The NCCN Guidelines for Genetic/Familial High-Risk Assessment: Breast and Ovarian focus specifically on the assessment of genetic mutations in BRCA1/BRCA2, TP53, and PTEN, and recommend approaches to genetic testing/counseling and management strategies in individuals with these mutations. Women's perceived risk of systemic recurrence (0% to 100%) was categorized as overestimation, reasonably accurate estimation, or underestimation (0% for invasive disease) and was compared across identified factors and by clinical presentation.Women identified 9 main factors related to their clinical experience (e.g., diagnosis and testing; treatment) and non-clinical beliefs (e.g., uncertainty; spirituality). 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. She completed her residency training in Internal Medicine at the Massachusetts General Hospital and her medical fellowship in Medical Oncology at Stanford University, where she was simultaneously earning a master's degree in Epidemiology. [7], On September 28, 2018, he resigned as president of product development at Oracle. 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. For BRCA1 and BRCA2 pathogenic variant carriers who underwent RRSO at age 40 years, the cause-specific cumulative risk of breast cancer was 49.7% (95% CI,40.0-60.3) and 52.7% (95% CI,47.9-58.7) by age 70 years, respectively, compared with 61.0% (95% CI,56.7-66.0) and 54.0% (95% CI,49.3-60.1), respectively, for women without RRSO.Although the primary indication for RRSO is the prevention of ovarian cancer, it is also critical to assess its association with breast cancer risk in order to guide clinical decision-making about RRSO use and timing. However, CTC transcriptional profiling is limited by leukocyte contamination; an approach to surmount this problem is single cell analysis. Vigen, C., Gomez, S. L., Sposto, R., Lu, Y., Kwan, M., John, E., Monroe, K., Keegan, T. H., Shariff-Marco, S., Kurian, A. W. Oncoshare: lessons learned from building an integrated multi-institutional database for comparative effectiveness research. Across pathogenic variants, annual mammography alone from 40 to 74 years was estimated to reduce breast cancer mortality by 36.4% (34.6%-38.2%) to 38.5% (37.8%-39.2%) compared with no screening. In a fragmented health care system, research can be challenging when one seeks to follow cancer patients as they seek care which can continue for months or years and may reflect many physician and patient decisions. Technical questions remain, however, about the performance and clinical interpretation of gene panels in comparison with traditional tests. 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%). Stratification of risk was evaluated by multivariable logistic regression models controlling for family cancer history. In total, 2,187 deaths (1,122 from breast cancer) were observed through December 31, 2010. Treatment and monitoring options for patients with metastatic breast cancer (MBC) are increasing, but little is known about variability in care. The largest trade Thomas's ever made was exercising 2,500,000 units of Oracle stock on 22 December 2014 worth over $77,400,000. Ninety-one percent spoke English at home, 70.1% had health insurance, and 67% had access to home internet. After controlling for clinical factors, care strategies varied significantly by nonclinical factors (median regional income with first-recorded therapy and imaging type, geographic region with these and with imaging frequency and use of tumor markers; P < .0001).Variability in US MBC care is explained by patient and disease factors and by nonclinical factors such as geographic region, suggesting that treatment decisions are influenced by local practice patterns and/or resources. Patients and health care providers rated the decision tool highly on measures of usability and clinical relevance. Half (54.7%) used AIs only, 27.6% used tamoxifen only and 17.7% used both tamoxifen and AIs sequentially. Second breast cancers are rare, and their reduction should be weighed against the harms associated with BLM. Breast oncology precision medicine: Genomic testing and treatment at the population level. Advances in bioinformatics also facilitate the interpretation of large amounts of genomic data. Assuming one-third of metastatic cancers were diagnosed at each earlier stage (I, II, and III), 52-126 fewer cancer-related deaths would be expected across subgroups, a relative reduction of 21-23%.Across population subgroups, non-Hispanic Black males have the highest burden of stage IV cancer and would have the most deaths averted from improved detection of cancer before metastasis.Detecting cancer before metastasis could meaningfully reduce deaths in all populations, but especially in non-Hispanic Black populations. This is equivalent to an absolute reduction of 95 invasive breast cancers, and 42 breast cancer deaths per 1,000 high-risk women. PURPOSE: This randomized phase III trial is studying letrozole to see how well it works 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. Weight is more informative than BMI for predicting breast cancer risk, consistent with non-adipose as well as adipose tissue being etiologically relevant. 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. Quantitative image features were extracted to characterize tumor morphology, intra-tumor heterogeneity of contrast agent wash-in/wash-out patterns, and tumor-surrounding parenchyma enhancement. [9] This resulted in the development of an online tool that helps people with BRCA mutations make preventive care decisions. We linked data to the California Cancer Registry, incorporating socio-demographic and tumor factors, and performed multivariable logistic regression analyses on the receipt of specific chemotherapy regimens. Hall, M. J., Hughes, E., Handorf, E., Gutin, A., Allen, B., Hartman, A., Kurian, A. W. Association of ovarian cancer (OC) risk with mutations detected by multiple-gene germline sequencing in 95,561 women. If results are promising, they may justify a randomized trial of statins for breast cancer chemoprevention, with a focus on HR-negative disease. Three quarters (74.6%) received some form of genetic counseling (43.5%, formal counseling and 31.1%, physician-directed discussion). The rate of final lumpectomy increased by 13% from 2013 to 2015, accompanied by a decrease in unilateral and bilateral mastectomy (P=.002). Quality improvement should focus on testing indicated patients rather than adding more genes. Analysis of multiply imputed, weighted data (mean n=1866) showed that 168 (9.8%) (SE, 0.74%) received a second opinion and 54 (3.2%) (SE, 0.47%) received chemotherapy from the second oncologist. In this role, she continued to research on the identification of women with elevated breast and gynecologic cancer risk and the development of new techniques for early cancer detection and risk reduction. Being underweight (BMI <18.5) was associated with increased risk of breast cancer mortality compared with being normal weight in non-Latina whites (hazard ratio (HR) = 1.91, 95% confidence interval (CI): 1.14, 3.20), whereas morbid obesity (BMI 40) was suggestive of increased risk (HR = 1.43, 95% CI: 0.84, 2.43). Relationships between sociodemographic and clinical factors and GCC receipt differed by subtype. trastuzumab or endocrine therapy) of particular subtypes of breast cancer among African-American patients. Lowry, K. P., Geuzinge, H. A., Stout, N. K., Alagoz, O., Hampton, J., Kerlikowske, K., de Koning, H. J., Miglioretti, D. L., van Ravesteyn, N. T., Schechter, C., Sprague, B. L., Tosteson, A. N., Trentham-Dietz, A., Weaver, D., Yaffe, M. J., Yeh, J. M., Couch, F. J., Hu, C., Kraft, P., Polley, E. C., Mandelblatt, J. S., Kurian, A. W., Robson, M. E. Time Trends in Receipt of Germline Genetic Testing and Results for Women Diagnosed With Breast Cancer or Ovarian Cancer, 2012-2019. Results were adjusted for multiple hypothesis testing. In Hong Kong and China, genetic testing and counseling are not as common as in the West. Compared to patients with earlier stage disease, patients with de novo metastatic disease were significantly more likely to have HER2+ tumors (HR+/HER2+: OR 1.29, 95% CI 1.17-1.42; HR-/HER2+: OR 1.40, 95%CI 1.25-1.57, vs. HR+/HER2-). We surveyed 504 attending oncologists (60.3% response rate ) about chemotherapy recommendations in node-negative and node-positive case scenarios. We developed the models in a dataset consisting of 23,564 non-mucinous EOC cases and 40,138 controls participating in the Ovarian Cancer Association Consortium (OCAC) and validated the best models in three populations of different ancestries: prospective data from 198,101 women of European ancestries; 7,669 women of East Asian ancestries; 1,072 women of African ancestries, and in 18,915 BRCA1 and 12,337 BRCA2 pathogenic variant carriers of European ancestries. Price, E. R., Hargreaves, J., Lipson, J. However, correlated genetic effects must be incorporated carefully to avoid overestimation of risk.A novel Fixed-Stratified method was developed that accounts for confounding when adding a new factor to an established risk model. Google Cloud CEO Thomas Kurian sent a memo to staff addressing the layoffs. Luhn, P., O'Hear, C., Ton, T. G., Hsieh, A., Yi, J., Chang, C. W., Funke, R., Kurian, A. W. Molecular receptor profiles in male mutation carriers with breast cancer. Tao, L., Chu, L., Wang, L. I., Moy, L., Brammer, M., Song, C., Green, M., Kurian, A. W., Gomez, S. L., Clarke, C. A. For mutation carriers with moderate or extensive residual disease after neoadjuvant therapy, BRCA1/2 status was re-sequenced in the residual surgical breast tumor tissue.Nineteen patients had a deleterious germline BRCA1/2 mutation and 4 had moderate residual disease at surgery. Therefore, there is an unmet clinical need to better predict the risk of progression among DCIS patients. Kurian and his wife Molly in 1966 in Pampady village of Kottayam district in Kerala, India. cancer. A., Teras, L. R., Terry, M. B., Torres, D., Troester, M. A., Vachon, C. M., van Deurzen, C. H., van Veen, E. M., Wagner, P., Weinberg, C. R., Wendt, C., Wesseling, J., Winqvist, R., Wolk, A., Yang, X. R., Zheng, W., Couch, F. J., Simard, J., Kraft, P., Easton, D. F., Pharoah, P. D., Schmidt, M. K., Garca-Closas, M., Chatterjee, N. Genetic Insights Into Biological Mechanisms Governing Human Ovarian Ageing, Multicancer hereditary syndrome testing: Genetic counselors' perspectives. These results may inform cancer risk counseling. Rai, A., Thompson, C., Kurian, A. W., Luft, H. S. Association of non-melanoma skin cancer with second non-cutaneous malignancy in the Women's Health Initiative. However, SPLC risk factors have not been established and the impact of tobacco smoking remains controversial. [], [] READ MORE:How Much Is Google Cloud New CEO Thomas Kurian Net Worth? Future work should explore reasons behind the high levels of sexual dysfunction and unmet needs in female survivors.It is important to routinely screen for sexual health concerns among female cancer survivors at all phases of the cancer trajectory including years posttreatment. Li-Fraumeni syndrome is a highly penetrant cancer syndrome associated with a high lifetime risk for cancer, including soft tissue sarcomas, osteosarcomas, premenopausal breast cancer, colon cancer, gastric cancer, adrenocortical carcinoma, and brain tumors. Surgery after initial lumpectomy to obtain more widely clear margins is common and may lead to mastectomy.To describe surgeons' approach to surgical margins for invasive breast cancer, and changes in postlumpectomy surgery rates, and final surgical treatment following a 2014 consensus statement endorsing a margin of "no ink on tumor. Since 2019, I have served as general counsel for Rotary International District 5300. Clinical data and pathologic characteristics were collected.BRCA1/2 status was the outcome in a logistic regression, and cancer diagnoses were the independent predictors. The accuracy of mammography and breast MRI was estimated from published data in high-risk women. White, D. P., Kurian, A. W., Stevens, J. L., Liu, B., Brest, A. E., Petkov, V. I. The overall literature on statins in relation to cancer incidence and survival is mixed, and additional research is warranted before any changes in clinical guidelines can be recommended. B., Yamaji, T. n., Zheng, Y. n., Milne, R. L., Dunning, A. M., Pharoah, P. D., Garca-Closas, M. n., Teo, S. H., Shu, X. O., Kang, D. n., Easton, D. F., Simard, J. n., Zheng, W. n. European polygenic risk score for prediction of breast cancer shows similar performance in Asian women. Predictors of second opinion use included college education vs less education (odds ratio [OR], 1.85; 95% CI, 1.24-2.75), frequent use of internet-based support groups (OR, 2.15; 95% CI, 1.12-4.11), an intermediate result on the 21-gene recurrence score assay (OR, 1.85; 95% CI, 1.11-3.09), and a variant of uncertain significance on hereditary cancer genetic testing (OR, 3.24; 95% CI, 1.09-9.59). Hodan, R. n., Kingham, K. n., Cotter, K. n., Folkins, A. K., Kurian, A. W., Ford, J. M., Longacre, T. n. Racial/ethnic disparities in survival after breast cancer diagnosis by estrogen and progesterone receptor status: A pooled analysis. Preliminary information about the In germline BRCA1 or BRCA2 (BRCA1/2) mutation carriers, restoration of tumor BRCA1/2 function by a secondary mutation is recognized as a mechanism of resistance to platinum and PARP inhibitors, primarily in ovarian cancer. PM01183 ,to evaluate whether the presence of a known germline mutation in BRCA 1/2 predicts Chemotherapy details were extracted from SEER text fields completed by registrars. Geczik, A. M., Ferris, J. S., Terry, M. B., Andrulis, I. L., Buys, S. S., Daly, M. B., Hopper, J. L., John, E. M., Kurian, A. W., Southey, M. C., Liao, Y., Genkinger, J. M. Association of illness mindsets with health-related quality of life in cancer survivors. Hartman, A., Mills, M. A., Kurian, A. W., Ford, J. M., Smith, D. N., Daniel, B. L. Magnetic resonance galactography: a new technique for localization of ductal atypia.