Gonzales, F., Shariff-Marco, S., Dwyer, L., Nuru-Jeter, A., Langer, M., Reeve, B., Taplin, S., Kurian, A., Lin-Gomez, S. Genetics of triple-negative breast cancer: Implications for patient care, Genetic/Familial High-Risk Assessment: Breast and Ovarian, Version 2.2015 Featured Updates to the NCCN Guidelines. View details for DOI 10.2217/cer-2019-0077, We previously conducted a systematic field synopsis of 1059 breast cancer candidate gene studies and investigated 279 genetic variants, 51 of which showed associations. In preclinical studies, statins inhibit multiple cancer-associated pathways in both hormone receptor (HR)-negative and HR-positive cell lines. 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). Clinical guidelines often use predicted lifetime risk from birth to define criteria for making decisions regarding breast cancer screening rather than thresholds based on absolute 5-year risk from current age.We used the Prospective Family Cohort Study of 14,657 women without breast cancer at baseline in which, during a median follow-up of 10years, 482 women were diagnosed with invasive breast cancer. Gene burden tests detected the strongest association for deletions in BRCA1 (P=3.7E-18). Among triple-negative breast cancer patients, cancer-specific mortality was lower with BRCA1 (hazard ratio [HR] = 0.49, 95% confidence interval [CI] = 0.35-0.69) and BRCA2 PVs (HR=0.60, 95% CI=0.41-0.89), and equivalent with PVs in other genes (HR=0.65, 95% CI=0.37-1.13), versus non-carriers. We assessed whether lifelong physical activity or sedentary time, assessed using genotype, may be causally associated with breast cancer risk overall, pre/post-menopause, and by case-groups defined by tumour characteristics.We performed two-sample inverse-variance-weighted MR using individual-level Breast Cancer Association Consortium case-control data from 130 957 European-ancestry women (69 838 invasive cases), and published UK Biobank data (n=91 105-377 234). View details for PubMedCentralID PMC3867595. evaluate the safety, tolerability, pharmacokinetics and feasibility of trastuzumab emtansine Therefore, there is an unmet clinical need to better predict the risk of progression among DCIS patients. View details for DOI 10.1007/s10689-007-9171-7, View details for Web of Science ID 000253712200022. View details for DOI 10.1016/j.jmoldx.2015.04.009, View details for DOI 10.1001/jamaoncol.2015.2719. View details for DOI 10.1038/s41598-021-89033-6, Breast cancer (BC) risk for BRCA1 and BRCA2 mutation carriers varies by genetic and familial factors. However, she will continue working with Mr. Kurianthrough January to ensure a smooth transition. Increasingly precise estimates of individual patients' risk of recurrence and commensurate predicted benefit from certain therapies hold significant promise in helping patients exercise autonomous decision-making for their breast cancer care, yet will also likely complicate decision-making for certain subgroups of patients. We calculated and compared age-specific incidence rates, incidence rate ratios, and 95% confidence intervals by subtype and race (black, white, Hispanic, and Asian). Unique associations include an inverse relation of serous cancer risk to body mass index, a positive relation of mucinous cancer risk to cigarette smoking, and a weakly positive relation of endometrioid cancer risk to body mass index. The authors described responses from approximately 73% of surgeons (370 surgeons), 61% of medical oncologists (306 medical oncologists), 67% of radiation oncologists (169 radiation oncologists), and 68% of patients (2502 patients).Approximately one-half (50.9%) of responding medical oncologists reported that someone in their practice often or always discusses financial burden with patients, as did 15.6% of surgeons and 43.2% of radiation oncologists. 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. will receive pertuzumab and trastuzumab administered sequentially as separate intravenous View details for DOI 10.1093/jncics/pkab090, View details for PubMedCentralID PMC8692829. DeRouen, M. C., Gomez, S. L., Press, D. J., Tao, L., Kurian, A. W., Keegan, T. H. PrECOG 0105: Final efficacy results from a phase II study of gemcitabine (G) and carboplatin (C) plus iniparib (BSI-201) as neoadjuvant therapy for triple-negative (TN) and BRCA1/2 mutation-associated breast cancer. The authors incorporated records from the population-based California Cancer Registry and then linked EMR-California Cancer Registry data sets of Community and University patients.The authors initially identified 8210 University patients and 5770 Community patients; linked data sets revealed a 16% patient overlap, yielding 12,109 unique patients. The Effect of Patient and Contextual Characteristics on Racial/Ethnic Disparity in Breast Cancer Mortality. View details for DOI 10.1093/jnci/djab151. (pharmacokinetic/pharmacodynamic) correlations and to evaluate the pharmacogenomic (PGx) However, little is known about the translation of trial results and guidelines to clinical practice. Microfluidic-based single cell transcriptional profiling of 87 cancer-associated and reference genes showed heterogeneity among individual CTCs, separating them into two major subgroups, based on 31 highly expressed genes. to the lymph nodes but is at high risk for returning (high-risk, lymph node-negative breast This multi-institutional, multidisciplinary approach may be useful for organizations to frame responses as similar legislation is passed across the United States. Idos, G. E., Kurian, A. W., Ricker, C., Sturgeon, D., Culver, J. O., Kingham, K. E., Koff, R., Chun, N. M., Rowe-Teeter, C., Lebensohn, A. P., Levonian, P., Lowstuter, K., Partynski, K., Hong, C., Mills, M. A., Petrovchich, I., Ma, C. S., Hartman, A. R., Allen, B., Wenstrup, R. J., Lancaster, J. M., Brown, K., Kidd, J., Evans, B., Mukherjee, B., McDonnell, K. J., Ladabaum, U., Ford, J. M., Gruber, S. B. Kurian, A. W., Hughes, E., Bernhisel, R., Probst, B., Lanchbury, J., Wagner, S., Gutin, A., Caswell-Jin, J., Rohan, T. E., Shadyab, A. H., Manson, J. E., Lane, D., Stefanick, M. L. Clinicopathologic features of invasive breast cancer (BC) diagnosed in carriers of germline PALB2, CHEK2 and ATM pathogenic variants. George & Thomas Kurian - identical twins, identical super-success. Most PVs were in 20 breast cancer-associated genes or ovarian cancer-associated genes; testing other genes yielded mostly VUS. A Study Evaluating The PF-03084014 In Combination With Docetaxel In Patients With Advanced Breast Cancer, A Study of Atezolizumab in Combination With Nab-Paclitaxel Compared With Placebo With Nab-Paclitaxel for Participants With Previously Untreated Metastatic Triple-Negative Breast Cancer (IMpassion130). Addressing barriers requires refining HCP-indicated populations (82%); developing evidence of actionability (82%) and pathogenicity/penetrance (64%); creating infrastructure and standards for informing and recontacting patients (45%); separating research from clinical use in the hybrid clinical-research setting (44%); and adjusting coverage frameworks (18%). Symptoms and survivorship needs differences between "good sleepers" and "bad sleepers" in survivors of breast and gynecologic cancers. The role of prophylactic versus therapeutic gastrectomy for HDGC was studied prospectively.Eighteen consecutive patients with CDH1 mutations and positive family history were studied prospectively, including 13 without and 5 with symptoms. Multivariable models and matched case-control analyses yielded similar results.Among nearly 100,000 clinically tested women, 7% carried a pathogenic mutation in one or more cancer-associated genes. For select women at increased risk for breast cancer, preventive medication can greatly decrease risk and is vastly underutilized. 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. Further studies are needed to assess patient understanding and subsequent cancer screening among patients from diverse backgrounds.Multigene panel tests for hereditary cancer have become widespread despite concerns about adverse psychological reactions among carriers of moderate-risk pathogenic variants (mutations) and among carriers of variants of uncertain significance. Weight is more informative than BMI for predicting breast cancer risk, consistent with non-adipose as well as adipose tissue being etiologically relevant. As Google lays off 12,000 employees . They usually undergo intensive cancer surveillance and may also consider surgical interventions, such as risk-reducing mastectomy or risk-reducing salpingo-oophorectomy (RRSO). We curated a comprehensive vocabulary by interviewing expert clinicians and processing radiology and pathology reports and progress notes. Shariff-Marco, S., Yang, J., John, E. M., Kurian, A. W., Cheng, I., Leung, R., Koo, J., Monroe, K. R., Henderson, B. E., Bernstein, L., Lu, Y., Kwan, M. L., Sposto, R., Vigen, C. L., Wu, A. H., Keegan, T. H., Gomez, S. L. Navigating choices when applying multiple imputation in the presence of multi-level categorical interaction effects. Materials & methods: 200 patients from the US Flatiron Health electronic health record-derived database (mTNBC diagnosis, January 2011-October 2016) who received 1L nab-paclitaxel (n=105) or paclitaxel (n=95) monotherapy were included. While free-text clinic notes may offer the greatest nuance and detail about a patient's clinical status, they are largely excluded in previous predictive models due to the increase in processing complexity and need for a complex modeling framework. How Much is Todd Chrisleys Net Worth in 2023? [3], Upon completing her fellowship, Kurian accepted a research scholar position supported by a Building Interdisciplinary Research Careers in Women's Health K12 award. SM use for coping was associated with lower QOL (p, View details for DOI 10.1007/s11764-020-00959-8. Vigen, C., Kwan, M. L., John, E. M., Gomez, S. L., Keegan, T. H., Lu, Y., Shariff-Marco, S., Monroe, K. R., Kurian, A. W., Cheng, I., Caan, B. J., Lee, V. S., Roh, J. M., Bernstein, L., Sposto, R., Wu, A. H. DISPARITIES AND DISCRIMINATION IN BREAST CANCER CARE AND QUALITY OF LIFE. Variation in surgeon attitudes about genetic testing and counseling may explain a substantial amount of this association. Shu, X. n., Long, J. n., Cai, Q. n., Kweon, S. S., Choi, J. Y., Kubo, M. n., Park, S. K., Bolla, M. K., Dennis, J. n., Wang, Q. n., Yang, Y. n., Shi, J. n., Guo, X. n., Li, B. n., Tao, R. n., Aronson, K. J., Chan, K. Y., Chan, T. L., Gao, Y. T., Hartman, M. n., Kee Ho, W. n., Ito, H. n., Iwasaki, M. n., Iwata, H. n., John, E. M., Kasuga, Y. n., Soon Khoo, U. n., Kim, M. K., Kong, S. Y., Kurian, A. W., Kwong, A. n., Lee, E. S., Li, J. n., Lophatananon, A. n., Low, S. K., Mariapun, S. n., Matsuda, K. n., Matsuo, K. n., Muir, K. n., Noh, D. Y., Park, B. n., Park, M. H., Shen, C. Y., Shin, M. H., Spinelli, J. J., Takahashi, A. n., Tseng, C. n., Tsugane, S. n., Wu, A. H., Xiang, Y. 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. Those who endorsed a maladaptive mindset (Cancer is a Catastrophe) reported lower health-related quality of life (HRQOL) compared with those who did not hold this belief (p < .001). The investigators propose to conduct a Phase I/randomized Phase II study design in order to Medicare's recent decision to cover NGTS makes this topic particularly urgent to examine. To study the impact of rising bilateral mastectomy rates among neoadjuvant chemotherapy (NAC) recipients in California.NAC for operable breast cancer (BC) can downstage disease and facilitate breast conservation. View details for DOI 10.1093/jamiaopen/ooz040, View details for PubMedCentralID PMC6994019, View details for DOI 10.2217/pme-2019-0045. Facebook Twitter Instagram KOO APP YOUTUBE Elections Little is known regarding whether growing awareness of the financial toxicity of a cancer diagnosis and its treatment has increased clinician engagement or changed the needs of current patients.The authors surveyed patients with early-stage breast cancer who were identified through population-based sampling from 2 Surveillance, Epidemiology, and End Results (SEER) regions and their physicians. 7 Richest Indian CEOs in the world -. Utilization of a multigene panel should also be considered, given the additional non-Lynch germline mutation identified in this cohort. Financial toxicity subgroups were compared based on a validated grading system.Participants (N=273; 74% breast cancer) averaged 54.65 years (SD=12.08), were 3.42 years (SD=4.20) post-diagnosis, and 33% reported cancer-related change in employment status. Significantly more patients in the intervention group compared with the control group had knowledge regarding the probability of a BRCA1 and/or BRCA2 pathogenic variant (35.8% vs 24.4%; P In a model adjusting only for age and study, breast cancer-specific hazard ratios relative to Whites were 1.69 (95% CI 1.46 - 1.96), 1.00 (0.84 - 1.19), and 0.52 (0.33 - 0.85) for African Americans, Latinas, and Asian Americans respectively. A., Goldberg, M. S., Gunel, P., Gndert, M., Hahnen, E., Haiman, C. A., Hberle, L., Hkansson, N., Hall, P., Hamann, U., Hart, S. N., Harvie, M., Hillemanns, P., Hollestelle, A., Hooning, M. J., Hoppe, R., Hopper, J., Howell, A., Hunter, D. J., Jakubowska, A., Janni, W., John, E. M., Jung, A., Kaaks, R., Keeman, R., Kitahara, C. M., Koutros, S., Kraft, P., Kristensen, V. N., Kubelka-Sabit, K., Kurian, A. W., Lacey, J. V., Lambrechts, D., Le Marchand, L., Lindblom, A., Loibl, S., Lubiski, J., Mannermaa, A., Manoochehri, M., Margolin, S., Martinez, M. E., Mavroudis, D., Menon, U., Mulligan, A. M., Murphy, R. A., Collaborators, N., Nevanlinna, H., Nevelsteen, I., Newman, W. G., Offit, K., Olshan, A. F., Olsson, H., Orr, N., Patel, A., Peto, J., Plaseska-Karanfilska, D., Presneau, N., Rack, B., Radice, P., Rees-Punia, E., Rennert, G., Rennert, H. S., Romero, A., Saloustros, E., Sandler, D. P., Schmidt, M. K., Schmutzler, R. K., Schwentner, L., Scott, C., Shah, M., Shu, X. O., Simard, J., Southey, M. C., Stone, J., Surowy, H., Swerdlow, A. J., Tamimi, R. M., Tapper, W. J., Taylor, J. Influence of payer coverage and out-of-pocket costs on ordering of NGS panel tests for hereditary cancer in diverse settings. View details for DOI 10.13063/2327-9214.1127, View details for PubMedCentralID PMC4435001. To construct a cohort of metastatic breast cancer (MBC) patients, we applied natural language processing techniques within a semisupervised machine learning framework to linked EMR-California Cancer Registry (CCR) data.We studied all female patients treated at Stanford Health Care with an incident breast cancer diagnosis from 2000 to 2014. 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). In MINDACT, PRS313 was associated with a low risk 70-gene signature. This portion of the NCCN Guidelines includes recommendations regarding diagnostic criteria and management of patients with Cowden Syndrome/PTEN hamartoma tumor syndrome. Among ovarian cancer patients, cancer-specific mortality was lower with PVs in BRCA2 (HR=0.35, 95% CI=0.25-0.49) and genes other than BRCA1/2 (HR=0.47, 95% CI=0.32-0.69). These NCCN Guidelines Insights summarize major discussion points of the 2015 NCCN Genetic/Familial High-Risk Assessment: Breast and Ovarian panel meeting. Hispanic respondents were less likely to have told a healthcare provider about their results than NHW (29% vs. 68%, p < .0001). Among all 63 mutation-positive patients, additional disease-specific screening and/or prevention measures beyond those based on personal and family history alone would be considered for most (33 [52%] of 63; 95% CI, 40.3%-64.2%). The four recurrent BRCA2 mutations (c.2808_2811delACAA, c.3109C>T, c.7436_7805del370 and c.9097_9098insA) accounted for 40% (16/40) of all BRCA2 mutations. spread. Idos, G., Kurian, A. W., Ricker, C., Sturgeon, D., Culver, J., Kingham, K., Koff, R., Chun, N. M., Rowe-Teeter, C., Kidd, J., Evans, B., Brown, K., Mills, M., Ma, C., Hong, C., McDonnell, K., Ladabaum, U., Ford, J. M., Gruber, S. B. Computing the cost of care per day of breast cancer survivor care. Many patients with breast cancer work for pay at the time of their diagnosis, and the treatment plan may threaten their livelihood. Participants were Black and non-Hispanic White women diagnosed with breast cancer, unselected for family history or age at diagnosis. Guidelines focus on syndromes associated with an increased risk of breast and/or ovarian cancer and are intended to assist with clinical and shared decision-making. The assay was associated with a net reduction in chemotherapy use by 10% (CI 4-16%). All P values are two-sided.We did not observe an age-related black-white crossover in incidence for any molecular subtype of breast cancer. For more information, please contact Mary Chen, (650) 723 - 8686. Across racial/ethnic groups, nearly half of all luminal breast cancers occur after age 70.These absolute risk estimates may inform health policy and resource planning across diverse populations, and can help patients and physicians weigh the probabilities of developing specific breast cancer subtypes against competing health risks. Kurian, A. W., Clarke, C. A., Carlson, R. W. Cancer risk reduction and reproductive concerns in female BRCA1/2 mutation carriers. Dennis, J., Tyrer, J. P., Walker, L. C., Michailidou, K., Dorling, L., Bolla, M. K., Wang, Q., Ahearn, T. U., Andrulis, I. L., Anton-Culver, H., Antonenkova, N. N., Arndt, V., Aronson, K. J., Freeman, L. E., Beckmann, M. W., Behrens, S., Benitez, J., Bermisheva, M., Bogdanova, N. V., Bojesen, S. E., Brenner, H., Castelao, J. E., Chang-Claude, J., Chenevix-Trench, G., Clarke, C. L., Colle, J. M., Couch, F. J., Cox, A., Cross, S. S., Czene, K., Devilee, P., Drk, T., Dossus, L., Eliassen, A. H., Eriksson, M., Evans, D. G., Fasching, P. A., Figueroa, J., Fletcher, O., Flyger, H., Fritschi, L., Gabrielson, M., Gago-Dominguez, M., Garca-Closas, M., Giles, G. G., Gonzlez-Neira, A., Gunel, P., Hahnen, E., Haiman, C. A., Hall, P., Hollestelle, A., Hoppe, R., Hopper, J. L., Howell, A., Jager, A., Jakubowska, A., John, E. M., Johnson, N., Jones, M. E., Jung, A., Kaaks, R., Keeman, R., Khusnutdinova, E., Kitahara, C. M., Ko, Y. D., Kosma, V. M., Koutros, S., Kraft, P., Kristensen, V. N., Kubelka-Sabit, K., Kurian, A. W., Lacey, J. V., Lambrechts, D., Larson, N. L., Linet, M., Ogrodniczak, A., Mannermaa, A., Manoukian, S., Margolin, S., Mavroudis, D., Milne, R. L., Muranen, T. A., Murphy, R. A., Nevanlinna, H., Olson, J. E., Olsson, H., Park-Simon, T. W., Perou, C. M., Peterlongo, P., Plaseska-Karanfilska, D., Pylks, K., Rennert, G., Saloustros, E., Sandler, D. P., Sawyer, E. J., Schmidt, M. K., Schmutzler, R. K., Shibli, R., Smeets, A., Soucy, P., Southey, M. C., Swerdlow, A. J., Tamimi, R. M., Taylor, J. 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