We used Cox proportional hazard regression modeling to calculate hazard ratios (HRs) and 95% confidence intervals (CI) overall and stratified by BRCA1 and BRCA2 pathogenic variant status, family history of breast cancer, menopausal status, and estrogen receptor-positive (ER+) breast cancer.We observed 618 incident invasive or in situ breast cancers over a median 12.9years. 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. Clarke, C. A., Hubbell, E., Kurian, A. W., Colditz, G. A., Hartman, A. R., Gomez, S. L. Abstract P5-03-02: Cancer risks associated with pathogenic variants in the ataxia telangiectasia mutated (ATM) gen. Hall, M., Larson, K., Bernhisel, R., Hughes, E., Rosenthal, E., Singh, N., Lancaster, J. M., Kurian, A. W. Pathogenic Variants in Breast Cancer Susceptibility Genes in Older Women-Reply. In all racial/ethnic groups, the models overpredicted in cases whose personal and family histories indicated >80% probability of carriage. Recently, a decline in breast cancer incidence was reported in the United States and several other developed countries, and a substantial reduction in menopausal hormone therapy use was proposed as a possible cause. This study is the next step in a larger research effort to In a multivariable model adjusted for age and subtype, there was no interaction between family history extent and PV prevalence for any gene except PALB2 (P = .037).Extent of family cancer history is not differentially associated with PVs across established breast cancer susceptibility genes and cannot be used to personalize genes selected for testing. Wapnir, I., Kurian, A. W., Lichtensztajn, D., Clarke, C. A., Gomez, S. Higher peripheral lymphocyte count to predict survival in triple-negative breast cancer (TNBC). Thomas Kurian, chief executive officer of Google Cloud, at the company's campus in Sunnyvale, California (Bloomberg) Thomas Kurian's changes have given momentum to Google Cloud and prompted . Scott, D. n., Friedman, S. n., Telli, M. L., Kurian, A. W. Modeling reductions in absolute cancer mortality from diagnosing cancers before metastasis, 2006-2015. PM at age 25 instead of age 40 offers minimal incremental benefit (1% to 2%); substituting screening for PM yields a similarly minimal decrement in survival (2% to 3%).Although PM at age 25 plus PO at age 40 years maximizes survival probability, substituting mammography plus MRI screening for PM seems to offer comparable survival. 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? His approach was validated by the unit's revenue growth last quarter of . Thirty-nine percent (95% CI, 36% to 41%) recalled hearing from a clinician that genetic discrimination is illegal. Kurian, A. W., Gong, G. D., John, E. M., Miron, A., Felberg, A., Phipps, A. I., West, D. W., Whittemore, A. S. Tailoring BRCAPRO to Asian-Americans IN REPLY. For more information, please contact Ashley Powell, (650) 724 - 3308. Other variables had negligible impact on disparity.While contextual, physical activity, body size, and comorbidity variables may influence breast cancer-specific mortality, they do not explain racial/ethnic mortality disparity.Other factors besides those investigated here may explain the existing racial/ethnic disparity in mortality. This study is about understanding the use of a genetic test (Myriad Genetics myRisk panel) [1] A Randomized, Phase 2, Neoadjuvant Study of Weekly Paclitaxel With or Without LCL161 in Patients With Triple Negative Breast Cancer. Lnning, P. E., Nikolaienko, O., Pan, K., Kurian, A. W., Eikesdal, H. P., Pettinger, M., Anderson, G. L., Prentice, R. L., Chlebowski, R. T., Knappskog, S. Incident comorbidities after tamoxifen or aromatase inhibitor therapy in a racially and ethnically diverse cohort of women with breast cancer. mutations are significant risk factors for hereditary breast and ovarian cancer (HBOC), its mutation frequency in HBOC of Chinese ethnicity is around 9%, in which nearly half are recurrent mutations. Powell, A. 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%. We used Cox regression to estimate risk associations with log-transformed weight and BMI after adjusting for underlying familial risk. Rodriguez, G. M., Ferguson, J. M., Kurian, A., Bondy, M., Patel, M. I. For Latinas, obesity was associated with more neighborhood crowding (Quartile 4 (Q4) vs. Q1: Odds Ratio (OR)=3.24; 95% Confidence Interval (CI): 1.50-7.00); breast cancer-specific mortality was inversely associated with neighborhood businesses (Q4 vs. Q1: Hazard Ratio (HR)=0.46; 95% CI: 0.25-0.85) and positively associated with multi-family housing (Q3 vs. Q1: HR=1.98; 95% CI: 1.20-3.26). Friese, C., Li, Y., Kurian, A. W., Katz, S. J. Jagsi, R. n., Ward, K. C., Abrahamse, P. H., Wallner, L. P., Kurian, A. W., Hamilton, A. S., Katz, S. J., Hawley, S. T. Association of Attending Surgeon With Variation in the Receipt of Genetic Testing After Diagnosis of Breast Cancer. A., Flaherty, P. J., Timms, K., Abkevich, V., Schackmann, E. A., Wapnir, I. L., Carlson, R. W., Chang, P., Sparano, J. Allison W. Kurian, M.D., M.Sc. Compared with IDC, CDH1 PVs were > 10-fold enriched, whereas PVs in BRCA1 were substantially reduced in ILC.The study establishes that PVs in ATM, BRCA2, CDH1, CHEK2, and PALB2 are associated with an increased risk of ILC, whereas BRCA1 PVs are not. 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. Data analyses were conducted using chi-square and t tests. Antimicrobial exposure during curative-intent treatment of triple-negative breast cancer (TNBC) may lead to gut microbiome dysbiosis, decreased circulating and tumor-infiltrating lymphocytes, and inferior outcomes. 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. 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). 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. Nine other genes were associated with a p-value, View details for DOI 10.1038/s42003-021-02990-6, Genome-wide association studies (GWAS) have identified multiple common breast cancer susceptibility variants. 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. For mutation carriers with moderate or extensive residual disease after neoadjuvant therapy, BRCA1/2 status was re-sequenced in the residual surgical breast tumor tissue.Nineteen patients had a deleterious germline BRCA1/2 mutation and 4 had moderate residual disease at surgery. Lopes Cardozo, J. M., Andrulis, I. L., Bojesen, S. E., Drk, T., Eccles, D. M., Fasching, P. A., Hooning, M. J., Keeman, R., Nevanlinna, H., Rutgers, E. J., Easton, D. F., Hall, P., Pharoah, P. D., van 't Veer, L. J., Schmidt, M. K. Contralateral Breast Cancer Risk Among Carriers of Germline Pathogenic Variants in ATM, BRCA1, BRCA2, CHEK2, and PALB2. Associations between sociodemographic and clinical factors and GCC receipt were examined.Most YAs were 35 to 39years old (51.2%) and partnered (56.4%); half had hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) tumors. All statistical tests were 2-sided. Emerging Opportunity of Cascade Genetic Testing for Population-Wide Cancer Prevention and Control. Breast cancer was the most common diagnosis (n=67; 21.5%). 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. These risk patterns did not differ by race/ethnicity (non-Latina white, African American, Latina, and Asian American). Breast cancer patients' misunderstanding of their systemic cancer recurrence risk has consequences on decision-making and quality of life. Among African American women, BC-specific mortality was higher among those treated at non-accredited hospitals (HR 1.57, CI 1.21-2.04) and those from lower SES neighborhoods (HR 1.48, CI 1.16-1.88) compared to NHW women without these characteristics. Screening with annual MRI starting at 35 years followed by annual mammography and MRI at 40 years was estimated to reduce breast cancer mortality by 54.4% (54.2%-54.7%) to 57.6% (57.2%-58.0%), with 4661 (4635-4688) to 5001 (4979-5023) false-positive screenings and 1280 (1272-1287) to 1368 (1362-1374) benign biopsies per 1000 women. We conclude that next-generation sequencing panel testing can provide results highly comparable to traditional testing and can uncover potentially actionable findings that may be otherwise missed. Letrozole in Treating Postmenopausal Women Who Have Received Hormone Therapy for Hormone Receptor-Positive Breast Cancer, Neratinib +/- Fulvestrant in Metastatic HER2 Non-amplified But HER2 Mutant Breast Cancer, Olaparib as Adjuvant Treatment in Patients With Germline BRCA Mutated High Risk HER2 Negative Primary Breast Cancer. "Uncertainty" and "family and personal history" were associated with overestimation, particularly for women with DCIS (75%; 84%). By modeling BRCA2-crisis invitro, we have derived insights into pre-neoplastic molecular alterations that may enhance the development of preventative therapies. Rates by gene did differ: in particular, a higher percentage of whites than nonwhites carried pathogenic CHEK2 variants (3.8% vs. 1.0%; P=0.002). Giving chemotherapy after surgery may kill any tumor cells that remain after surgery Somewhat higher uncertainty and distress were identified among carriers of high- and moderate-risk pathogenic variants, and lower levels were identified among those with a variant of uncertain significance or a negative result. Rapid HRM mutation screening for a panel of the founder mutations were developed and validated.In this study, our findings suggest that BRCA mutations account for a substantial proportion of hereditary breast/ovarian cancer in Southern Chinese population. 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). ", "New World Pioneers. View details for Web of Science ID 000236796400112. We identified de novo MBC patients from CCR and extracted information on distant recurrences from patient notes in EMR. As their father's career involved moving around India, the twins boarded at the Jesuit-run St Joseph's Boys High School in Bangalore. Kurian, A. W., Friese, C. R., Bondarenko, I. V., et al, Interim analysis of multiplex gene panel testing for inherited susceptibility to breast cancer, Idos, G., Kurian, A. W., McDonnell, K. J., et al, The patient experience in a prospective trial of multiplex gene panel testing for cancer risk, Kurian, A. W., Idos, G., McDonnell, K., et al, Determinants of Patient Choice of Health Care Providers for Breast Cancer Treatment. 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