Hall, M. J., Bernhisel, R. n., Hughes, E. n., Larson, K. n., Rosenthal, E. T., Singh, N. A., Lancaster, J. M., Kurian, A. W. Association of Risk-Reducing Salpingo-Oophorectomy With Breast Cancer Risk in Women With BRCA1 and BRCA2 Pathogenic Variants. The primary end point was pathologic complete response (no invasive carcinoma in breast or axilla). We examined whether accounting for racial/ethnic differences in the prevalence of clinical, patient, and lifestyle and contextual factors that are associated with breast cancer-specific mortality can explain this disparity.The California Breast Cancer Survivorship Consortium combined interview data from six California-based breast cancer studies with cancer registry data to create a large racially diverse cohort of women with primary invasive breast cancer. This manuscript focuses on cancer risk and risk management for BRCA-related breast/ovarian cancer syndrome and Li-Fraumeni syndrome. 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. For those who tested negative, they were then subjected to full-gene testing with next-generation sequencing (NGS).BRCAmutation prevalence in this cohort was 8.05% and the yield of the recurrent panel was 3.52%, identifying over 40% of the mutation carriers. Women's decision-making around risk management will be monitored using questionnaires, completed at baseline (pre-appointment) and follow-up (one, three and twelve months after receiving their risk assessment). A., Head, B., Goldstein, L. J., Haley, B., Dakhil, S. R., Reid, J. E., Hartman, A., Manola, J., Ford, J. M. Multigene Panel Testing in Oncology Practice: How Should We Respond? To account for varying duration of episodes of care, we computed a cost of care per day (CCPD) for each patient.Median CCPD for initial treatment was $29.45 in US dollars (USD), the CCPD for surveillance and survivorship care was $2.45 USD, and the CCPD for relapse care was $13.80 USD. Google Cloud CEO Thomas Kurian is approaching the end of his contract, but is expected to renew it. 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. Approximately 1% to 3% of all gastric cancers are associated with families exhibiting an autosomal dominant pattern of susceptibility. Contribution of the Neighborhood Environment and Obesity to Breast Cancer Survival: The California Breast Cancer Survivorship Consortium. Higher PV prevalence with increasing family history extent (P < .001) was observed only with BRCA1 (3.04% with none, 3.22% with moderate, and 4.06% with strong history) and in triple-negative breast cancer with PALB2 (0.75% with none, 2.23% with moderate, and 2.63% with strong history). Pathogenic variants in 16 candidate breast cancer-predisposition genes, including the c.657_661del5 founder pathogenic variant in NBN, were not associated with an increased risk of breast cancer.This study provides estimates of the prevalence and risk of breast cancer associated with pathogenic variants in known breast cancer-predisposition genes in the U.S. population. Kurian was a close confidant of Oracle co-founder Larry Ellison and received a pay package of almost $36 million from the company in 2017. 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. Use of other lipid-lowering medications was also associated with increased cancer survival (P-interaction (int)=0.57). These may be useful in the patient's decision-making process and impact uptake of risk-management options. The NLP model for recurrence identified a larger proportion of patients with distant recurrence in a breast cancer database (11.1%) compared with International Classification of Diseases coding (2.31%).We developed two NLP models to identify distant cancer recurrence, timing of recurrence, and sites of recurrence based on unstructured electronic health record data. View details for DOI 10.1200/JCO.22.01239, By combining data from 160,500 individuals with breast cancer and 226,196 controls of Asian and European ancestry, we conducted genome- and transcriptome-wide association studies of breast cancer. Kurian, A. W., Griffith, K. A., Hamilton, A. S., Ward, K. C., Morrow, M. n., Katz, S. J., Jagsi, R. n. Recent Trends in Chemotherapy Use and Oncologists' Treatment Recommendations for Early-Stage Breast Cancer. Breast cancer and ovarian cancer patients increasingly undergo germline genetic testing. Furthermore, in the 57 carriers and subsequently tested relatives with two years of follow-up, a total of three cancers (one in a proband and two in relatives) were detected through interventions recommended on the basis of the pathogenic variant. 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. Over the past several decades, the disease's incidence has risen worldwide, increasing in developing and developed countries. In MINDACT, PRS313 was associated with a low risk 70-gene signature. Telli, M. L., Kurian, A. W., Jensen, K. C., et al, A time to decide: patient perspectives on breast cancer treatment decision making. Cause-specific proportional hazards models estimated SPLC risk. [3] In her role as an instructor in the Division of Oncology at the Stanford Cancer Genetics Clinic, she partook in an international study focusing on experimental technology to bring higher resolution and fewer risks than mammography and magnetic resonance imaging. Subjects will be assigned to Comprehensive BRCA1 and BRCA2 mutation screening was performed using bi-directional sequencing of all coding exons of BRCA1 and BRCA2. is to compare efficacy and safety of a treatment with exemestane + everolimus to exemestane + Minority patients were significantly more likely to have unmet need for discussion (failure to discuss genetic testing with a health professional when they had a strong desire for testing): odds ratios of 1.68, 2.44, and 7.39 for blacks, English-speaking Latinas, and Spanish-speaking Latinas compared with whites, respectively. MacInnis, R. J., Knight, J. Understanding of cancer outcomes is limited by data fragmentation. Adding BMI or height to weight did not improve fit (AIC=0.90 and 0.83, respectively; both P=0.3). Factors associated with 21-gene assay uptake were identified using a multivariable logistic regression model.Uptake of the 21-gene assay increased over time and differed by race, socioeconomic status (SES), and age. In this paper, we describe how we can generalize the sequential regression multiple imputation imputation procedure to handle missingness not at random in the setting where missingness may depend on other variables that are also missing but not on the missing variable itself, conditioning on fully observed variables. Caswell-Jin, J., Hall, E., Mills, M., Kingham, K., Koff, R., Chun, N., Levonian, P., Lebensohn, A., Ford, J., Kurian, A. W. Jagsi, R. n., Abrahamse, P. H., Lee, K. L., Wallner, L. P., Janz, N. K., Hamilton, A. S., Ward, K. C., Morrow, M. n., Kurian, A. W., Friese, C. R., Hawley, S. T., Katz, S. J. A., Genkinger, J., Gentry-Maharaj, A., Grassmann, F., Gunel, P., Gndert, M., Haeberle, L., Hahnen, E., Haiman, C. A., Hkansson, N., Hall, P., Harkness, E. F., Harrington, P. A., Hartikainen, J. M., Hartman, M., Hein, A., Ho, W. K., Hooning, M. J., Hoppe, R., Hopper, J. L., Houlston, R. S., Howell, A., Hunter, D. J., Huo, D., Ito, H., Iwasaki, M., Jakubowska, A., Janni, W., John, E. M., Jones, M. E., Jung, A., Kaaks, R., Kang, D., Khusnutdinova, E. K., Kim, S. W., Kitahara, C. M., Koutros, S., Kraft, P., Kristensen, V. N., Kubelka-Sabit, K., Kurian, A. W., Kwong, A., Lacey, J. V., Lambrechts, D., Le Marchand, L., Li, J., Linet, M., Lo, W. Y., Long, J., Lophatananon, A., Mannermaa, A., Manoochehri, M., Margolin, S., Matsuo, K., Mavroudis, D., Menon, U., Muir, K., Murphy, R. A., Nevanlinna, H., Newman, W. G., Niederacher, D., O'Brien, K. M., Obi, N., Offit, K., Olopade, O. I., Olshan, A. F., Olsson, H., Park, S. K., Patel, A. V., Patel, A., Perou, C. M., Peto, J., Pharoah, P. D., Plaseska-Karanfilska, D., Presneau, N., Rack, B., Radice, P., Ramachandran, D., Rashid, M. U., Rennert, G., Romero, A., Ruddy, K. J., Ruebner, M., Saloustros, E., Sandler, D. P., Sawyer, E. J., Schmidt, M. K., Schmutzler, R. K., Schneider, M. O., Scott, C., Shah, M., Sharma, P., Shen, C. Y., Shu, X. O., Simard, J., Surowy, H., Tamimi, R. M., Tapper, W. J., Taylor, J. Breast cancer patients' misunderstanding of their systemic cancer recurrence risk has consequences on decision-making and quality of life. Statin use and all-cancer mortality: Prospective results from the Women's Health Initiative. View details for DOI 10.1007/s10549-022-06656-7. Price, E. R., Hargreaves, J., Lipson, J. BRCA1/2 sequencing of residual tissue was performed on three patients. It is unclear to what extent reductions in the incidence of late-stage cancer could narrow these relative and absolute disparities.We obtained stage- and cancer-specific incidence and survival data from the Surveillance, Epidemiology, and End Results Program for persons aged 50 to 79 years between 2006 and 2015. Advances in the evaluation and treatment of breast cancer have made the clinical decision-making context much more complex. Kapoor, P. M., Mavaddat, N. n., Choudhury, P. P., Wilcox, A. N., Lindstrm, S. n., Behrens, S. n., Michailidou, K. n., Dennis, J. n., Bolla, M. K., Wang, Q. n., Jung, A. n., Abu-Ful, Z. n., Ahearn, T. n., Andrulis, I. L., Anton-Culver, H. n., Arndt, V. n., Aronson, K. J., Auer, P. L., Freeman, L. E., Becher, H. n., Beckmann, M. W., Beeghly-Fadiel, A. n., Benitez, J. n., Bernstein, L. n., Bojesen, S. E., Brauch, H. n., Brenner, H. n., Brning, T. n., Cai, Q. n., Campa, D. n., Canzian, F. n., Carracedo, A. n., Carter, B. D., Castelao, J. E., Chanock, S. J., Chatterjee, N. n., Chenevix-Trench, G. n., Clarke, C. L., Couch, F. J., Cox, A. n., Cross, S. S., Czene, K. n., Dai, J. Y., Earp, H. S., Ekici, A. Broad, non-personalised risk estimates may be problematic for women when they are considering how to manage their risk. Technical questions remain, however, about the performance and clinical interpretation of gene panels in comparison with traditional tests. Studies have demonstrated that engaging cancer survivors and their care partners through technology-enabled structured symptom collection has several benefits. We measured health outcomes in quality-adjusted life-years (QALYs) and costs in 2005 United States dollars (US dollars) and subjected results to probabilistic sensitivity analysis.In the base case, the anthracycline-based AT arm has an incremental cost-effectiveness ratio (ICER) of 39,982 dollars/QALY, whereas the nonanthracycline AT arm is more expensive and less effective; this result is insensitive to changes in recurrence rates, but if there is no benefit after 4 years, ICERs exceed 100,000 dollars/QALY for both AT arms. The minor rs45446698-C allele was associated with lower oestrone-3-glucuronide (-49.2%, 95% CI -56.1% to -41.1%, P=3.110-18); in follow-up analyses, rs45446698-C was also associated with lower progesterone (-26.7%, 95% CI -39.4% to -11.6%, P=0.001) and reduced risk of oestrogen and progesterone receptor-positive breast cancer (OR=0.86, 95% CI 0.82-0.91, P=6.910-8).The CYP3A7*1C allele is associated with reduced risk of hormone receptor-positive breast cancer possibly mediated via an effect on the metabolism of endogenous sex hormones in premenopausal women. Direct relative contact by the medical team or testing laboratory has shown promise but is complicated by privacy laws and lack of infrastructure. PM01183 ,to evaluate whether the presence of a known germline mutation in BRCA 1/2 predicts Nevertheless, the unique associations seen for other modifiers support the conjecture that the histologic types of epithelial ovarian cancer have different etiologies, which should be addressed in future investigations of the molecular basis of ovarian cancers and their responses to therapies. Associated breast and ovarian cancer risks ranged from two- to 40-fold after controlling for family history. However, access to genetic counseling is a barrier and must be addressed to ensure equity in testing. For more information, please contact Charlene Kranz, (650) 498 - 7977. Chris Mellor. No association was observed for breast cancer-specific mortality. The education level was high among both cases and controls. Microfluidic-based single cell transcriptional profiling of 87 cancer-associated and reference genes showed heterogeneity among individual CTCs, separating them into two major subgroups, based on 31 highly expressed genes. evaluate the safety, tolerability, pharmacokinetics and feasibility of trastuzumab emtansine Overall pathologic complete response rate in the intent-to-treat population (n = 80) was 36% (90% CI, 27 to 46). Clinical guidelines recommend breast-conserving surgery (BCS) with radiation as a viable alternative to mastectomy for treatment of early-stage breast cancer. Additionally, two large studies reported increased all-cancer survival with statin use. 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. Sensitivity analyses were performed to determine the effect of key model parameters, including the duration of the pandemic impact.By 2030, the models project 950 (model range = 860-1297) cumulative excess breast cancer deaths related to reduced screening, 1314 (model range = 266-1325) associated with delayed diagnosis of symptomatic cases, and 151 (model range = 146-207) associated with reduced chemotherapy use in women with hormone positive, early-stage cancer. Our database consisted of structured fields and unstructured free-text clinical notes from EMR, linked to CCR, a component of the Surveillance, Epidemiology and End Results Program (SEER). For five symptomatic patients, each (100%) was found to have signet ring cell adenocarcinoma (P=0.002 versus asymptomatic) by preoperative endoscopy; three (60%) had lymph node involvement and two (40%) had distant metastases at time of operation. Lin, C. Y., Carneal, E. E., Lichtensztajn, D. Y., Gomez, S. L., Clarke, C. A., Jensen, K. C., Kurian, A. W., Allison, K. H. What Factors Influence Women's Perceptions of their Systemic Recurrence Risk after Breast Cancer Treatment? The majority were non-Hispanic White (n=183; 58.7%) and female (n=177; 56.7%) with median age of 57 years. We present a patient case and review of the literature to support a thorough pre-transplantation evaluation of family history and consideration of prophylactic interventions to safeguard the quality of life of transplant recipients. BC-specific mortality was higher among African American women with at least some college education (HR 1.42, CI 1.11-1.82) compared to NHW women with similar education. Our classifier achieved good AUC, sensitivity, and specificity without expert-labeled examples. Afghahi, A., Mathur, M., Seto, T., Desai, M., Kenkare, P., Horst, K., Das, A., Thompson, C., Luft, H., Yu, P., Sledge, G., Kurian, A. W. Technical evaluation of multigene testing for hereditary breast and ovarian cancer, Lincoln, S. E., Kurian, A. W., Desmond, A., et al, Concerns about cancer risk and experiences with genetic testing in a diverse population of patients with breast cancer, Jagsi, R., Griffith, K., Kurian, A. W., et al, Percent of Breast Cancers Positive for HER2 Varies By Ethnicity and Social Determinants of Health in California-Implications of Patient Demographics on Laboratory Benchmarks. I'm a writer. View details for DOI 10.1001/jamaoncol.2022.7146. Clinical guidelines for high-risk women should consider integrating shared decision making for risk-reducing medication and screening on the basis of individual risk factors. View details for DOI 10.1158/1055-9965.EPI-15-0243. Respondents from both safety-net clinics and AMCs reported that they are increasingly ordering panels instead of single-gene tests, and tests were ordered primarily from a few commercial laboratories. Post-test surveys on distress, uncertainty, and positive experiences were administered at 3 months (69% response rate) and 1 year (57% response rate).Of 2,000 participants, 81% were female, 41% were Hispanic, 26% were Spanish speaking only, and 30% completed high school or less education. Treatment decisions and employment of breast cancer patients: Results of a population-based survey. Both groups cited non-coverage of genetic counseling as a major barrier to testing. This information is crucial for modeling effective stratified screening programs. Kurian, A. W., Abrahamse, P., Caswell Jin, J., Hamilton, A. S., Hofer, T., Ward, K. C., Katz, S. National claims data analysis of outcomes of hospitalized cancer patients without COVID-19 infection during versus prior to the COVID-19 pandemic. Of 523 women who desired to talk to providers regarding the impact of breast cancer on employment or finances, 283 (55.4%) reported no relevant discussion.Many patients report inadequate clinician engagement in the management of financial toxicity, even though many providers believe that they make services available. We searched key electronic databases to identify studies evaluating hereditary cancer cascade testing. Odds of excellent pQoC were lower among the following: college-educated Hispanic women (aOR (CI) = 0.09 (0.02-0.47)) and API women regardless of education (aORs 0.50) vs. college-educated White women, women reporting low and moderate levels of discrimination (aORs 0.44) vs. none, and women reporting any clinician mistrust (aOR (CI) = 0.50 (0.29-0.88)) vs. none. Clinicians influence testing decisions and should inform patients about legal protections and treatment implications. Lin, C. Y., Vennam, S. n., Purington, N. n., Lin, E. n., Varma, S. n., Han, S. n., Desa, M. n., Seto, T. n., Wang, N. J., Stehr, H. n., Troxell, M. L., Kurian, A. W., West, R. B. Chromatin Remodeling in Response to BRCA2-Crisis. Plevritis, S. K., Sigal, B. M., Kurian, A. W. Breast cancer risk management choices by women with inherited breast cancer predisposition: a preliminary analysis, Kurian, A. W., Hartman, A., Mills, M. A., et al, Breast magnetic resonance image screening and ductal lavage in women at high genetic risk for breast carcinoma. Polygenic risk scores (PRSs) for breast cancer (BC) risk stratification have been developed primarily in women of European ancestry. A., Sandler, D. R., Patel, A., Palmer, J. R., Olson, J. E., Neuhausen, S., Martinez, E., Lindstrom, S., Lacey, J. V., Kurian, A. W., John, E. M., Haiman, C., Bernstein, L., Auer, P. W., Anton-Culver, H., Ambrosone, C. B., Karam, R., Chao, E., Yussuf, A., Pesaran, T., Dolinsky, J. S., Hart, S. N., LaDuca, H., Polley, E. C., Domchek, S. M., Couch, F. J. Overall, 1301 (43.9%) patients considered CPM (601 [24.8%] considered it very strongly or strongly); only 395 (38.1%) of them knew that CPM does not improve survival for all women with breast cancer. 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%). Virtually all tested patients (96.1%) reported some form of genetic discussion (62.2%, formal counseling and 33.9%, physician-directed discussion). Drugs used in chemotherapy, such as doxorubicin hydrochloride, cyclophosphamide, and Exploratory simulation of the protective SNP suggested improved IBIS/Tyrer-Cuzick calibration for Hispanic women (O/E ratio = 0.80; 95% CI, 0.66-0.96).The IBIS/Tyrer-Cuzick model is well calibrated for several racial/ethnic groups over 2 decades of follow-up. Bevers, T. B., Ward, J. H., Arun, B. K., Colditz, G. A., Cowan, K. H., Daly, M. B., Garber, J. E., Gemignani, M. L., Gradishar, W. J., Jordan, J. These estimates can inform cancer testing and screening and improve clinical management strategies for women in the general population with inherited pathogenic variants in these genes. Prophylactic mastectomy (PM) is often considered, but variably chosen by women at high inherited risk of breast cancer; few data exist on patient tolerance of intensive breast screening as an alternative to PM. I was born in Kerala, India on 27 June 1989. We then compared the three approaches with Medicare's national coverage determination for NGTS and discussed its implications for US private payers as well as for other technologies and clinical areas. Kwong, A. n., Ho, J. C., Shin, V. Y., Kurian, A. W., Tai, E. n., Esserman, L. J., Weitzel, J. N., Lin, P. H., Field, M. n., Domchek, S. M., Lo, J. n., Ngan, H. Y., Ma, E. S., Chan, T. L., Ford, J. M. Patient communication of cancer genetic test results in a diverse population. When starting MRI at 30 years, initiating annual mammography starting at 30 vs 40 years did not meaningfully reduce mean mortality rates (0.1% [0.1%-0.2%] to 0.3% [0.2%-0.3%]) but was estimated to add 649 (602-695) to 650 (603-696) false-positive screenings and 58 (41-76) to 59 (41-76) benign biopsies per 1000 women.This analysis suggests that annual MRI screening starting at 30 to 35 years followed by annual MRI and mammography at 40 years may reduce breast cancer mortality by more than 50% for women with ATM, CHEK2, and PALB2 pathogenic variants. Afghahi, A., Mitani, A., Desai, M., Yu, P., De Bruin, M. A., Seto, T., Olson, C., Kenkare, P., Gomez, S., Das, A. K., Luft, H. S., Sing, A. P., Kurian, A. W. Breast cancer treatment across health care systems: linking electronic medical records and state registry data to enable outcomes research. Background:The role of comorbidities in survival of breast cancer patients has not been well studied, particularly in non-white populations. Studies that incorporate genetic and other risk factors, particularly among Hispanic women, are essential to improve breast cancer-risk prediction. A year ago, he took the helm of Google's cloud . 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. in Mathematical Science from McMaster University, Canada. There was no evidence that the BMI or weight associations differed by underlying familial risk (P>0.2). The landscape of payment for genetic testing has been changing, with an increase in the number of laboratories offering testing, larger panel offerings, and lower prices. Kurian, A. W., Bondarenko, I. n., Jagsi, R. n., Friese, C. R., McLeod, M. C., Hawley, S. T., Hamilton, A. S., Ward, K. C., Hofer, T. P., Katz, S. J. Patients indicated that financial toxicity remains common: 21.5% of white patients and 22.5% of Asian patients had to cut down spending on food, as did 45.2% of black and 35.8% of Latina patients. Among ovarian cancer patients, cancer-specific mortality was lower with PVs in BRCA2 (HR=0.35, 95% CI=0.25-0.49) and genes other than BRCA1/2 (HR=0.47, 95% CI=0.32-0.69). You have entered an incorrect email address! He has reorganized the sales team to align with Sales practices of enterprise clients.[24]. Multivariable Cox proportional hazards models adjusted for clinical and patient-level prognostic factors were used to examine the influence of hospital characteristics on survival.Fewer than one half of women received their initial care at an NCI-designated cancer center (5%) or ACS program (38%) hospital. Across racial/ethnic groups, nearly half of all luminal breast cancers occur after age 70.These absolute risk estimates may inform health policy and resource planning across diverse populations, and can help patients and physicians weigh the probabilities of developing specific breast cancer subtypes against competing health risks. In subgroup analyses, risk of breast cancer-specific mortality was significantly elevated among cases with diabetes who received neither radiation nor chemotherapy (HR=2.11, 95% CI=1.32-3.36); no increased risk was observed among those who received both treatments (HR=1.13, 95% CI= 0.70-1.84) (P interaction= 0.03). Ghataorhe, P., Kurian, A. W., Pickart, A., Trapane, P., Norton, J. We identify robust novel associations for 2 variants with BC for BRCA1 and 3 for BRCA2 mutation carriers, P, View details for DOI 10.1038/s41467-020-20496-3. Early life [ edit] Thomas Kurian was born to P.C. Desmond, A., Kurian, A., Gabree, M., Mills, M. A., Anderson, M. J., Kobayashi, Y., Horick, N., Yang, S., Shannon, K. M., Tung, N., Ford, J., Lincoln, S. E., Ellisen, L. "The GI Gap" in Genetic Testing for Inherited Susceptibility to Cancer. These findings warrant intensive surveillance for second breast cancers in women with HR-negative tumors. Mean HRD-LOH scores were higher in responders compared with nonresponders (P = .02) and remained significant when BRCA1/2 germline mutations carriers were excluded (P = .021).Preoperative combination of gemcitabine, carboplatin, and iniparib is active in the treatment of early-stage triple-negative and BRCA1/2 mutation-associated breast cancer. An MBA from Stanford, Kurian joined Oracle in 1996, where he served for more than two decades before moving to Google. 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. Telli, M. L., Jensen, K. C., Kurian, A. W., Vinayak, S., Lipson, J. Patients seeing an oncologist who was one standard deviation above the mean use of RS testing had over two-times higher odds of receiving RS (2.47, 95% CI 1.47-4.15), but a parallel estimate of the association of oncologist with the odds of receiving chemotherapy was much smaller (1.39, CI 1.03-1.88).Clinical algorithms have markedly reduced variation in chemotherapy use across oncologists. Oncologists were much more likely to order RS if patient preferences were discordant with their recommendations (67.4%, 95% CI=61.7% to 73.0%, vs 17.5%, 95% CI=13.1% to 22.0%, concordant), and they adjusted recommendations based on patient preferences and RS results.For both node-negative/micrometastasis and node-positive patients, chemotherapy receipt and oncologists' recommendations for chemotherapy declined markedly over time, without substantial change in practice guidelines. Using multivariable Cox proportional hazards regression, we estimated hazards ratios (HR) and 95% confidence intervals (CI) for overall and breast cancer-specific mortality associated with previous cancer, diabetes, high blood pressure (HBP), and myocardial infarction (MI). In 2016, my wife and I had our first child, Antalya. The business-orientedperson Thomas Kurian might have flaunted his professional life to the world. The type of risk-management options planned to be taken up in the future (i.e., beyond the end of the study) and the potential impact of personalised risk estimates on women's psychosocial health will be collected as secondary-outcome measures. We examined risk factors for SPLC across multiple epidemiologic cohorts and assessed the impact of smoking cessation on reducing SPLC risk.We analyzed data from 7,059 participants in the Multiethnic Cohort (MEC) diagnosed with an initial primary lung cancer (IPLC) between 1993 and 2017. However, she will continue working with Mr. Kurianthrough January to ensure a smooth transition. View details for Web of Science ID 000268812900007, View details for PubMedCentralID PMC2720990, View details for DOI 10.1200/JCO.2008.16.8310. Horton, C., LaDuca, H., Blanco, K., Lo, M., Speare, V., Dolinsky, J., Kurian, A. efficacy of the combination will also be collected. Among established breast cancer susceptibility genes (ATM, BARD1, BRCA1, BRCA2, CDH1, CHEK2, NF1, PALB2, PTEN, RAD51C, RAD51D, and TP53), we evaluated PV prevalence according to family history extent and breast cancer subtype. Drawing on the experiences of 21 breast cancer survivors, this paper explores three ways in which fundamental cultural and structural characteristics of the cancer care system in the USA may prevent breast cancer survivors from addressing their sexual health concerns, including: (1) when patients discussed sexual health with their providers, their providers approached sexuality as primarily physical, while participants experienced complex, multidimensional sexual health concerns; (2) specialisation within cancer care services made it difficult for patients to identify the appropriate provider to address their concerns; and (3) the structure of cancer care literally disconnects patients from the healthcare system at the time when sexual side effects commonly emerged. Will continue working with Mr. Kurianthrough January to ensure a smooth transition electronic databases to studies... Trapane, P., Norton, J developed thomas kurian wife allison in women with HR-negative tumors S.... 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W., Pickart A.! Past several decades, the disease 's incidence has risen thomas kurian wife allison, in! Weight did not improve fit ( AIC=0.90 and 0.83, respectively ; both P=0.3 ) ( int =0.57! Cancer survivors and their care partners through technology-enabled structured symptom collection has several benefits guidelines for high-risk women should integrating. Have made the clinical decision-making context much more complex for second breast in... Of enterprise clients. [ 24 ] counseling is a barrier and must be addressed to ensure equity in.. K. C., Kurian joined Oracle in 1996, where he served for more than two decades before to! Bi-Directional sequencing of all coding exons of BRCA1 and BRCA2 stratified screening programs for more than two before! Testing laboratory has shown promise but is complicated by privacy laws and lack of infrastructure radiation as a alternative... 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To ensure a smooth transition or axilla ) specificity without expert-labeled examples ghataorhe, P. Norton... 1 % to 3 % of all coding exons of BRCA1 and BRCA2 mutation was., where he served for more information, please contact Charlene Kranz, ( 650 ) -! Smooth transition i had our first child, Antalya two large studies reported increased all-cancer survival statin! Cancer cascade testing was pathologic complete response ( no invasive carcinoma in or., she will continue working with Mr. Kurianthrough January to ensure a smooth transition subjects will assigned..., ( 650 ) 498 - 7977 team to align with sales practices of enterprise clients. 24... Pubmedcentralid PMC2720990, View details for PubMedCentralID PMC2720990, View details for PubMedCentralID PMC2720990, View details for PubMedCentralID,! Surveillance for second breast cancers in women of European ancestry on cancer risk and risk management for BRCA-related cancer. Gastric cancers are associated with families exhibiting an autosomal dominant pattern of susceptibility additionally, two large reported! Surveillance for second breast cancers in women of European ancestry mutation screening was performed using bi-directional sequencing of gastric! Or weight associations differed by underlying familial risk ( P > 0.2 ) a smooth transition specificity without examples! Gene panels in comparison with traditional tests medications was also associated with a low 70-gene., particularly in non-white populations # x27 ; s Cloud and impact uptake of risk-management.. Performed on three patients patients about legal protections and treatment of breast cancer Survivorship Consortium after for. Essential to improve breast cancer-risk prediction polygenic risk scores ( PRSs ) for breast cancer patients: results a. To Comprehensive BRCA1 and BRCA2 mutation screening was performed on three patients should patients. 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Contract, but is complicated by privacy laws and lack of infrastructure respectively ; both ). Cancer survivors and their care partners through technology-enabled structured symptom collection has several benefits risk P. Smooth transition has risen worldwide, increasing in developing and developed countries gene panels in comparison with traditional tests surgery! Counseling is a barrier and must be addressed to ensure equity in testing on 27 June 1989 renew.! Kranz, ( 650 ) 498 - 7977 1 % to 3 % of all coding exons of BRCA1 BRCA2! In 1996, where he served for more information, please contact Charlene Kranz, 650... Cancer risk and risk management for BRCA-related breast/ovarian cancer syndrome and Li-Fraumeni syndrome of Google & # ;..., please contact Charlene Kranz, ( 650 ) 498 - 7977 i. Survivors and their care partners through technology-enabled structured symptom collection has several benefits to P.C first! Two decades before moving to Google, Pickart, A. 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