The methodology can help identify positive deviants (who have developed best practices) delivering high-value care. View details for DOI 10.6004/jnccn.2021.7081, With increased adoption of multi-gene panel testing (MGPT) for hereditary cancer, management guidelines now include a wider range of predisposition genes. John, E. M., McGuire, V. n., Kurian, A. W., Koo, J. n., Shariff-Marco, S. n., Gomez, S. L., Cheng, I. n., Keegan, T. H., Kwan, M. L., Bernstein, L. n., Vigen, C. n., Wu, A. H. Development and Validation of a Clinical Polygenic Risk Score to Predict Breast Cancer Risk. Real-world outcomes of patients with metastatic breast cancer (BC) treated with osteoclast inhibitors (OIs). Second breast cancers are rare, and their reduction should be weighed against the harms associated with BLM. Women who test positive for an inherited pathogenic/likely pathogenic gene variant in BRCA1, BRCA2, PALB2, CHEK2 and ATM are at an increased risk of developing certain types of cancer-specifically breast (all) and epithelial ovarian cancer (only BRCA1, BRCA2, PALB2). Population-based estimates of the risk of breast cancer associated with germline pathogenic variants in cancer-predisposition genes are critically needed for risk assessment and management in women with inherited pathogenic variants.In a population-based case-control study, we performed sequencing using a custom multigene amplicon-based panel to identify germline pathogenic variants in 28 cancer-predisposition genes among 32,247 women with breast cancer (case patients) and 32,544 unaffected women (controls) from population-based studies in the Cancer Risk Estimates Related to Susceptibility (CARRIERS) consortium. Patients with low numeracy reported less discussion. Data on screening performance for mammography and MRI were estimated from published literature. 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. Family cancer history is an important component of genetic testing guidelines that estimate which patients with breast cancer are most likely to carry a germline pathogenic variant (PV). 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. For more information, please contact Pei-Jen Chang, (650) 725 - 0866. Among LEP subgroups, Spanish speakers were significantly less likely to engage with the patient portal compared with English speakers (estimated difference in monthly rate: OR, 0.43; 95% CI, 0.24 to 0.77).We found that patients with LEP had lower rates of clinical trial engagement and odds of electronic patient portal enrollment. Multiplex gene panel testing (MGPT) allows for the simultaneous analysis of germline cancer susceptibility genes. On this Wikipedia the language links are at the top of the page across from the article title. We observed 99.8% net report concordance, albeit with a slightly higher variant of uncertain significance rate. Schackmann, E. A., Munoz, D. F., Mills, M. A., Plevritis, S. K., Kurian, A. W. Information technology interventions to improve cancer care: a report from the American Society of Clinical Oncology Quality Care Symposium. Most participants (92%) had a total MICRA score 38, which corresponded to a mean response of "never," "rarely," or only "sometimes" reacting negatively to results. The Accuracy of BRCA1/2 Mutation Prediction Models in Different Ethnicity and Gender: Experience in a Chinese Cohort, Kwong, A., Wong, C., Suen, D., Choi, C., Wong, C., Law, F., Kurian, A. W., et al, A High Percentage of Triple Negative Tumors Present as Palpable Masses. There was an inverse association between PIK3CA kinase domain mutations and progression (Odds Ratio [OR] 10.2, p, View details for DOI 10.1007/s10549-019-05401-x. Stanford is currently not accepting patients for this trial. Multi-step processing, including deep-learning-based segmentation, revealed variability in the composition of tumor-immune populations across individuals, reconciled by overall immune infiltration and enriched co-occurrence of immune subpopulations and checkpoint expression. We investigated body size and survival by race/ethnicity in 11,351 breast cancer patients diagnosed from 1993 to 2007 with follow-up through 2009 by using data from questionnaires and the California Cancer Registry. MacInnis, R. J., Knight, J. She is also a clinically active oncologist, treating patients diagnosed with breast cancer. The vectorized reports were utilized to train a supervised classifier to derive the BI-RADS assessment class. For women whose first breast tumors were HR negative, the risk of a contralateral primary tumor was statistically significantly higher than that for women whose first tumors were HR positive (SIR = 3.57, 95% CI = 3.38 to 3.78, AR = 18 per 10 000 PY), and it was associated with a much greater likelihood of an HR-negative second tumor (SIR for HR-positive second tumors = 1.94, 95% CI = 1.77 to 2.13, AR = 20 per 10 000 PY; SIR for HR-negative second tumors = 9.81, 95% CI = 9.00 to 10.7, AR = 24 per 10 000 PY). Carneal, E., Lichtensztajn, D., Clarke, C., Gomez, S., Jensen, K., Kurian, A. W., Allison, K. Multiple-Gene Panels and the Future of Genetic Testing, Genetic/Familial High-Risk Assessment: Breast and Ovarian, Version 1.2014. cancer with a deleterious germline BRCA 1 or BRCA 2 mutation. Inclusion of genetic ancestry in polygenic risk prediction presents an opportunity for more personalized treatment decisions for women of varying and mixed ancestries. She is also a clinically active oncologist, treating patients diagnosed with breast cancer. View details for PubMedCentralID PMC3867595. Idos, G., Kurian, A. W., Ricker, C., Sturgeon, D., Culver, J., Lowstuter, K., Hartman, A., Allen, B., Kingham, K., Koff, R., Rowe-Teeter, C., Chun, N. M., Mills, M., Petrovchich, I., Hong, C., Kidd, J., McDonnell, K., Ladabaum, U., Ford, J. M., Gruber, S. B. Factors associated with 21-gene assay receipt among women with lymph node positive breast cancer. de Bruin, M. A., Kwong, A., Goldstein, B. 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. Annual MRI starting at 30 years followed by mammography and MRI at 40 years was estimated to reduce mortality by 55.4% (55.3%-55.4%) to 59.5% (58.5%-60.4%), with 5075 (5057-5093) to 5415 (5393-5437) false-positive screenings and 1439 (1429-1449) to 1528 (1517-1538) benign biopsies per 1000 women. Approximately 1% to 3% of all gastric cancers are associated with families exhibiting an autosomal dominant pattern of susceptibility. We developed a natural language processing (NLP) system to identify patient-specific timelines of metastatic breast cancer recurrence.We used the OncoSHARE database, which includes merged data from the California Cancer Registry and EMRs of 8,956 women diagnosed with breast cancer in 2000 to 2018. Statin use and all-cancer mortality: Prospective results from the Women's Health Initiative. This was evident for women with a first-degree family history of breast cancer (HR=0.68, 95% CI: 0.50-0.93), women without BRCA1 or BRCA2 pathogenic variants (HR=0.71, 95% CI: 0.53-0.95), postmenopausal women (HR=0.63, 95% CI: 0.44-0.89), and for risk of ER+breast cancer (HR=0.63, 95% CI: 0.40-0.98).Adherence to the 2020 ACS Guideline recommendations for BMI, physical activity, and alcohol consumption could reduce breast cancer risk for postmenopausal women and women at increased familial risk. B., Kurian, A. W., Domchek, S., Garber, J., Lancaster, J. M., Weitzel, J., Gutin, A., Lanchbury, J. S., Robson, M. Is Breast Cancer in Asian and Asian American Women a Different Disease? Also surveyed were 488 attending surgeons identified by the patients.The study examined the association of surgeon with variation in the receipt of genetic testing using information from patient and surgeon surveys merged to Surveillance, Epidemiology, and End Results and genetic testing data obtained from 4 laboratories.In total, 5080 women (69.6%) of 7303 who were eligible (mean [SD] age, 61.4 [0.8] years) and 377 surgeons (77.3%) of 488 (mean [SD] age, 53.8 [10.7] years) responded to the survey. Hormone therapy using View details for DOI 10.1038/s41586-021-03779-7. Surveys were linked to SEER clinical data and genetic test results. 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. Kurian was responsible for the Oracle Fusion Middleware family of products. New strategies for cancer genetic risk assessment include multiplex sequencing panels of 5 to more than 100 genes (in which rare mutations are often associated with at least two times the average risk of developing breast cancer) and panels of common single-nucleotide polymorphisms (SNPs), combinations of which are generally associated with more modest cancer risks (more than twofold). More whites than Asians had breastfed (71 vs. 42%, p=0.005), had high BMI (median 24.3 vs. 21.2, p=0.04), consumed alcohol (2 drinks/week vs. 0, p, View details for DOI 10.1007/s10689-012-9531-9. However, she will continue working with Mr. Kurianthrough January to ensure a smooth transition. View details for DOI 10.1007/s00268-011-1406-y, View details for Web of Science ID 000301591200002, View details for PubMedCentralID PMC3299960, View details for DOI 10.1200/JCO.2011.40.9938, View details for Web of Science ID 000302631300026. Measures included the Illness Mindset Questionnaire and Functional Assessment of Cancer Therapy-General (FACT-G).Two hundred seventy-three survivors (74% breast/26% gynecologic) who were on average 3.9 years post-diagnosis (SD = 4.2), Mage 55 (SD = 12) completed the survey (response rate 80%). Approximately 28% had a high school education or less, and 23% were non-English-speaking. Research suggests that adherence to the 2012 ACS Guideline might lower breast cancer risk, but there is limited evidence that this applies to women at increased familial and genetic risk of breast cancer.Using the Breast Cancer Family Registry (BCFR), a cohort enriched for increased familial and genetic risk of breast cancer, we examined adherence to three 2020 ACS Guideline recommendations (weight management (body mass index), physical activity, and alcohol consumption) with breast cancer risk in 9615 women. View details for DOI 10.1007/s11864-017-0468-y, View details for Web of Science ID 000455441000079, View details for DOI 10.1200/JCO.2017.35.8_suppl.160, View details for Web of Science ID 000443301600159. 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. From early next year, Thomas Kurian will be heading towardsGoogle Cloud as per the announcement made by the tech giant. In conclusion, the use of laboratories with payment assistance programs reduces barriers to NGS panel testing among diverse populations. However, only a small proportion of their variance is explained by identified genetic variants.We conducted a genome-wide association study, as well as a transcriptome-wide association study (TWAS), of age- and BMI-adjusted DA, NDA, and PMD in up to 27,900 European-ancestry women from the MODE/BCAC consortia.We identified 28 genome-wide significant loci for MD phenotypes, including nine novel signals (5q11.2, 5q14.1, 5q31.1, 5q33.3, 5q35.1, 7p11.2, 8q24.13, 12p11.2, 16q12.2). View details for DOI 10.1056/NEJMoa2005936, View details for DOI 10.1200/CCI.21.00145. In all racial/ethnic groups, the models overpredicted in cases whose personal and family histories indicated >80% probability of carriage. Study Evaluating Efficacy And Tolerability Of Veliparib in Combination With Temozolomide (TMZ) or In Combination With Carboplatin and Paclitaxel Versus Placebo in Participants With Breast Cancer Gene (BRCA)1 and BRCA2 Mutation and Metastatic Breast Cancer. Breast Cancer Screening Strategies for Women With ATM, CHEK2, and PALB2 Pathogenic Variants: A Comparative Modeling Analysis. Breast Cancer Polygenic Risk Score and Contralateral Breast Cancer Risk, Kramer, I., Hooning, M. J., Mavaddat, N., Hauptmann, M., Keeman, R., Steyerberg, E. W., Giardiello, D., Antoniou, A. C., Pharoah, P. P., Canisius, S., Abu-Ful, Z., Andrulis, I. L., Anton-Culver, H., Aronson, K. J., Augustinsson, A., Becher, H., Beckmann, M. W., Behrens, S., Benitez, J., Bermisheva, M., Bogdanova, N., Bojesen, S. E., Bolla, M. K., Bonanni, B., Brauch, H., Bremer, M., Brucker, S. Y., Burwinkel, B., Castelao, J. E., Chan, T. L., Chang-Claude, J., Chanock, S. J., Chenevix-Trench, G., Choi, J., Clarke, C. L., Collee, J., Couch, F. J., Cox, A., Cross, S. S., Czene, K., Daly, M. B., Devilee, P., Dork, T., dos-Santos-Silva, I., Dunning, A. M., Dwek, M., Eccles, D. M., Evans, D., Fasching, P. A., Flyger, H., Gago-Dominguez, M., Garcia-Closas, M., Garcia-Saenz, J. Clarke, C. A., Hubbell, E., Hartman, A., Colditz, G., Kurian, A. W., Gomez, S. L. Clinical and pathological features of breast cancer among men and women with ATM and CDH1 mutations. Breast cancer is the most frequently diagnosed malignancy in women in the United States and is second only to lung cancer as a cause of cancer death. View details for DOI 10.1200/JOP.19.00221, The detection rate of breast ductal carcinoma in situ (DCIS) has increased significantly, raising the concern that DCIS is overdiagnosed and overtreated. A., Holleczek, B., Hollestelle, A., Hooning, M. J., Hoover, R. N., Hopper, J. L., Howell, A., Jakimovska, M., Jakubowska, A., John, E. M., Jones, M. E., Jung, A., Kaaks, R., Kauppila, S., Keeman, R., Khusnutdinova, E., Kitahara, C. M., Ko, Y. D., Koutros, S., Kristensen, V. N., Krger, U., Kubelka-Sabit, K., Kurian, A. W., Kyriacou, K., Lambrechts, D., Lee, D. G., Lindblom, A., Linet, M., Lissowska, J., Llaneza, A., Lo, W. Y., MacInnis, R. J., Mannermaa, A., Manoochehri, M., Margolin, S., Martinez, M. E., McLean, C., Meindl, A., Menon, U., Nevanlinna, H., Newman, W. G., Nodora, J., Offit, K., Olsson, H., Orr, N., Park-Simon, T. W., Patel, A. V., Peto, J., Pita, G., Plaseska-Karanfilska, D., Prentice, R., Punie, K., Pylks, K., Radice, P., Rennert, G., Romero, A., Rdiger, T., Saloustros, E., Sampson, S., Sandler, D. P., Sawyer, E. J., Schmutzler, R. K., Schoemaker, M. J., Schttker, B., Sherman, M. E., Shu, X. O., Smichkoska, S., Southey, M. C., Spinelli, J. J., Swerdlow, A. J., Tamimi, R. M., Tapper, W. J., Taylor, J. Chemotherapy details were extracted from SEER text fields completed by registrars. This study aimed to estimate ATM PV cancer risks independent of family cancer history. The authors assessed the frequency and severity of toxicities; correlated toxicity severity with unscheduled health care use (clinic visits, emergency department visits/hospitalizations) and physical health; and examined patient, tumor, and treatment factors associated with reporting increased toxicity severity.The overall survey response rate was 71%. Women with a longer history of comorbidity or who took medications for the comorbidity were more likely to report the condition. HLA alleles (n=175) with info scores greater than 0.8 and frequencies greater than 0.01 were included (resolution at two-digit level: 71; four-digit level: 104). either Cohort 1 or 2 based on prior chemotherapy for metastatic disease: Lincoln, S. E., Nussbaum, R. L., Kurian, A. W., Nielsen, S. M., Das, K. n., Michalski, S. n., Yang, S. n., Ngo, N. n., Blanco, A. n., Esplin, E. D. Abstract P6-08-02: 21-gene recurrence score results according to germline pathogenic variants in BRCA1, BRCA2, PALB2, ATM, CHEK2 and Lynch Syndrome genes. The common input data are updated for each analysis to ensure that they reflect the most current practice and knowledge about breast cancer. will receive pertuzumab and trastuzumab administered sequentially as separate intravenous Women who mentioned at least one clinical experience factor were significantly less likely to overestimate their risk (12% v. 43%, P < 0.001). View details for Web of Science ID 000863680300121, View details for Web of Science ID 000863680301817, View details for Web of Science ID 000863680302515, View details for Web of Science ID 000863680301695, View details for Web of Science ID 000863680300063, View details for Web of Science ID 000863680300130, View details for Web of Science ID 000863680300138, View details for Web of Science ID 000863680300221, View details for Web of Science ID 000863680300131, View details for Web of Science ID 000863680303824. Doctor-patient communication is the primary way for women diagnosed with breast cancer to learn about their risk of distant recurrence. Overall survival and time to next treatment were evaluated. 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. Results were similar for breast cancer-specific survival, except that African Americans and non-Hispanic Whites living in high-SES neighborhoods had similar survival.Strategies to address the underlying factors that may influence treatment intensity and adherence, such as comorbidities and logistical barriers, should be targeted at low-SES non-Hispanic White and all African American patients. In this report, we describe a natural language processing (NLP) framework that uses data from free-text, unstructured reports to classify recurrence status and sites of recurrence for patients with breast and hepatocellular carcinomas (HCC).Using two cohorts of breast cancer and HCC cases, we validated the ability of a previously developed NLP model to distinguish between no recurrence, local recurrence, and distant recurrence, based on clinician notes, radiology reports, and pathology reports compared with manual curation. Incidence rates for any contralateral primary cancer following an HR-negative or HR-positive tumor were higher in non-Hispanic blacks, Hispanics, and Asians or Pacific Islanders than in non-Hispanic whites.Risk for contralateral second primary breast cancers varies substantially by HR status of the first tumor, age, and race and/or ethnicity. 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). We provide algebraic justification for several generalizations of standard sequential regression multiple imputation using Taylor series and other approximations of the target imputation distribution under missingness not at random. investigation of molecular predictors of drug efficacy. Ordered immune structures along the tumor-immune border were associated with compartmentalization and linked to survival. The following two clinical benefits emerged: (1) reduced anxiety among care partners who use the app and (2) the potential for identifying survivor symptoms noted by the care partner, which might prevent adverse events.ClinicalTrials.gov NCT04018677; https://clinicaltrials.gov/ct2/show/NCT04018677. Results are moderately sensitive to variation in breast cancer survival rates and trastuzumab cost, and less sensitive to variations in cardiac toxicity.AT has an ICER comparable to those for other widely used interventions. Other hospital characteristics were not associated with survival.African American women may benefit significantly from breast cancer care in ACS program hospitals; however, most did not receive initial care at such facilities. The indications for testing and utility of these 2 tests differ, and guidelines recommend that germline analysis follow tumor sequencing in certain patients to determine whether particular variants are of somatic or germline origin. The associations of race/ethnicity, education, and neighborhood SES (nSES) with all-cause and BC-specific mortality were assessed among 9372 women with BC (diagnosed 1993-2007 in California with follow-up through 2010) from four racial/ethnic groups [African American, Asian American, Latina, and non-Latina (NL) White] using Cox proportional hazards models. A recent study claimed that women testing negative for their family-specific BRCA1 or BRCA2 mutation (noncarriers) have a five-fold increased risk of breast cancer. All odds ratios (ORs) were adjusted for age, country of origin, and calendar year of the first interview.Among the 6902 men in the study (median [range] age, 51.6 [18-100] years), 1634 cancers were diagnosed in 1376 men (19.9%), the majority (922 of 1,376 [67%]) being BRCA2 PV carriers. "This was a population-based cohort survey study of 7303 eligible women ages 20 to 79 years with stage I and II breast cancer diagnosed in 2013 to 2015 and identified from the Georgia and Los Angeles County, California, Surveillance, Epidemiology, and End Results registries. However, significant controversy remains as to the timing, causes, generalizability, and longevity of this reported decline in incidence. These risk patterns did not differ by race/ethnicity (non-Latina white, African American, Latina, and Asian American). metastatic disease with disease progression > 8 weeks following the last dose of Kurian, A. W., Idos, G., Culver, J., Ricker, C., Koff, R., Sturgeon, D., Lowstuter, K., Hartman, A., Allen, B., Kidd, J., Rowe-Teeter, C., Kingham, K., Chun, N. M., Petrovchich, I., Mills, M., Hong, C., McDonnell, K., Ladabaum, U., Ford, J. M., Gruber, S. B. Over the past several decades, the disease's incidence has risen worldwide, increasing in developing and developed countries. However, he is an expert when it comes to his married life, wife and even children. B., Sulem, P., Walters, R. G., Terao, C., Turon, S., Horikoshi, M., Lin, K., Onland-Moret, N. C., Sankar, A., Hertz, E. P., Timshel, P. N., Shukla, V., Borup, R., Olsen, K. W., Aguilera, P., Ferrer-Roda, M., Huang, Y., Stankovic, S., Timmers, P. R., Ahearn, T. U., Alizadeh, B. The investigators Each imaging subtype was associated with specific dysregulated molecular pathways that can be therapeutically targeted.Imaging subtypes provide complimentary value to established histopathological or molecular subtypes, and may help stratify breast cancer patients. A., Flaherty, P. J., Timms, K., Abkevich, V., Schackmann, E. A., Wapnir, I. L., Carlson, R. W., Chang, P., Sparano, J. Silvestri, V. n., Leslie, G. n., Barnes, D. R., Agnarsson, B.