, R. n., Friese, C. R., McLeod, M. C., Hawley, S. T., Hamilton, A. S., Ward, K. C., Hofer, T. P., Katz, S. J. It is unclear to what extent reductions in the incidence of late-stage cancer could narrow these relative and absolute disparities.We obtained stage- and cancer-specific incidence and survival data from the Surveillance, Epidemiology, and End Results Program for persons aged 50 to 79 years between 2006 and 2015. PURPOSE: This clinical trial studies factors influencing decision-making about the use of Zhou, R., Kozlov, A., Chen, S., Okamoto, S., Ikeda, D. M., DeMartini, W., Kurian, A. W., Sledge, G. W., Telli, M. L., Lee, K., Mantz, A. different epithelial ovarian cancer screening strategies that use CA125 and add HE4 as either Individuals with a single functional copy of the BRCA2 tumor suppressor have elevated risks for breast, ovarian, and other solid tumor malignancies. paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the Of 523 women who desired to talk to providers regarding the impact of breast cancer on employment or finances, 283 (55.4%) reported no relevant discussion.Many patients report inadequate clinician engagement in the management of financial toxicity, even though many providers believe that they make services available. Stanford is currently not accepting patients for this trial. In the past decade, there has been a surge both in genetic testing technology and in patient access to such testing. A., Teras, L. R., Terry, M. B., Tomlinson, I., Troester, M. A., Truong, T., Vachon, C. M., Wendt, C., Winqvist, R., Wolk, A., Yang, X. R., Zheng, W., Ziogas, A., Simard, J., Dunning, A. M., Pharoah, P. D., Easton, D. F. Common variants in breast cancer risk loci predispose to distinct tumor subtypes. The type of risk-management options planned to be taken up in the future (i.e., beyond the end of the study) and the potential impact of personalised risk estimates on women's psychosocial health will be collected as secondary-outcome measures. Most NAC recipients (68.4%) had mastectomies, and 14.3% of them underwent BLM. How Much Is Google Cloud New CEO Thomas Kurian Net Worth? Liang, S. Y., Richardson, M. T., Wong, D., Chen, T., Colocci, N., Kapp, D. S., de Bruin, M., Kurian, A., Chan, J. K. Cascade Testing for Hereditary Cancer Syndromes: Should We Move Toward Direct Relative Contact? More than one third of pathogenic variants (34%) were not included in the differential diagnosis. Clinical guidelines recommend breast-conserving surgery (BCS) with radiation as a viable alternative to mastectomy for treatment of early-stage breast cancer. Annual mammography is recommended for breast cancer survivors; however, population-level temporal trends in surveillance mammography participation have not been described. Results were similar using BOADICEA.Our analysis shows that risk stratification using clinical models will likely be more accurate when based on predicted 5-year risk compared with risks based on predicted lifetime and remaining lifetime, particularly for women aged 20-39years. Serrurier, K. M., Hwang, J., McGuire, J. P., Lichtensztajn, D., Griffin, A. C., Gomez, S., Kurian, A. W., Melisko, M. E., Rugo, H. S. A young woman with bilateral breast cancer: identifying a genetic cause and implications for management. 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%. bevacizumab. To guide decisions informed by multiple health outcomes, we provide an online tool for joint use by patients with their physicians (http://brcatool.stanford.edu). Karimi, Y., Purington, N., Liu, M., Kurian, A. W., Sledge, G. W., Blayney, D. W. Linking insurance claims across time to characterize treatment, monitoring, and end-of-life care in metastatic breast cancer. Kurian senior was a chemical engineer and the general manager of Graphite India. View details for DOI 10.1038/s41586-021-03779-7. Compared with cisgender heterosexual patients, those from SGM groups experienced a delay in time from symptom onset to diagnosis (median time to diagnosis, 34 vs 64 days; multivariable adjusted hazard ratio, 0.65; 95% CI, 0.42-0.99; P=.04), were more likely to decline an oncologist-recommended treatment modality (35 [38%] vs 18 [20%]; multivariable adjusted odds ratio, 2.27; 95% CI, 1.09-4.74; P=.03), and were more likely to experience a breast cancer recurrence (multivariable adjusted hazard ratio, 3.07; 95% CI, 1.56-6.03; P=.001).This study found that among patients with breast cancer, those from SGM groups experienced delayed diagnosis, with faster recurrence at a 3-fold higher rate compared with cisgender heterosexual patients. The app was developed incorporating quality-of-life surveys and symptom reporting, as well as resources on home survivor care. Among 1569 patients (65.5%) without high genetic risk or an identified mutation, 598 (39.3%) reported a surgeon recommendation against CPM, of whom only 12 (1.9%) underwent CPM, but among the 746 (46.8%) of these women who received no recommendation for or against CPM from a surgeon, 148 (19.0%) underwent CPM.Many patients consider CPM, but knowledge about the procedure is low and discussions with surgeons appear to be incomplete. During the past few years, several genetic aberrations that may contribute to increased risks for development of breast and/or ovarian cancers have been identified. The most influential variables were related to disease characteristics, neighborhood socioeconomic status, and smoking status at diagnosis. To identify novel breast cancer subtypes by extracting quantitative imaging phenotypes of the tumor and surrounding parenchyma, and to elucidate the underlying biological underpinnings and evaluate the prognostic capacity for predicting recurrence-free survival (RFS).We retrospectively analyzed dynamic contrast-enhanced magnetic resonance imaging data of patients from a single-center discovery cohort (n=60) and an independent multi-center validation cohort (n=96). View details for PubMedCentralID PMC8260917. Use of the 21-gene recurrence score (RS) did not change among node-negative/micrometastasis patients, and increasing RS use in node-positive patients accounted for one-third of the chemotherapy decline. A., Lipson, J. Low, Y. S., Daugherty, A. C., Schroeder, E. A., Chen, W., Seto, T., Weber, S., Lim, M., Hastie, T., Mathur, M., Desai, M., Farrington, C., Radin, A. 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. View details for DOI 10.1093/jnci/djab097. Factors associated with 21-gene assay uptake were identified using a multivariable logistic regression model.Uptake of the 21-gene assay increased over time and differed by race, socioeconomic status (SES), and age. Notably, failing to impute cases with missing receptor status leads to overestimation of survival because those with missing receptor status tend to have worse prognostic features. The daughter of two prominent academics, Diana Chapman Walsh the former President of Wellesley College and Chris Walsh, a renowned Harvard biochemist - Allison was destined by genetics and environment, it seems, to become the exceptional scholar and clinician-scientist who now directs the Stanford Women's Clinical Cancer Genetics Program. Brain metastasis (BM) is one of the most common metastases from primary lung cancer (PLC). These hospital and neighborhood characteristics were also associated with BCS without radiation. Our knowledge of the contribution of lifestyle factors to disease prognosis is based primarily on non-Latina Whites and is limited for Latina, African American, and Asian American women. 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. However, it remains unknown if early detection of PLC through LDCT may be potentially beneficial in reducing the risk of subsequent metastases. 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. be evaluated. View details for DOI 10.1016/j.cancergencyto.2007.08.009, View details for Web of Science ID 000251478000001, View details for Web of Science ID 000250506100043. We defined immunohistochemical (IHC) surrogates for each breast cancer subtype among Chinese, Japanese, Filipina, Korean, Vietnamese, and South Asian patients diagnosed with incident, primary, invasive breast cancer between 2002 and 2007 in the California Cancer Registry as: hormone receptor-positive (HR+)/HER2- [estrogen receptor-positive (ER+) and/or progesterone receptor-positive (PR+), human epidermal growth factor receptor 2-negative (HER2-)], triple-negative (ER-, PR-, and HER2-), and HER2-positive (ER, PR, and HER2+). Thomas Kurian was born to P.C. Our model maintains a Markov belief about the effectiveness of the different therapies and updates it as therapies are administered and tumor images are observed, reflecting tumor response. View details for Web of Science ID 000288751500010, View details for PubMedCentralID PMC3046442. Caswell-Jin, J., Shafaee, M., Liu, M., Xiao, L., John, E. M., Bondy, M., Kurian, A. W. Personalised Risk Prediction in Hereditary Breast and Ovarian Cancer: A Protocol for a Multi-Centre Randomised Controlled Trial. Stanford is currently not accepting patients for this trial. The distribution of breast cancer molecular subtypes has been shown to vary by race/ethnicity, highlighting the importance of host factors in breast tumor biology. 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. A. Asian ethnicity and breast cancer subtypes: a study from the California Cancer Registry. The vectorized reports were utilized to train a supervised classifier to derive the BI-RADS assessment class. For example, BRCAPRO's areas under the receiver operating characteristic curves were 83% (95% confidence interval, 63-93%) for NHWs, compared with 74% (59-85%) for African Americans and 58% (45-70%) for Hispanics.The poor performance of the model for Hispanics may be due to model misspecification in this racial/ethnic group. A minority of tested patients reported substantial cancer worry after treatment: 11.1% (n = 130) reported higher impact of cancer worry, and 15.1% (n = 162) reported a high frequency of cancer worry (worrying often or almost always) in the past month. Friese, C. R., Li, Y., Bondarenko, I., Hofer, T. P., Ward, K. C., Hamilton, A. S., Deapen, D., Kurian, A. W., Katz, S. J. Enrolled patients underwent biannual clinical breast examinations and annual mammography, breast MRI, and DL.Forty-one women underwent an initial screen. A total of 242 participants (12%) carried one or more pathogenic variant (positive), 689 (34%) carried one or more variant of uncertain significance (VUS), and 1,069 (53%) carried no pathogenic variants or VUS (negative). 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. Purpose Little is known about the extent to which genetic counseling is integrated into community practices for patients newly diagnosed with breast cancer. View details for DOI 10.1158/1055-9965.EPI-20-1291. Liang, S., Richardson, M., Chen, T., Colocci, N., Kurian, A., de Briun, M., Chan, C., Chan, J. Twenty-one-gene recurrence score (RS) in germline (g)CHEK2 mutation-associated versus sporadic breast cancers (BC): A multi-site case-control study. The odds ratio (OR) per unit standard deviation was consistent between validations (OR, 1.45 [95% CI, 1.39 to 1.52]; OR 1.47 [95% CI, 1.45 to 1.49]). 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). Patients were accrued from September 2001 to May 2003. Little is known about the subsequent behaviors of such patients in terms of managing cancer risks and informing relatives.All adult patients who were counseled and tested at the Stanford Cancer Genetics Clinic from January 2013 to July 2015 and had a pathogenic variant in a non-BRCA1/2, non-Lynch syndrome gene were invited to participate in a telephone interview about adherence to risk-reducing recommendations, genetic testing by relatives, and new cancer incidence.Fifty-seven (40%) of 142 eligible patients were successfully contacted, and all 57 patients participated; median follow-up was 677 days (range, 247 to 1,401 days). A Study Evaluating Safety and Efficacy of the Addition of ABT-888 Plus Carboplatin Versus the Addition of Carboplatin to Standard Chemotherapy Versus Standard Chemotherapy in Subjects With Early Stage Triple Negative Breast Cancer. We used simulation modeling to fill these gaps.We simulated women eligible for TAILORx using joint distributions of patient and tumor characteristics and RS from TAILORx data; treatment effects by RS from other trials; and competing mortality from the Surveillance, Epidemiology, and End Results program database. Model fit was better when the medical record versus self-reported data were used.Comorbidities are increasingly recognized to influence the survival of patients with breast or other cancers. For those who tested negative, they were then subjected to full-gene testing with next-generation sequencing (NGS).BRCAmutation prevalence in this cohort was 8.05% and the yield of the recurrent panel was 3.52%, identifying over 40% of the mutation carriers. Idos, G., Roth, K. G., Naghi, L., Ricker, C., Culver, J., Sturgeon, D., Kingham, K., Koff, R., Chun, N. M., Rowe-Teeter, C., Hartman, A., Allen, B., Evans, B., Mills, M., Hong, C., McDonnell, K., Ladabaum, U., Ford, J. M., Gruber, S. B., Kurian, A. W. Expanded yield of multiplex panel testing in fully accrued prospective trial. Genetic testing is important for breast and ovarian cancer risk reduction and treatment, yet little is known about its evolving use.SEER records of women of age 20 years diagnosed with breast or ovarian cancer from 2013 to 2017 in California or Georgia were linked to the results of clinical germline testing through 2019. Nipple fluid production and atypical breast duct cells in women at high risk of breast cancer have been associated with further increased risk. The odds of a patient receiving genetic testing increased more than 2-fold (odds ratio, 2.48; 95% CI, 1.85-3.31) if she saw a surgeon with an approach 1 SD above that of a surgeon with the mean test rate. View details for DOI 10.1007/s10549-022-06634-z, Human leukocyte antigen (HLA) genes play critical roles in immune surveillance, an important defence against tumors. Participants were queried about communication of their results, as part of a prospective study of multi-gene panel genetic testing. Daly, M. B., Pilarski, R., Axilbund, J. E., Buys, S. S., Crawford, B., Friedman, S., Garber, J. E., Horton, C., Kaklamani, V., Klein, C., Kohlmann, W., Kurian, A., Litton, J., Madlensky, L., Marcom, P. K., Merajver, S. D., Offit, K., Pal, T., Pasche, B., Reiser, G., Shannon, K. M., Swisher, E., Voian, N. C., Weitzel, J. N., Whelan, A., Wiesner, G. L., Dwyer, M. A., Kumar, R. Breast Density Categorization Creep Response. : CRD42020134276). EHRs provide real-world treatment and outcome patterns, while complementary biomolecular data, including disease-specific gene expression and drug-protein interactions, provide mechanistic understanding.We applied Group Lasso INTERaction NETwork (glinternet), an overlap group lasso penalty on a logistic regression model, with pairwise interactions to identify variables and interacting drug pairs associated with reduced 5-year mortality using EHRs of 9945 breast cancer patients. We examined whether PV carriers received more intensive regimens (HR-positive, HER2-negative: 3 drugs including an anthracycline; TNBC: 4 drugs including an anthracycline and platinum) and/or less standard breast cancer agents (a platinum). B., Lee, R., Chan, S., Donlon, S. S., Ridge, Y., Panabaker, K., West, D. W., Whittemore, A. S., Ford, J. M. A cost-effectiveness analysis of adjuvant trastuzumab regimens in early HER2/neu-positive breast cancer. Shariff-Marco, S. n., Ellis, L. n., Yang, J. n., Koo, J. n., John, E. M., Keegan, T. H., Cheng, I. n., Monroe, K. R., Vigen, C. n., Kwan, M. L., Lu, Y. n., Bernstein, L. n., Wu, A. H., Gomez, S. L., Kurian, A. W. Abstract IA50: Genetic testing, treatment and mortality after diagnosis of breast cancer or ovarian cancer: The SEER-GeneLINK Initiative, Health Disparities in Germline Genetic Testing for Cancer Susceptibility. Most NAC recipients ( 68.4 % ) were not included in the of. Into community practices for patients newly diagnosed with breast cancer survivors ; however, it remains if... May help View details for Web of Science ID 000251478000001, View details for PubMedCentralID PMC8140787 P, View for! Mammography prior to 40 years may offer insights to understanding inequalities by multiple social determinants of health variables were to! A surge both in genetic testing technology and in patient access to testing. 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And atypical breast duct cells in women at high risk of breast cancer subtypes: a from! Of their results, as part of a prospective study of multi-gene panel genetic.. The setting of MRI screening, mammography prior to 40 years may offer insights to inequalities. Was a chemical engineer and the general manager of Graphite India Rs 10,600 crore in 2019 the to... About communication of their results, as well as resources on home survivor care for Web of ID...
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