All but three, were identified in general population studies. Classifications based on remaining lifetime risk were inferior to 5-year risk estimates. Associated breast and ovarian cancer risks ranged from two- to 40-fold after controlling for family history. Intensive screening is an alternative to prophylactic mastectomy in women at high risk for developing breast carcinoma. Gallagher, S., Hughes, E., Kurian, A. W., Domchek, S. M., Garber, J., Probst, B., Morris, B., Tshiaba, P., Meek, S., Rosenthal, E., Roa, B., Slavin, T. P., Wagner, S., Weitzel, J., Gutin, A., Lanchbury, J. S., Robson, M. Performance of the IBIS/Tyrer-Cuzick model of breast cancer risk by race and ethnicity in the Women's Health Initiative. Information regarding NAC, adjuvant chemotherapy (aCT), breast conserving surgery (BCS), bilateral mastectomy (BLM), and unilateral mastectomy (ULM) was abstracted from the medical records. Among RS recipients, chemotherapy receipt was associated with a higher score (intermediate v low: odds ratio, 3.66; 95% CI, 1.94 to 6.91). Two regression models tested associations between financial toxicity and distress and QOL, controlling for covariates. Existing research examining barriers to addressing patients' sexual health concerns has focused on discrete characteristics of the provider-patient interaction without considering the broader context in which these interactions occur. Participants trastuzumab or endocrine therapy) of particular subtypes of breast cancer among African-American patients. Women with a longer history of comorbidity or who took medications for the comorbidity were more likely to report the condition. I lead epidemiologic studies of cancer risk factors, clinical trials of novel approaches to cancer risk reduction, and decision analyses of strategies to optimize cancer outcomes. Zeidman, A., Benedict, C., Tolby, L., Zion, S., Fisher, S., Kurian, A. W., Berek, J. S., Woldeamanuel, Y., Schapira, L., Palesh, O. Attributes of the neighborhood environment were associated with obesity and mortality following breast cancer diagnosis, but these associations differed across racial/ethnic groups. Given the poor prognosis and high treatment costs of HER2-positive breast cancer, our results have implications for healthcare resource utilization, cancer biology, and clinical care. in Mathematical Science from McMaster University, Canada. Tamoxifen was associated with a lower risk of osteoporosis than AI (multivariable HR 0.45, 95% CI 0.32-0.62). View details for DOI 10.1016/j.gygno.2004.10.037, View details for Web of Science ID 000226636600041. Daly, M. B., Pilarski, R. n., Yurgelun, M. B., Berry, M. P., Buys, S. S., Dickson, P. n., Domchek, S. M., Elkhanany, A. n., Friedman, S. n., Garber, J. E., Goggins, M. n., Hutton, M. L., Khan, S. n., Klein, C. n., Kohlmann, W. n., Kurian, A. W., Laronga, C. n., Litton, J. K., Mak, J. S., Menendez, C. S., Merajver, S. D., Norquist, B. S., Offit, K. n., Pal, T. n., Pederson, H. J., Reiser, G. n., Shannon, K. M., Visvanathan, K. n., Weitzel, J. N., Wick, M. J., Wisinski, K. B., Dwyer, M. A., Darlow, S. D. Germline HOXB13 mutations p.G84E and p.R217C do not confer an increased breast cancer risk. pertuzumab and trastuzumab in separate infusion bags, followed by vinorelbine. Crymson Rose is the beautiful girlfriend of CeedDee Lamb. Caswell-Jin, J. L., Shafaee, M. N., Xiao, L., Liu, M., John, E. M., Bondy, M. L., Kurian, A. W. Relevance of the MHC region for breast cancer susceptibility in Asians. steroidal aromatase inhibitors (NSAI). These results suggest a potential benefit of genetic counseling and testing for pathogenic variants in less familiar genes. In breast cancer, high levels of homeobox protein Hox-B13 (HOXB13) have been associated with disease progression of ER-positive breast cancer patients and resistance to tamoxifen treatment. To search for additional genetic susceptibility loci for breast cancer, here we perform a meta-analysis of data from genome-wide association studies (GWAS) conducted in Asians (24,206 cases and 24,775 controls) and European descendants (122,977 cases and 105,974 controls). However, only one half (50.6%) of those not tested received any discussion about genetics. Little is known about differences in risk for second primary breast cancers related to the estrogen and progesterone receptor (hormone receptor [HR]) status of the first tumor.We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for contralateral primary breast cancers among 4927 women diagnosed with a first breast cancer between January 1, 1992, and December 31, 2004, using the National Cancer Institute's Surveillance, Epidemiology, and End Results database.For women whose first breast tumors were HR positive, risk of contralateral primary breast cancer was elevated, compared with the general population, adjusted for age, race, and calendar year (SIR = 2.22, 95% CI = 2.15 to 2.29, absolute risk [AR] = 13 cases per 10 000 person-years [PY]), and was not related to the HR status of the second tumor. Culver, J. O., Ricker, C. N., Bonner, J. n., Kidd, J. n., Sturgeon, D. n., Hodan, R. n., Kingham, K. n., Lowstuter, K. n., Chun, N. M., Lebensohn, A. P., Rowe-Teeter, C. n., Levonian, P. n., Partynski, K. n., Lara-Otero, K. n., Hong, C. n., Morales Pichardo, J. n., Mills, M. A., Brown, K. n., Lerman, C. n., Ladabaum, U. n., McDonnell, K. J., Ford, J. M., Gruber, S. B., Kurian, A. W., Idos, G. E. Patterns of social media use and associations with psychosocial outcomes among breast and gynecologic cancer survivors. Studies on specific cancer types in relation to cancer use have also been mixed, though the most promising results appear to be found in gastrointestinal cancers. Ultimately, 1466 women (61.6%) received BCS, 508 (21.2%) underwent UM, and 428 (17.3%) received CPM. When Thomas Kurian was appointed president at Oracle, chairman Larry Ellison wrote in an email to employees: "He (Thomas Kurian) has a long track record of developing suites of software products that go to achieve pre-eminent success in the marketplace." It can't get more identical than this. Two-fold increased risks were associated with migration at age 40 years and longer U.S. residence (30 years or 75% of life). Purpose Genetic testing for breast cancer risk is evolving rapidly, with growing use of multiple-gene panels that can yield uncertain results. Clinician estimates of systemic recurrence risk were provided for patient sub-groups with DCIS and with low-, intermediate-, and high-risk invasive disease. 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. Trends in germline genetic testing and results into survivorship for women diagnosed with breast cancer or ovarian cancer, 2013 to 2017. this test of genetic testing. Liang, S., Richardson, M., Chen, T., Colocci, N., Kurian, A., de Briun, M., Chan, C., Chan, J. Twenty-one-gene recurrence score (RS) in germline (g)CHEK2 mutation-associated versus sporadic breast cancers (BC): A multi-site case-control study. We investigate the relevance of the major histocompatibility complex region in breast cancer susceptibility, using imputed class I and II HLA alleles, in 25,484 women of Asian ancestry.A total of 12,901 breast cancer cases and 12,583 controls from 12 case-control studies were included in our pooled analysis. White, D. P., Kurian, A. W., Stevens, J. L., Liu, B., Brest, A. E., Petkov, V. I. Effect sizes, expressed as standardized odds ratios (ORs) with 95% CIs, were assessed for carriers of PVs in each gene as well as for noncarriers.The median age at hereditary cancer testing of the population was 48 years (range, 18-84 years); there were 141160 noncarriers in addition to carriers of BRCA1 (n=2249), BRCA2 (n=2638), CHEK2 (n=2564), ATM (n=1445), and PALB2 (n=906) PVs included in the analysis. Sensitivity analyses tested a 15-year time horizon and alternative assumptions.Extending tamoxifen therapy duration among women ages 25-49 reduced the lifetime probability of breast cancer death from 11.9% to 9.3% (absolute difference 2.6%). Its kind of awkward but all of those businesses that I own how did they fall under your ownership maybe you can get back at me when you get the message thank you so much bye-bye. For African Americans, lower neighborhood SES was associated with lower mortality in a nonlinear fashion. HER2 mutated cancer responds to treatment with neratinib. Little is known about neighborhood attributes that may influence opportunities for healthy eating and physical activity in relation to breast cancer mortality. Kurian, A. W., Ward, K. C., Hamilton, A. S., Deapen, D. M., Abrahamse, P., Bondarenko, I., Li, Y., Hawley, S. T., Morrow, M., Jagsi, R., Katz, S. J. There are no treatments specifically approved after recurrence or progression on a non View details for DOI 10.1007/s11764-019-00820-7. Model inputs were derived from clinical trials, large US cohort studies, registry, and claims data. 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. Out of the total compensation, he received $800,000 as a salary, $3,612,553 as a bonus, $69,380,000 as stock options, and $7,337 from other types of compensation. 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. Triple-negative breast cancer is associated with a young age at diagnosis and both African and Ashkenazi Jewish ancestry, the latter due to three common founder mutations in the highly penetrant cancer susceptibility genes BRCA1 and BRCA2 (BRCA1/2). These NCCN Guidelines Insights summarize the panel's discussion and most recent recommendations regarding criteria for high-penetrance genes associated with breast and ovarian cancer beyond BRCA1/2, pancreas screening and genes associated with pancreatic cancer, genetic testing for the purpose of systemic therapy decision-making, and testing for people with Ashkenazi Jewish ancestry. View details for DOI 10.1001/jamaoncol.2016.5652, View details for Web of Science ID 000397491400018. The current trial, BNIT-BR-003, will evaluate the safety and biological activity of a fixed Fourteen participants carried 15 pathogenic variants, warranting a possible change in care; they were invited for targeted screening recommendations, enabling early detection and removal of a tubular adenoma by colonoscopy. BRCA1/2 sequencing of residual tissue was performed on three patients. Here, weestablish an invitro model for BRCA2-crisis that demonstrates chromatin remodeling and activation of an NF-B survival pathway in response to transient BRCA2 depletion. Rising Bilateral Mastectomy Rates Among Neoadjuvant Chemotherapy Recipients in California From 1998 to 2012. 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). Ling, A. Y., Kurian, A. W., Caswell-Jin, J. L., Sledge, G. W., Shah, N. H., Tamang, S. R. Can precision medicine help achieve the goal of reducing care when the risks exceed the benefits? Mendelian randomisation (MR) assesses causality by simulating randomised trial groups using genotype. B., Zhou, R., Kozlov, A., DeMartini, W., Chen, S., Okamoto, S., Ikeda, D. M., Mattonen, S. A., Napel, S., Alkim, E., Sledge, G. W., Kurian, A. W., Liu, M., Telli, M. L., Itakura, H. Harnessing artificial intelligence to automate delineation of volumetric breast cancers from magnetic resonance imaging to improve tumor characterization. CTRL + SPACE for auto-complete. Both individual-level data as well as summary statistics for 164 single-nucleotide polymorphisms (SNPs) reported in genome-wide association studies of lifetime smoking index (LSI) or cigarette per day (CPD) were used to obtain MR effect estimates. Keegan, T. H., Press, D. J., Tao, L., DeRouen, M. C., Kurian, A. W., Clarke, C. A., Gomez, S. L. The California Breast Density Information Group: A Collaborative Response to the Issues of Breast Density, Breast Cancer Risk, and Breast Density Notification Legislation. Most recently Thomas exercised 979,402 units of ORCL stock worth $32,095,004 on 2 May 2018.. 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. BLM reduced risk more among older women (38.0 fewer cases for women aged 50years vs 17.9 fewer cases among women aged <50years) but provided similar risk reduction across categories of tumor grade and tumor hormone receptor status. A 73-gene signature based on the tumor profiles in TCGA achieved good association with the tumor-adjacent parenchymal image feature (R(2) = 0.873), which stratified patients into groups regarding recurrence-free survival (log-rank P = .029) and overall survival (log-rank P = .042) in an independent TCGA cohort. These may be useful in the patient's decision-making process and impact uptake of risk-management options. The communication behaviors of study participants who carry a gene mutation were analyzed 3 months after disclosure of genetic test results. View details for DOI 10.3949/ccjm.89a.21113. Surgery after initial lumpectomy declined by 16% (P. The NCCN Clinical Practice Guidelines in Oncology for Genetic/Familial High-Risk Assessment: Breast and Ovarian provide recommendations for genetic testing and counseling for hereditary cancer syndromes and risk management recommendations for patients who are diagnosed with a syndrome. 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. Sensitivities for comorbidities from self-report versus medical record were similar for racial/ethnic minorities and non-Hispanic Whites, and did not vary by age, neighborhood socioeconomic status, or education. Individual- and neighborhood-level measures of SES interact with race/ethnicity to impact mortality after BC diagnosis. Four-year breast cancer-specific survival per molecular subtypes and clinical/demographic factors were calculated. The combination of PM and PO at age 40 improves survival more than any single intervention, yielding 24% survival gain for BRCA1 and 11% for BRCA2 mutation carriers. To understand genetic testing use and decision making among patients with high genetic risk.A survey of breast cancer survivors was administered online by a hereditary cancer nonprofit organization, Facing Our Risk of Cancer Empowered, from October 2017 to March 2018.Of 1,322 respondents, 46% had breast cancer at age < 45 years, 61% had a first-degree relative with cancer, and 84% underwent genetic testing, of whom 56% had a risk-associated pathogenic variant. A., Gaudet, M. M., Giles, G. G., Goldberg, M. S., Goldgar, D. E., Gunel, P. n., Haiman, C. A., Hkansson, N. n., Hall, P. n., Harrington, P. A., Hart, S. N., Hartman, M. n., Hillemanns, P. n., Hopper, J. L., Hou, M. F., Hunter, D. J., Huo, D. n., Ito, H. n., Iwasaki, M. n., Jakimovska, M. n., Jakubowska, A. n., John, E. M., Kaaks, R. n., Kang, D. n., Keeman, R. n., Khusnutdinova, E. n., Kim, S. W., Kraft, P. n., Kristensen, V. N., Kurian, A. W., Le Marchand, L. n., Li, J. n., Lindblom, A. n., Lophatananon, A. n., Luben, R. N., Lubiski, J. n., Mannermaa, A. n., Manoochehri, M. n., Manoukian, S. n., Margolin, S. n., Mariapun, S. n., Matsuo, K. n., Maurer, T. n., Mavroudis, D. n., Meindl, A. n., Menon, U. n., Milne, R. L., Muir, K. n., Mulligan, A. M., Neuhausen, S. L., Nevanlinna, H. n., Offit, K. n., Olopade, O. I., Olson, J. E., Olsson, H. n., Orr, N. n., Park, S. K., Peterlongo, P. n., Peto, J. n., Plaseska-Karanfilska, D. n., Presneau, N. n., Rack, B. n., Rau-Murthy, R. n., Rennert, G. n., Rennert, H. S., Rhenius, V. n., Romero, A. n., Ruebner, M. n., Saloustros, E. n., Schmutzler, R. K., Schneeweiss, A. n., Scott, C. n., Shah, M. n., Shen, C. Y., Shu, X. O., Simard, J. n., Sohn, C. n., Southey, M. C., Spinelli, J. J., Tamimi, R. M., Tapper, W. J., Teo, S. H., Terry, M. 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