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. These models can be used to perform large-scale retrospective studies in oncology. We used data from the Breast Cancer Association Consortium (BCAC) including 1062 women of European ancestry with metastatic breast cancer, 606 of whom died of breast cancer. What Was Actress Katherine Macgregor Cause Of Death? We assessed model calibration by evaluating observed versus predicted mutations and attribute diagrams, and model discrimination using areas under the receiver operating characteristic curves.Both models were well-calibrated within each racial/ethnic group, with some exceptions. The odds ratio for higher impact of cancer worry was 0.81 (95% CI, 0.51 to 1.28) for multigene versus BRCA1/2-only testing. We found statistically significant differences in reporting of insurance as a frequently used payment method for HCPs and in-person genetic counseling (84% versus 59%, respectively, p. This study evaluated breast and gynecologic cancer patients' sexual function, unmet needs related to sexuality, and distress.Secondary analyses of a cross-sectional survey study evaluated measures of sexual function (Female Sexual Function Index [FSFI]), unmet needs (Supportive Care Needs Scale), and distress (Patient Health Questionnaire). The current study reports rates of knowledge regarding the probability of a BRCA1 and/or S pathogenic variant and genetic testing in patients with breast cancer, collected as part of a randomized controlled trial of a tailored, comprehensive, and interactive decision tool (iCanDecide).A total of 537 patients newly diagnosed with early-stage breast cancer were enrolled at the time of their first visit in 22 surgical practices, and were surveyed 5 weeks (496 patients; Response Rate [RR], 92%) after enrollment after treatment decision making. Kurian, A. W., Abrahamse, P., Ward, K. C., Hamilton, A. S., Deapen, D., Berek, J. S., Hoang, L., Yussuf, A., Dolinsky, J., Brown, K., Slavin, T., Hofer, T. P., Katz, S. J. 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. Lin, G., Scheuner, M., Trosman, J., Sales, P., Ackerman, S., Douglas, M., Weldon, C., Kurian, A., Phillips, K. Multi-gene panel testing results prompt frequent and guideline adherent changes to cancer risk management recommendations based on clinician report. We concluded that further adaptation of the coverage framework will facilitate a better suited assessment of NGTS and future genomics innovations. Use, attitudes, and perceptions of tumor genomic testing: Survey of TAPUR physicians. 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. Multiple US birth cohorts were simulated.Screening mammography and treatment.The models compared age-adjusted, overall, and ER/ERBB2-specific breast cancer mortality rates from 2000 to 2012 for women aged 30 to 79 years relative to the estimated mortality rate in the absence of screening and treatment (baseline rate); mortality reductions were apportioned to screening and treatment.In 2000, the estimated reduction in overall breast cancer mortality rate was 37% (model range, 27%-42%) relative to the estimated baseline rate in 2000 of 64 deaths (model range, 56-73) per 100000 women: 44% (model range, 35%-60%) of this reduction was associated with screening and 56% (model range, 40%-65%) with treatment. Patients' assessments of the amount of information they received about whether to get tested were similarly high whether they were counseled by a genetics expert or by a physician only (80.8% v 79.4% stated information was just right, P = .59). Hartman, A. R., Daniel, B. L., Kurian, A. W., Mills, M. A., Nowels, K. W., Dirbas, F. M., Kingham, K. E., Chun, N. M., Herfkens, R. J., Ford, J. M., Plevritis, S. K. Ductal lavage of non-fluid yielding ducts in BRCA1 and BRCA2 mutation carriers and other women at high genetic risk for breast cancer, Kurian, A. W., Mills, M. A., Nowels, K. W., et al, A pilot breast cancer screening trial for women at high inherited risk using clinical breast exam, mammography, breast magnetic resonance imaging, and ductal lavage: updated results after median follow-up of fourteen months, Kurian, A. W., Daniel, B. L., Mills, M. A., et al, Identification of ductal atypia with MR galactography. To reduce the barrier of testing, a multiplex SNaPshot genotyping panel that targeted 25 ChineseBRCA1/2mutation hotspots was developed, and its feasibility was evaluated in a local cohort of 441 breast and 155 ovarian cancer patients. View details for DOI 10.1200/JCO.2015.63.5524. SM users indicated using SM for social support (34.3%) and loneliness (24.6%) more than for information-seeking (15.9%), coping (18.8%), or self-disclosure (14%). Disparities in guideline-concordant care and pQoC persisted after controlling for medical discrimination, clinician mistrust, and decision-making.Interpersonal aspects of the patient-clinician interaction had an impact on pQoC but not receipt of guideline-concordant treatment and did not explain disparities in either outcome.Although breast cancer survivors' interpersonal interactions with clinicians did not influence receipt of appropriate treatment, intervention strategies to improve patient-clinician relations may help attenuate disparities in survivors' pQoC. All but three, were identified in general population studies. In this approach, we impute missing values using regression models for each variable, conditional on the other variables in the data. Over the past several decades, the disease's incidence has risen worldwide, increasing in developing and developed countries. There was no difference in quality of life (QOL), functional social support (FSS), distress, or decision regret between SM users and non-users. For select women at increased risk for breast cancer, preventive medication can greatly decrease risk and is vastly underutilized. Kurian, A. W., Hughes, E., Bernhisel, R., Larson, K., Caswell-Jin, J., Shadyab, A. H., Ochs-Balcom, H., Pan, K., Qi, L., Reding, K., Hartman, A., Lancaster, J. M., Tang, J. Y., Stefanick, M. L. Radiomics features to identify distinct subtypes of triple-negative breast cancers. We compared the ability of each NLP model to identify the presence, timing, and site of recurrence, when compared against manual chart review and International Classification of Diseases coding.A total of 1,273 patients were included in the development and validation of the two models. Oncol. For more information, please contact Naheed Mangi, 650-723-0658. View details for Web of Science ID 000369634300006. 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. These results suggest that precision medicine may help optimize cancer treatment across health care settings. An optimized PRS was validated in 2 independent cohorts (n = 13,174; n = 141,160).Within the training cohort (n = 24,259), 4,291 women (18%) had a personal history of breast cancer and 8,725 women (36%) reported breast cancer in a first-degree relative. Clinical use of the 21-gene assay and patient experiences in early-stage breast cancer. The age-specific incidence of HR(+)/HER2(+) and HR(-)/HER2(+) subtypes did not vary markedly between white and black women.The black-white crossover in breast cancer incidence occurs only when all breast cancer subtypes are combined and relates largely to higher rates of triple-negative breast cancers and lower rates of HR(+)/HER2(-) breast cancers in black vs white women. the G2/M phase in tumor cell lines, and potentiates the cell cycle effects of DNA damaging Logistic and multinomial logistic regression of the data were conducted to identify factors associated with (1) CPM vs all other treatments combined, (2) CPM vs unilateral mastectomy (UM), and (3) CPM vs breast-conserving surgery (BCS). View details for DOI 10.6004/jnccn.2021.0001, View details for Web of Science ID 000587855200005, View details for Web of Science ID 000607202800270, View details for Web of Science ID 000560368307247, View details for Web of Science ID 000560368303141, View details for Web of Science ID 000560368301028, View details for Web of Science ID 000560368301153, View details for Web of Science ID 000560368301027, View details for Web of Science ID 000560368301071, View details for Web of Science ID 000546262400156. On multivariable analysis, factors associated with CPM included younger age (per 5-year increase: odds ratio [OR], 0.71; 95% CI, 0.65-0.77), white race (black vs white: OR, 0.50; 95% CI, 0.34-0.74), higher educational level (OR, 1.69; 95% CI, 1.20-2.40), family history (OR, 1.63; 95% CI, 1.22-2.17), and private insurance (Medicaid vs private insurance: OR, 0.47; 95% CI, 0.28-0.79). Evidence-based guidelines recommend cascade genetic counseling and testing for hereditary cancer syndromes, providing relatives the opportunity for early detection and prevention of cancer. For more information, please contact Pei-Jen Chang, 650-725-0866. Google Cloud CEO Thomas Kurian is approaching the end of his contract, but is expected to renew it. Approximately one-third (34.1%) of the surgeon variation was explained by patient volume and surgeon attitudes about genetic testing and counseling. veliparib in combination with TMZ or in combination with carboplatin and paclitaxel compared These findings emphasize the need to address challenges in personalized communication about genetic testing. To examine the temporal trajectory of insurance coverage for next-generation tumor sequencing (sequencing) by private US payers, describe the characteristics of coverage adopters and nonadopters, and explore adoption trends relative to the Centers for Medicare and Medicaid Services' National Coverage Determination (CMS NCD) for sequencing.We identified payers with positive coverage (adopters) or negative coverage (nonadopters) of sequencing on or before April 1, 2019, and abstracted their characteristics including size, membership in the BlueCross BlueShield Association, and whether they used a third-party policy. Early life [ edit] Thomas Kurian was born to P.C. The genetic test results were as follows: 7% had a high-risk PV, 6% had a moderate-risk PV, 35% had a variant of uncertain significance (VUS), and 52% were negative. Stanford is currently not accepting patients for this trial. Compared with breast-conserving surgery with radiation (10-year mortality, 16.8% [95% CI, 16.6%-17.1%]), unilateral mastectomy was associated with higher all-cause mortality (hazard ratio [HR], 1.35 [95% CI, 1.32-1.39]; 10-year mortality, 20.1% [95% CI, 19.9%-20.4%]). Mendelian randomisation (MR) assesses causality by simulating randomised trial groups using genotype. Roberts, M. C., Kurian, A. W., Petkov, V. I. Trends in genetic testing and results for women diagnosed with breast cancer or ovarian cancer, 2013-2017, Development of a breast cancer risk assessment model for ATM mutation carriers incorporating tyrer-cuzick and a polygenic risk score (PRS). We evaluated the performance of a customized germline-DNA sequencing panel for cancer-risk assessment in a representative clinical sample.Patients referred for clinical BRCA1/2 testing from 2002 to 2012 were invited to donate a research blood sample. 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). Zeidman, A., Benedict, C., Zion, S. R., Fisher, S., Tolby, L., Kurian, A. W., Berek, J. S., Woldeamanuel, Y. W., Schapira, L., Palesh, O. 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. In the Oncoshare project, we have developed such methods as part of a collaborative multi-institutional CER study of patterns, predictors, and outcome of breast cancer care. 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. 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. (IV) infusions (followed by vinorelbine) and conventional sequential administration of Clinically determined 10-year risk of distant recurrence was established for low and intermediate invasive cancer patients. Breast cancer is a major global problem, with nearly 1 million cases occurring each year. Seneviratne, M. G., Bozkurt, S., Patel, M., Seto, T., Brooks, J. D., Blayney, D. W., Kurian, A. W., Hernandez-Boussard, T. Guidelines Do Not Proscribe Surgeons Performing Genetic Testing Reply. 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. Idos, G., Roth, K. G., Naghi, L., Ricker, C., Culver, J., Sturgeon, D., Kingham, K., Koff, R., Chun, N. M., Rowe-Teeter, C., Hartman, A., Allen, B., Evans, B., Mills, M., Hong, C., McDonnell, K., Ladabaum, U., Ford, J. M., Gruber, S. B., Kurian, A. W. Expanded yield of multiplex panel testing in fully accrued prospective trial. A convenient way to implement multiple imputation is sequential regression multiple imputation, also called chained equations multiple imputation. The identified loci implicate a broad range of DNA damage response (DDR) processes and include loss-of-function variants in key DDR-associated genes. Her research focus was on identifying risk for breast and ovarian cancer. Select this result to view Allison Thomas's phone number, address, and more. View details for PubMedID 30289174. Su, C. C., Wu, J. T., Neal, J. W., Popat, R. A., Kurian, A. W., Backhus, L. M., Nagpal, S., Leung, A. N., Wakelee, H. A., Han, S. S. Greater Financial Toxicity Relates to Greater Distress and Worse Quality of Life Among Breast and Gynecologic Cancer Survivors. Women's health clinicians are poised to evaluate risk, promote breast cancer risk reduction, and manage overall health. Idos, G., Kurian, A. W., Ricker, C., Sturgeon, D., Culver, J., Kingham, K., Koff, R., Chun, N. M., Rowe-Teeter, C., Kidd, J., Evans, B., Brown, K., Mills, M., Ma, C., Hong, C., McDonnell, K. J., Ladabaum, U., Ford, J. M., Gruber, S. B. 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. metastatic disease with disease progression > 8 weeks following the last dose of However, only one half (50.6%) of those not tested received any discussion about genetics. And ovarian cancer all but three, were identified in general population studies approximately one-third ( 34.1 % ) the... 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