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Linking electronic health records to better understand breast cancer patient pathways within and between two health systems. Yang, R. L., Kurian, A. W., Winton, L. M., Weill, D., Patel, K., Kingham, K., Wapnir, I. L. Validation of self-reported comorbidity status of breast cancer patients with medical records: the California Breast Cancer Survivorship Consortium (CBCSC). We used insurance claims data to understand how breast cancer incidence and treatment after diagnosis changed nationwide over the course of the pandemic.Using the Optum Research Database from January 2017 to March 2021, including approximately 19 million US adults with commercial health insurance, we identified new breast cancer diagnoses and first treatment after diagnosis. To characterize patients' treatment and survivorship experiences, we reported the tumor features and treatments associated with risk-reducing interventions; for example, in most BRCA2 mutation carriers (81%), MRI screening diagnoses stage I, hormone receptor-positive breast cancers, which may not require chemotherapy.Cancer risk-reducing options for BRCA1/2 mutation carriers vary in their impact on cancer incidence, recommended treatments, quality of life, and survival. Joint estimation of Single Nucleotide Polymorphism (SNP) effects in models could improve predictive performance over standard approaches of PRS construction. View details for DOI 10.1038/s41416-021-01432-8. Katz, S. J., Tocco, R., Hawley, S. T., An, L., Hodan, R., Ward, K. C., Kurian, A. W. Association of germline genetic testing results with chemotherapy regimens received by women with early-stage breast cancer. African American PV carriers had similarly elevated risks of CBC as non-Hispanic White PV carriers. Google Cloud CEO Thomas Kurian sent a memo to staff addressing the layoffs. Breast cancer incidence is higher among black women than white women before age 40 years, but higher among white women than black women after age 40 years (black-white crossover). Pathogenic variants in BARD1, RAD51C, and RAD51D were associated with increased risks of estrogen receptor-negative breast cancer and triple-negative breast cancer, whereas pathogenic variants in ATM, CDH1, and CHEK2 were associated with an increased risk of estrogen receptor-positive breast cancer. The sensitivity analyses yielded similar results and showed no strong evidence of pleiotropic effect.Our MR study provides supportive evidence for a potential causal association with breast cancer risk for lifetime smoking exposure but not cigarettes per day among smokers. Since 2019, I have served as general counsel for Rotary International District 5300. View details for DOI 10.1001/jamaoncol.2020.7995. Candidate polygenic risk scores (PRSs) as predictors of personal breast cancer history were developed through multivariable logistic regression models adjusted for age, cancer history, and ancestry. 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. Aredo, J. V., Luo, S. J., Gardner, R. M., Sanyal, N. n., Choi, E. n., Hickey, T. P., Riley, T. L., Huang, W. Y., Kurian, A. W., Leung, A. N., Wilkens, L. R., Robbins, H. A., Riboli, E. n., Kaaks, R. n., Tjnneland, A. n., Vermeulen, R. C., Panico, S. n., Le Marchand, L. n., Amos, C. I., Hung, R. J., Freedman, N. D., Johansson, M. n., Cheng, I. n., Wakelee, H. A., Han, S. S. A Population-Based Study of Genes Previously Implicated in Breast Cancer. These results may inform cancer risk counseling. This report presents a case involving a 35-year-old woman with no family history of breast or ovarian cancer who presented with a palpable right breast lump. The major limitation of this work was the small sample size, even pooling data from all 1059 studies. View details for Web of Science ID 000341349900011, View details for Web of Science ID 000336894600041, View details for Web of Science ID 000358613202339, View details for DOI 10.1200/jco.2014.32.15_suppl.6580, View details for Web of Science ID 000358613203765. ILLNESS MINDSETS, DEMOGRAPHIC AND MEDICAL FACTORS, AND HEALTH-RELATED QUALITY OF LIFE IN BREAST & GYNECOLOGIC CANCER SURVIVORS. evaluate the safety, tolerability, pharmacokinetics and feasibility of trastuzumab emtansine
Risk patterns were similar across race/ethnicity (non-Latina White, Latina, African American and Asian American), body size, menopausal status, and stage at diagnosis. ATM PVs are associated with multiple cancer risks and, while professional society guidelines support that carriers are eligible for increased breast and pancreatic cancer screening, increased screening for prostate and gastric cancer may also be warranted. View details for DOI 10.1038/s41598-021-99409-3, Given the high heterogeneity among breast tumors, associations between common germline genetic variants and survival that may exist within specific subgroups could go undetected in an unstratified set of breast cancer patients.We performed genome-wide association analyses within 15 subgroups of breast cancer patients based on prognostic factors, including hormone receptors, tumor grade, age, and type of systemic treatment. Self-reported race/ethnicity was 46% NHW, 41% Hispanic, 10% Asian, and 2% Black. Roberts, M. C., Kurian, A. W., Petkov, V. I. For a hypothetical cohort of 100,000 persons, we estimated cancer-related deaths under assumptions that cancers diagnosed at stage IV were diagnosed at earlier stages.Stage IV cancers represented 18% of all estimated diagnoses but 48% of all estimated cancer-related deaths within 5 years. Katz, S., Friese, C., Li, Y., Deapen, D., Hamilton, A., Ward, K., Kurian, A. W. Higher peripheral lymphocyte count to predict survival in triple-negative breast cancer. By modeling BRCA2-crisis invitro, we have derived insights into pre-neoplastic molecular alterations that may enhance the development of preventative therapies. We identified 1886 MBC patients, 512 (27.1%) of whom were de novo MBC patients and 1374 (72.9%) were recurrent MBC patients. 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). Since their inception in 2000, the Cancer Intervention and Surveillance Network (CISNET) breast cancer models have collaborated to use a nationally representative core of common input parameters to represent key components of breast cancer control in each model. This study evaluated breast and gynecologic cancer patients' subjective experiences of financial toxicity and associations with distress and quality of life (QOL).A cross-sectional survey study included measures of financial toxicity (Comprehensive Score for financial Toxicity [COST] Version 2), distress (Patient Health Questionnaire [PHQ-4]), and QOL (Functional Assessment of Cancer Therapy [FACT-G]). A second opinion from a medical oncologist may facilitate decision making for women with breast cancer, yet little is known about second opinion use.To investigate the patterns and correlates of second opinion use and the effect on chemotherapy decisions.A total of 1901 women newly diagnosed with stages 0 to II breast cancer between July 2013 and September 2014 (response rate, 71.0%) were accrued through 2 population-based Surveillance, Epidemiology, and End Results registries (Georgia and Los Angeles County, California) and surveyed about their experiences with medical oncologists, decision making, and chemotherapy use.Factors associated with second opinion use were evaluated using logistic regression. The CBCSC represents a large and racially/ethnically diverse cohort of breast cancer patients from California. Kurian, A. W., Hughes, E., Handorf, E. A., Gutin, A., Allen, B., Hartman, A. R., Hall, M. J. Pathogenic germline mutations in emerging cancer genes: What happens after panel testing? African-American women had superior breast cancer survival when receiving initial care in ACS hospitals versus other hospitals (non-ACS program and non-NCI-designated cancer center; hazard ratio, 0.67; 95% CI, 0.55 to 0.83). Furthermore, additional familial testing would be considered for those with first-degree relatives (42 [72%] of 58; 95% CI, 59.8%-82.2%) based on potential management changes for mutation-positive relatives. Thomas Kurian, chief executive officer of cloud services at Google LLC, speaks during the Google Cloud Next '19 event in San Francisco, California, U.S., on Tuesday, April 9, 2019. Molecular subtypes were categorized according to tumor expression of hormone receptor (HR, based on estrogen and progesterone receptors) and human epidermal growth factor receptor 2 (HER2). Thomas Kanjapalill Kurian, The American Board of Internal Medicine - Cardiovascular Disease, The American Board of Internal Medicine - Clinical Cardiac Electrophysiology provides Cardiac Electrophysiology care at Ascension in Austin, Texas. Women were identified through the population-based Surveillance Epidemiology and End Results registries of Los Angeles County and Georgia. Breast cancer is a common manifestation of an underlying genetic susceptibility to cancer, and 5% to 10% of all breast cancers are associated with a germline mutation in a known risk allele. Keegan, T. H., DeRouen, M. C., Press, D. J., Kurian, A. W., Clarke, C. A. Factors associated with mastectomy included tumor characteristics such as larger tumor size, patient characteristics such as older age and foreign birthplace among some Asian Americans ethnicities, and additional factors including hospital [smaller hospital size, not National Cancer Institute cancer center, low socioeconomic status (SES) patient composition, and high hospital Asian Americans patient composition] and neighborhood characteristics (ethnic enclaves of low SES). Gallagher, S., Hughes, E., Kurian, A. W., Domchek, S. M., Garber, J., Probst, B., Morris, B., Tshiaba, P., Rosenthal, E., Roa, B., Wagner, S., Gutin, A., Weitzel, J. N., Lanchbury, J., Robson, M. E. Development and validation of natural language processing (NLP) algorithm for detection of distant versus local breast cancer recurrence and metastatic site. The estimated relative contributions associated with screening vs treatment varied by molecular subtype: for ER+/ERBB2-, 36% (model range, 24%-50%) vs 64% (model range, 50%-76%); for ER+/ERBB2+, 31% (model range, 23%-41%) vs 69% (model range, 59%-77%); for ER-/ERBB2+, 40% (model range, 34%-47%) vs 60% (model range, 53%-66%); and for ER-/ERBB2-, 48% (model range, 38%-57%) vs 52% (model range, 44%-62%).In this simulation modeling study that projected trends in breast cancer mortality rates among US women, decreases in overall breast cancer mortality from 2000 to 2012 were associated with advances in screening and in adjuvant therapy, although the associations varied by breast cancer molecular subtype. View details for DOI 10.1200/JCO.2006.06.3081, View details for Web of Science ID 000244384000006. "He always looks back at Thomas and says, 'Thomas, what do you think? A larger screening trial is needed to determine which subgroups of high-risk women will benefit and whether the identification of malignant and high-risk lesions at an early stage will impact breast carcinoma incidence and mortality. We identified differentially expressed genes from 14 case-control human breast cancer gene expression datasets and integrated them with drug-protein networks. BRCA1/2 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. Some experts have called for the adaptation of the coverage framework to make it better equipped for assessing NGTS. Kurian, A. W., Ward, K. C., Abrahamse, P. n., Hamilton, A. S., Deapen, D. n., Morrow, M. n., Jagsi, R. n., Katz, S. J. Kurian, A. W., Lichtensztajn, D. Y., Keegan, T. H., Leung, R. W., Shema, S. J., Hershman, D. L., Kushi, L. H., Habel, L. A., Kolevska, T., Caan, B. J., Gomez, S. L. Novel BRCA1 and BRCA2 genomic rearrangements in Southern Chinese breast/ovarian cancer patients. Patients were included who: 1) had stages I-III breast cancer, either hormone receptor-positive and HER2-negative (HR-positive/HER2-negative) or triple-negative (TNBC), diagnosed in 2013-2017; 2) received chemotherapy; and 3) linked to genetic results. Johnson, N. n., Maguire, S. n., Morra, A. n., Kapoor, P. M., Tomczyk, K. n., Jones, M. E., Schoemaker, M. J., Gilham, C. n., Bolla, M. K., Wang, Q. n., Dennis, J. n., Ahearn, T. U., Andrulis, I. L., Anton-Culver, H. n., Antonenkova, N. N., Arndt, V. n., Aronson, K. J., Augustinsson, A. n., Baynes, C. n., Freeman, L. E., Beckmann, M. W., Benitez, J. n., Bermisheva, M. n., Blomqvist, C. n., Boeckx, B. n., Bogdanova, N. V., Bojesen, S. E., Brauch, H. n., Brenner, H. n., Burwinkel, B. n., Campa, D. n., Canzian, F. n., Castelao, J. E., Chanock, S. J., Chenevix-Trench, G. n., Clarke, C. L., Conroy, D. M., Couch, F. J., Cox, A. n., Cross, S. S., Czene, K. n., Drk, T. n., Eliassen, A. H., Engel, C. n., Evans, D. G., Fasching, P. A., Figueroa, J. n., Floris, G. n., Flyger, H. n., Gago-Dominguez, M. n., Gapstur, S. M., Garca-Closas, M. n., Gaudet, M. M., Giles, G. G., Goldberg, M. S., Gonzlez-Neira, A. n., Gunel, P. n., Hahnen, E. n., Haiman, C. A., Hkansson, N. n., Hall, P. n., Hamann, U. n., Harrington, P. A., Hart, S. N., Hooning, M. J., Hopper, J. L., Howell, A. n., Hunter, D. J., Jager, A. n., Jakubowska, A. n., John, E. M., Kaaks, R. n., Keeman, R. n., Khusnutdinova, E. n., Kitahara, C. M., Kosma, V. M., Koutros, S. n., Kraft, P. n., Kristensen, V. N., Kurian, A. W., Lambrechts, D. n., Le Marchand, L. n., Linet, M. n., Lubiski, J. n., Mannermaa, A. n., Manoukian, S. n., Margolin, S. n., Martens, J. W., Mavroudis, D. n., Mayes, R. n., Meindl, A. n., Milne, R. L., Neuhausen, S. L., Nevanlinna, H. n., Newman, W. G., Nielsen, S. F., Nordestgaard, B. G., Obi, N. n., Olshan, A. F., Olson, J. E., Olsson, H. n., Orban, E. n., Park-Simon, T. W., Peterlongo, P. n., Plaseska-Karanfilska, D. n., Pylks, K. n., Rennert, G. n., Rennert, H. S., Ruddy, K. J., Saloustros, E. n., Sandler, D. P., Sawyer, E. J., Schmutzler, R. K., Scott, C. n., Shu, X. O., Simard, J. n., Smichkoska, S. n., Sohn, C. n., Southey, M. C., Spinelli, J. J., Stone, J. n., Tamimi, R. M., Taylor, J. talazoparib (also known as BMN 673) in subjects with locally advanced or metastatic breast
View details for PubMedID 30289174. Wu, A. H., Kurian, A. W., Kwan, M. L., John, E. M., Lu, Y., Keegan, T. H., Gomez, S. L., Cheng, I., Shariff-Marco, S., Caan, B. J., Lee, V. S., Sullivan-Halley, J., Tseng, C., Bernstein, L., Sposto, R., Vigen, C. Next-generation sequencing for hereditary breast and gynecologic cancer risk assessment. 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%). Crymson Rose is the beautiful girlfriend of CeedDee Lamb. Such programs represent a major change to the financing and affordability of genetic testing. Women with germline BRCA1 and BRCA2 mutations have five- to 20-fold increased risks of developing breast and ovarian cancer. Between racial/ethnic groups, there are important differences in the spectrum of BRCA1 compared with BRCA2 mutations, in BRCA1/2 variants of uncertain significance, and in the accuracy of clinical models that predict BRCA1/2 mutation carriage.Given the significant prevalence of BRCA1/2 mutations across race/ethnicity, there is a need to expand and customize genetic counseling, genetic testing, and follow-up care for members of all racial/ethnic groups. B., John, E. M., Joseph, V. n., Konstantopoulou, I. n., Kurian, A. W., Kwong, A. n., Landucci, E. n., Lesueur, F. n., Loud, J. T., Machackova, E. n., Mai, P. L., Majidzadeh-A, K. n., Manoukian, S. n., Montagna, M. n., Moserle, L. n., Mulligan, A. M., Nathanson, K. L., Nevanlinna, H. n., Ngeow Yuen Ye, J. n., Nikitina-Zake, L. n., Offit, K. n., Olah, E. n., Olopade, O. I., Osorio, A. n., Papi, L. n., Park, S. K., Pedersen, I. S., Perez-Segura, P. n., Petersen, A. H., Pinto, P. n., Porfirio, B. n., Pujana, M. A., Radice, P. n., Rantala, J. n., Rashid, M. U., Rosenzweig, B. n., Rossing, M. n., Santamaria, M. n., Schmutzler, R. K., Senter, L. n., Simard, J. n., Singer, C. F., Solano, A. R., Southey, M. C., Steele, L. n., Steinsnyder, Z. n., Stoppa-Lyonnet, D. n., Tan, Y. Y., Teixeira, M. R., Teo, S. H., Terry, M. B., Thomassen, M. n., Toland, A. E., Torres-Esquius, S. n., Tung, N. n., van Asperen, C. J., Vega, A. n., Viel, A. n., Vierstraete, J. n., Wappenschmidt, B. n., Weitzel, J. N., Wieme, G. n., Yoon, S. Y., Zorn, K. K., McGuffog, L. n., Parsons, M. T., Hamann, U. n., Greene, M. H., Kirk, J. Methods of direct contact included telephone calls, letters, and e-mails; respective rates of genetic testing completion were 61% (95% CI, 51 to 70), 48% (95% CI, 37 to 59), and 48% (95% CI, 45 to 50).Most relatives at risk for hereditary cancer do not undergo cascade genetic counseling and testing, forgoing potentially life-saving medical interventions. Association results in European ancestry samples were compared to single-marker association results in the same cohort. Liu, J. n., Prager-van der Smissen, W. J., Colle, J. M., Bolla, M. K., Wang, Q. n., Michailidou, K. n., Dennis, J. n., Ahearn, T. U., Aittomki, K. n., Ambrosone, C. B., Andrulis, I. L., Anton-Culver, H. n., Antonenkova, N. N., Arndt, V. n., Arnold, N. n., Aronson, K. J., Augustinsson, A. n., Auvinen, P. n., Becher, H. n., Beckmann, M. W., Behrens, S. n., Bermisheva, M. n., Bernstein, L. n., Bogdanova, N. V., Bogdanova-Markov, N. n., Bojesen, S. E., Brauch, H. n., Brenner, H. n., Briceno, I. n., Brucker, S. Y., Brning, T. n., Burwinkel, B. n., Cai, Q. n., Cai, H. n., Campa, D. n., Canzian, F. n., Castelao, J. E., Chang-Claude, J. n., Chanock, S. J., Choi, J. Y., Christiaens, M. n., Clarke, C. L., Couch, F. J., Czene, K. n., Daly, M. B., Devilee, P. n., Dos-Santos-Silva, I. n., Dwek, M. n., Eccles, D. M., Eliassen, A. H., Fasching, P. A., Figueroa, J. n., Flyger, H. n., Fritschi, L. n., Gago-Dominguez, M. n., Gapstur, S. M., Garca-Closas, M. n., Garca-Senz, J. Specifically, we determined that 1) the state or regional cancer registry makes the most efficient starting point for determining inclusion of subjects; 2) the data dictionary should be based on existing registry standards, such as Surveillance, Epidemiology and End Results (SEER), when applicable; 3) the Social Security Administration Death Master File (SSA DMF), rather than clinical resources, provides standardized ascertainment of mortality outcomes; and 4) CER database development efforts, despite the immediate availability of electronic data, may take as long as two years to produce validated, reliable data for research. For more information, please contact Naheed Mangi, 650-723-0658. 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