Successfully catheterized patients were younger (median age 41 versus 53 years, P = 0.0003) and more often premenopausal (51.7% versus 20%, P = 0.041). There was no difference in quality of life (QOL), functional social support (FSS), distress, or decision regret between SM users and non-users. 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. Respondents often recalled clinicians informing them about inheritance patterns (65%; 95% CI, 62% to 67%), surgical implications (65%; 95% CI, 63% to 68%), and other cancer risks (66%; 95% CI, 63% to 68%) but less often that results could have potential implications for clinical trial eligibility (38%; 95% CI, 36% to 42%) or targeted therapies (14%; 95% CI, 12% to 16%). Kwong, A., Ng, E. K., Law, F. B., Wong, H. N., Wa, A., Wong, C. L., Kurian, A. W., West, D. W., Ford, J. M., Ma, E. S. Genetic Polymorphisms as Predictors of Breast Cancer Risk, Identification of BRCA1/2 Founder Mutations in Southern Chinese Breast Cancer Patients Using Gene Sequencing and High Resolution DNA Melting Analysis. This study aimed to evaluate the association of the PRS313 with clinicopathologic characteristics of, and survival following, breast cancer.Women with invasive breast cancer were included, 98,397 of European ancestry and 12,920 of Asian ancestry, from the Breast Cancer Association Consortium (BCAC), and 683 women from the European MINDACT trial. For more information, please contact Pei-Jen Chang, 650-725-0866. View details for DOI 10.1038/s41467-020-17680-w. Continued efforts to ensure prompt return to screening and minimize delays in evaluation of symptomatic women can largely mitigate the effects of the initial pandemic-associated disruptions. In the $50 (USD) arm, 16 of 57 eligible patients participated (28.1%) and they invited 38 relatives: 18 relatives enrolled and 17 ordered testing.Cascade genetic testing in families with hereditary cancer syndromes accrued through a population-based cancer registry can be achieved through an online platform that offers genetic risk education and low-cost testing to relatives. These NCCN Guidelines Insights summarize major discussion points of the 2015 NCCN Genetic/Familial High-Risk Assessment: Breast and Ovarian panel meeting. The entire coding region, exon-intron boundaries, and all known pathogenic variants in other regions were sequenced for 42 genes that had cancer risk associations. In a study published in the Journal of Clinical Oncology, she specifically addressed how computer models failed in predicting the presence of dangerous genetic mutations in Asian women compared to white women. : CRD42020134276). Multivariable analysis was performed to identify predictors of RS and chemotherapy use.In all, 10,125 patients with breast cancer were diagnosed in the University or Community systems from 2005 to 2011; 2,418 (23.9%) met RS guidelines criteria, of whom 15.6% received RS. A Florida man is charged with second degree human trafficking in Shelby County.32-year-old Korian Durell Thomas is being held in the Shelby County Jail on $180,000 bond. BRCAPRO and BOADICEA underestimated the number of male BRCA1/2 mutation carriers whilst Myriad II underestimated the number of both male and female carriers. cells, by stopping them from dividing, or by stopping them from spreading. [21] Kurian and Larry Ellison reportedly had a falling out over the direction of its cloud business. Relationships between sociodemographic and clinical factors and GCC receipt differed by subtype. Mechanistically, we identify BRCA2 chromatin binding, histone acetylation, and associated transcriptional activity as critical determinants of the epigenetic response to BRCA2-crisis. In total, 2,187 deaths (1,122 from breast cancer) were observed through December 31, 2010. Neoadjuvant gemcitabine (1,000 mg/m(2) intravenously [IV] on days 1 and 8), carboplatin (area under curve of 2 IV on days 1 and 8), and iniparib (5.6 mg/kg IV on days 1, 4, 8, and 11) were administered every 21 days for four cycles, until the protocol was amended to six cycles. The model closely reproduced observed rates in both independent data sets.Our validated clinical decision tool is flexible, readily adaptable to include new therapies, and can support discussions about genomic testing and early breast cancer treatment. Rates were stratified by age group (40-49 vs 50-64 years), visit with a surgical/oncology specialist or primary care provider within the prior year, and sociodemographic characteristics. Clinically significant discrepancies between the lab provided test reports and other major commercial laboratories were identified, including differences between pathogenic/likely pathogenic (P/LP) and variant of uncertain significance (VUS) classifications, via review of ClinVar archives. Katz, S. J., Hawley, S. T., Bondarenko, I. n., Jagsi, R. n., Ward, K. C., Hofer, T. P., Kurian, A. W. Heterogeneous Enhancement Patterns of Tumor-adjacent Parenchyma at MR Imaging Are Associated with Dysregulated Signaling Pathways and Poor Survival in Breast Cancer. Overestimators (OR.50, CI 0.31-0.81) or those who perceived zero risk (OR.46, CI 0.29-0.72) more often said that their doctor did not discuss risk. is a Professor of Medicine and of Epidemiology and Population Health at Stanford University School of Medicine. Thomas Kurian launched Anthos, a Google Cloud platform for companies to put and manage their data in different clouds. Racial/ethnic disparities in breast cancer survival are well documented, but the influence of health care institutions is unclear. Model input parameters were derived from meta-analyses, clinical trials, and large observational data. Dr. Thomas K. Kurian is a cardiologist in Austin, Texas and is affiliated with multiple hospitals in the area, including Ascension Seton Medical Center Austin and Ascension Seton Shoal Creek. Although both recurrent HOXB13 mutations p.G84E and p.R217C were not associated with breast cancer risk, the risk estimation for p.R217C was not very precise. 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. Use of and mortality after bilateral mastectomy compared with other surgical treatments for breast cancer in California, 1998-2011. However, little is known about the translation of trial results and guidelines to clinical practice. Future research areas include randomized controlled trials, studies on specific cancer types in relation to statin use, studies on populations without clinical indication for statins, elucidation of underlying biological mechanisms, and investigation of different statin types. 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. The odds ratio for higher impact of cancer worry was 0.81 (95% CI, 0.51 to 1.28) for multigene versus BRCA1/2-only testing. Many of these variants have differential associations by estrogen receptor (ER) status, but how these variants relate with other tumor features and intrinsic molecular subtypes is unclear.Among 106,571 invasive breast cancer cases and 95,762 controls of European ancestry with data on 173 breast cancer variants identified in previous GWAS, we used novel two-stage polytomous logistic regression models to evaluate variants in relation to multiple tumor features (ER, progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and grade) adjusting for each other, and to intrinsic-like subtypes.Eighty-five of 173 variants were associated with at least one tumor feature (false discovery rate, View details for DOI 10.1186/s13058-021-01484-x, View details for DOI 10.1097/01.ogx.0000800176.90737.65, View details for Web of Science ID 000732787100013, View details for DOI 10.1200/JCO.2020.39.28_suppl.106, View details for Web of Science ID 000707130200105. Hartman, A. R., Daniel, B. L., Kurian, A. W., Mills, M. A., Nowels, K. W., Dirbas, F. M., Kingham, K. E., Chun, N. M., Herfkens, R. J., Ford, J. M., Plevritis, S. K. Ductal lavage of non-fluid yielding ducts in BRCA1 and BRCA2 mutation carriers and other women at high genetic risk for breast cancer, Kurian, A. W., Mills, M. A., Nowels, K. W., et al, A pilot breast cancer screening trial for women at high inherited risk using clinical breast exam, mammography, breast magnetic resonance imaging, and ductal lavage: updated results after median follow-up of fourteen months, Kurian, A. W., Daniel, B. L., Mills, M. A., et al, Identification of ductal atypia with MR galactography. Stanford is currently not accepting patients for this trial. Clinical use of the 21-gene assay and patient experiences in early-stage breast cancer. In germline BRCA1 or BRCA2 (BRCA1/2) mutation carriers, restoration of tumor BRCA1/2 function by a secondary mutation is recognized as a mechanism of resistance to platinum and PARP inhibitors, primarily in ovarian cancer. test the tolerability and efficacy of AZD0530 (also called saracatinib) when used together The NCCN Genetic/Familial High-Risk Assessment: Breast and Ovarian panel meets at least annually to review comments from reviewers within their institutions, examine relevant new data from publications and abstracts, and reevaluate and update their recommendations. Hall, M. J., Hughes, E., Handorf, E., Gutin, A., Allen, B., Hartman, A., Kurian, A. W. Association of ovarian cancer (OC) risk with mutations detected by multiple-gene germline sequencing in 95,561 women. Jagsi, R., Ward, K. C., Abrahamse, P., Wallner, L. P., Kurian, A. W., Hamilton, A. S., Katz, S. J., Hawley, S. T. Promoting breast cancer screening after multiplex genetic panel testing (MGPT) and genetic counseling. Trosman, J. R., Weldon, C. B., Gradishar, W. J., Benson, A. The influence of demographic and pathologic features was used in a multivariable logistic regression model to compare expected with observed HER2-positive percentages by region.There was significant geographic variation by California counties (11.6%-26%). BRCA1/2 mutation carriers were enrolled from cancer genetics clinics in Hong Kong and California according to standardized entry criteria. mechanism has not yet been fully elucidated, however based on experiments on tumor cells 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. Screening and prevention decisions for women at increased risk of developing breast cancer depend on genetic and clinical factors to estimate risk and select appropriate interventions. Google Cloud CEO Thomas Kurian focused on new partnerships, recent customer wins and new tools for multi-cloud environments, hybrid work, cybersecurity and edge infrastructure in his keynote. Halley, M. C., May, S. G., Rendle, K. A., Frosch, D. L., Kurian, A. W. Obesity and Mortality After Breast Cancer by Race/Ethnicity: The California Breast Cancer Survivorship Consortium. (pharmacokinetic/pharmacodynamic) correlations and to evaluate the pharmacogenomic (PGx) 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. Data analyses were conducted using chi-square and t tests. Lung cancer survivors are at high risk of a second primary lung cancer (SPLC). Kurian, A. W., Whittemore, A. S., Ford, J. M. The Decline in Breast Cancer Incidence: Real or Imaginary? We evaluated the effects of 5 years of risk-reducing medication (tamoxifen/aromatase inhibitors) with annual screening mammography magnetic resonance imaging (MRI) compared with no screening, MRI, or risk-reducing medication. In this approach, we impute missing values using regression models for each variable, conditional on the other variables in the data. For more information, please contact Marilyn Florero, (650) 724 - 1953. The goal of developing educational materials for referring clinicians and patients was reached with the construction of an easily accessible Web site that contains information about breast density, breast cancer risk assessment, and supplementary imaging. View details for Web of Science ID 000207843700006. The stomach and resected lymph nodes were evaluated pathologically.Six patients were identified as CDH1 carriers from a single family. Kurian, A. W., Ward, K. C., Abrahamse, P. n., Bondarenko, I. n., Hamilton, A. S., Deapen, D. n., Morrow, M. n., Berek, J. S., Hofer, T. P., Katz, S. J. Compared with the patient-mediated approach, direct relative contact resulted in significantly higher uptake of genetic counseling for all relatives (63% [95% CI, 49 to 75] v 35% [95% CI, 24 to 48]) and genetic testing for first-degree relatives (62% [95% CI, 49 to 73] v 40% [95% CI, 32 to 48]). A., Ozanne, S. E., Namekawa, S. H., Solc, P., Murabito, J. M., Ong, K. K., Hoffmann, E. R., Murray, A., Roig, I., Perry, J. R. Germline Pathogenic Variants in Cancer Predisposition Genes Among Women With Invasive Lobular Carcinoma of the Breast. The magnitude of breast and ovarian cancer risk associated with many clinically tested genes, and independent of family cancer history, remains to be quantified.We queried a commercial laboratory database of 95,561 women tested clinically for hereditary cancer risk with a 25-gene (APC, ATM, BARD1, BMPR1A, BRCA1, BRCA2, BRIP1, CDH1, CDK4, CHEK2, MLH2, MSH2, MSH6, MUTYH, NBN, P14ARF, P16, PALB2, PMS2, PTEN, RAD51C, RAD51D, SMAD4, STK11, and TP53) next-generation sequencing panel. Similar patterns were seen for BC-specific mortality. Circulating tumor cells (CTCs) are rare cells found in the blood of patients with solid tumors and may play a key role in cancer dissemination. Afghahi, A., Rigdon, J., Purington, N., Desal, M., Pierson, E., Mathur, M., Thompson, C. A., Curtis, C., West, R. B., Horst, K. C., Gomez, S., Ford, J. M., Sledge, G. W., Kurian, A. W. Safety of multiplex gene testing for inherited cancer risk: Interim analysis of a clinical trial. Family history was defined as strong (suggestive of PVs in high-penetrance genes such as BRCA1/2 or TP53, including male breast, ovarian, pancreatic, sarcoma, or multiple female breast cancers), moderate (any other cancer history), or none. Sensitivity analyses indicated that the breast cancer mortality impact would be approximately double if the modeled pandemic effects on screening, symptomatic diagnosis, and chemotherapy extended for 12months.Initial pandemic-related disruptions in breast cancer care will have a small long-term cumulative impact on breast cancer mortality. Multivariable predictors of NAC treatment were stage (III), younger age (<40 yrs), Black or Hispanic race/ethnicity versus non-Hispanic White (OR 1.10, 95% confidence interval (CI) 1.05-1.16), and care at a National Cancer Institute (NCI)-designated center (OR 1.70, CI 1.58-1.82). In the multivariable model, when clinical and SES variables were controlled for, racial differences in test uptake were no longer observed. The exact mechanisms of carcinogenesis due to BRCA2 haploinsufficiency remain unclear, but one possibility is that at-risk cells are subject to acute periods of decreased BRCA2 availability and function ("BRCA2-crisis"), which may contribute to disease. Association of illness mindsets with health-related quality of life in cancer survivors. We received paired pre- and posttest responses for 2172 patients (response rate=14.3%). Pathogenic germline variants were detected in 617 patients (30.5%; 95% CI, 28.5%-32.6%) and were prevalent across patient ages (1-85 years) and cancer types, including cancers known to be strongly associated with germline variance (eg, breast, colorectal) as well as others (eg, renal, lung, and bladder). Potential effects of misclassification of comorbidity status should be considered in the interpretation of research results. 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. For more information, please contact Mary Chen, (650) 723 - 8686. 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. Rising Bilateral Mastectomy Rates Among Neoadjuvant Chemotherapy Recipients in California From 1998 to 2012. Ethnic distribution of the population also influenced HER2-positive percentages. The purpose of this 2-stage, 2-cohort Phase 2 trial is to evaluate the safety and efficacy of Lindstrm, S., Wang, L., Feng, H., Majumdar, A., Huo, S., Macdonald, J., Harrison, T., Turman, C., Chen, H., Mancuso, N., Bammler, T., Gallinger, S., Gruber, S. B., Gunter, M. J., Le Marchand, L., Moreno, V., Offit, K., de Vivo, I., O'Mara, T. A., Spurdle, A. A polygenic risk score (PRS) consisting of 313 common genetic variants (PRS313) is associated with risk of breast cancer and contralateral breast cancer. To determine the influence of payer coverage and out-of-pocket costs on the ordering of NGS panel tests for hereditary cancer in diverse settings, we conducted semi-structured interviews with providers who conduct genetic counseling and order next-generation sequencing (NGS) panels purposefully recruited from 11 safety-net clinics and academic medical centers (AMCs) in California and North Carolina, states with diverse populations and divergent Medicaid expansion policies. To estimate the risk of contralateral breast cancer (CBC) among women with germline pathogenic variants (PVs) in ATM, BRCA1, BRCA2, CHEK2, and PALB2.The study population included 15,104 prospectively followed women within the CARRIERS study treated with ipsilateral surgery for invasive breast cancer. This cohort will enable analyses to jointly consider a variety of clinical, lifestyle, and contextual factors in attempting to explain the long-standing disparities in breast cancer outcomes. Women reported chemotherapy recommendations, the receipt of chemotherapy, testing experiences, and decision satisfaction. Association of Genetic Testing Results with Mortality Among Women with Breast Cancer or Ovarian Cancer. Reply to S.M. We considered whether weight is more informative than body mass index = weight/height2 (BMI) when predicting breast cancer risk for post-menopausal women, and if the weight association differs by underlying familial risk. Polygenic risk scores (PRS) for epithelial ovarian cancer (EOC) have the potential to improve risk stratification. By contrast, VUS results were more frequent among nonwhites, with potential significance for the impact of MGS testing by race/ethnicity.GENETICS in MEDICINE advance online publication, 27 July 2017; doi:10.1038/gim.2017.96. Katz, S. J., Hawley, S. T., Jagsi, R., Kurian, A. W. Contralateral Prophylactic Mastectomy Decisions in a Population-Based Sample of Patients With Early-Stage Breast Cancer. View details for DOI 10.1200/JCO.21.00640. 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. Incidence rates were calculated by subtype (triple-negative; HR+/HER2-; HR+/HER2+; HR-/HER2+), and logistic regression was used to evaluate differences in subtype characteristics by age group.AYAs had higher proportions of HR+/HER2+, triple-negative and HR-/HER2+ breast cancer subtypes and higher proportions of patients of non-White race/ethnicity than did older women. epithelial ovarian cancer. 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). 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