Polygenic risk scores (PRS) have been shown to predict breast cancer risk in European women, but their utility in Asian women is unclear. Yuan, Y., Van Dyke, A., Kurian, A. W., Negoita, S., Petkov, V. I. Breast cancer was the most common diagnosis (n=67; 21.5%). The conference . Mr. Kurians other twin George speaks of his mother for being both loving and strict. paclitaxel to see how well they work with or without bevacizumab in treating patients with Thomas Kurian is the CEO of Google Cloud and former president of Oracle Corporation. Gallagher, S., Hughes, E., Kurian, A. W., Domchek, S. M., Garber, J., Probst, B., Morris, B., Tshiaba, P., Rosenthal, E., Roa, B., Wagner, S., Gutin, A., Weitzel, J. N., Lanchbury, J., Robson, M. E. Development and validation of natural language processing (NLP) algorithm for detection of distant versus local breast cancer recurrence and metastatic site. (T-DM1) administered by intravenous (IV) infusion in combination with paclitaxel (and We sought to characterize the use of social media (SM) among breast and gynecologic cancer survivors, as well as associations between patterns of SM use and psychosocial outcomes.Two hundred seventy-three breast and gynecologic cancer survivors recruited at the Stanford Women's Cancer Center completed the study. The study included 9,701 patients with breast cancer who were diagnosed between 1993 and 2007. Who Is Cate Campbell Boyfriend Adam Kerr, Are They Engaged? Afghahi, A., Mathur, M., Thompson, C. A., Mitani, A., Rigdon, J., Desai, M., Yu, P. P., de Bruin, M. A., Seto, T., Olson, C., Kenkare, P., Gomez, S. L., Das, A. K., Luft, H. S., Sledge, G. W., Sing, A. P., Kurian, A. W. Yield of multiplex panel testing compared to expert opinion and validated prediction models. View details for DOI 10.1158/1055-9965.EPI-15-0055, View details for DOI 10.1001/jama.2015.8088. 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. 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%). By contrast, ATM PV carriers did not have significantly increased CBC risks. 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. The panel also discussed revisions to genetic testing criteria that take into account ovarian cancer histology and personal history of pancreatic cancer. Thomas has made over 39 trades of the Oracle stock since 2009, according to the Form 4 filled with the SEC. Women with mutations in the BRCA1 or BRCA2 cancer susceptibility genes face unique choices regarding management of their high risk for breast and ovarian cancer that impact their reproductive options. Reportedly, Kurian quit working due to disagreements with Executive Chairman. High- and moderate-risk PV carriers did not differ significantly from one another in the total MICRA score, uncertainty, distress, or positive experiences.In a diverse population undergoing genetic counseling and multigene panel testing for hereditary cancer risk, the psychological response corresponded to test results and showed low distress and uncertainty. The study sample (N = 1,711) comprised patients with indications for formal genetic risk evaluation. We used inverse propensity weighting and multiple imputations to derive complete information for each patient about treatment status with and without testing.A half of the 1545 women eligible for testing (ER+ or PR+, HER2-, and stage I-II) received RS. These results may guide women with BRCA1/2 mutations in their choices between prophylactic surgery and breast screening. 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. A recent fine-scale mapping analysis to refine these associations resulted in 1 (signal 1), 5 (signal 2), and 42 (signal 3) credible causal variants at these loci. For eight hypothetical cohorts of 100,000 persons defined by race/ethnicity and sex, we estimated cancer-related deaths if cancers diagnosed at stage IV were detected earlier, by assigning them outcomes of earlier stages.We observed a three-fold difference in the absolute burden of stage IV cancer between the group with the highest rate (non-Hispanic Black males, 337 per 100,000) and the lowest rate (non-Hispanic Asian/Pacific Islander females,117 per 100,000). In this paper, we present an evaluation of the approaches we undertook and the lessons we learned in building and validating the Oncoshare data resource. Kurian, A. W., Ward, K. C., Howlader, N., Deapen, D., Hamilton, A. S., Mariotto, A., Miller, D., Penberthy, L. S., Katz, S. J. Cascade Genetic Testing of Relatives for Hereditary Cancer Risk: Results of an Online Initiative. We found that the vast majority of respondents (94%, 127/135) ordered an HCP for patients rather than single-gene tests to assess hereditary cancer predisposition. Relative to screening with mammography alone, the cost per QALY gained by adding MRI from ages 35 to 54 years is 55,420 dollars for BRCA1 mutation carriers, 130,695 dollars for BRCA2 mutation carriers, and 98,454 dollars for BRCA2 mutation carriers who have mammographically dense breasts.Breast MRI screening is more cost-effective for BRCA1 than BRCA2 mutation carriers. View details for DOI 10.1093/jamiaopen/ooz040, View details for PubMedCentralID PMC6994019, View details for DOI 10.2217/pme-2019-0045. Eight genes (ATM, BARD1, BRCA1, BRCA2, CHEK2, PALB2, PTEN, and TP53) were associated with breast cancer, with odds ratios (ORs) ranging from two-fold (ATM: OR, 1.74; 95% CI, 1.46 to 2.07) to six-fold (BRCA1: OR, 5.91; 95% CI, 5.25 to 6.67). View details for DOI 10.1158/1055-9965.EPI-08-1090, View details for DOI 10.1200/JCO.2008.20.7191, View details for Web of Science ID 000262894400031. Kim, S. M., Hatami, F., Harris, J. S., Kurian, A. W., Ford, J., King, D., Scalari, G., Giovannini, M., Hoyler, N., Faist, J., Harris, G. Comparative Analysis of Bio-Medical Imaging at 3.7 Terahertz with a High Power Quantum Cascade Laser, Kim, S. M., Hatami, F., Gu, A., Kurian, A. W., et al, A clinic-based study of BRCA1/2 mutation epidemiology in Asians, Kurian, A. W., Chun, N. M., Millls, M. A., et al, Opinions of women with high inherited breast cancer risk about prophylactic mastectomy: an initial evaluation from a screening trial including magnetic resonance imaging and ductal lavage. These results may inform clinical decision-making about ET, and reassure patients who have bothersome symptoms on AIs that they are unlikely to develop worse comorbidities if they switch to tamoxifen. Here, we implemented computationally efficient, penalized, logistic regression models (lasso, elastic net, stepwise) to individual level genotype data and a Bayesian framework with continuous shrinkage, "select and shrink for summary statistics" (S4), to summary level data for epithelial non-mucinous ovarian cancer risk prediction. [11], On December 1, 2015, Kurian was promoted to associate professor of medicine, health research, and policy. "Uncertainty" and "family and personal history" were associated with overestimation, particularly for women with DCIS (75%; 84%). 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. Most recently Thomas exercised 979,402 units of ORCL stock worth $32,095,004 on 2 May 2018.. The business-orientedperson Thomas Kurian might have flaunted his professional life to the world. These results suggest that precision medicine may help optimize cancer treatment across health care settings. For more information, please contact Annabel Castaneda, 650-498-7977. These findings have implications for risk prevention for women at increased risk of breast cancer. Risk of all histologic types was unassociated with age at menarche, age at menopause, a history of infertility, noncontraceptive estrogen use, and alcohol consumption.The most important modifiers of ovarian cancer risk (parity and oral contraceptive use) showed similar associations across the histologies. In an independent cohort, 18% of women shifted breast cancer risk categories from their Tyrer-Cuzick-based risk compared with risk estimates by CRS.Integrating clinical and polygenic factors into a risk model offers more effective risk stratification and supports a personalized genomic approach to breast cancer screening and prevention. To determine the contribution of germline pathogenic variants (PVs) in hereditary cancer testing panel genes to invasive lobular carcinoma (ILC) of the breast.The study included 2,999 women with ILC from a population-based cohort and 3,796 women with ILC undergoing clinical multigene panel testing (clinical cohort). Kurian was responsible for the Oracle Fusion Middleware family of products. We examined the performances of the IBIS and BOADICEA risk models when using alternative thresholds by comparing predictions based on 5-year risk with those based on lifetime risk from birth and remaining lifetime risk. A., Giles, G. G., Goldgar, D. E., Gonzalez-Neira, A., Haiman, C. A., Hakansson, N., Hamann, U., Hartman, M., Heemskerk-Gerritsen, B. M., Hollestelle, A., Hopper, J. L., Hou, M., Howell, A., Ito, H., Jakimovska, M., Jakubowska, A., Janni, W., John, E. M., Jung, A., Kang, D., Kets, C., Khusnutdinova, E., Ko, Y., Kristensen, V. N., Kurian, A. W., Kwong, A., Lambrechts, D., Le Marchand, L., Li, J., Lindblom, A., Mannermaa, A., Manoochehri, M., Margolin, S., Matsuo, K., Mavroudis, D., Meindl, A., Milne, R. L., Mulligan, A., Muranen, T. A., Neuhausen, S. L., Nevanlinna, H., Newman, W. G., Olshan, A. F., Olson, J. E., Olsson, H., Park-Simon, T., Peto, J., Petridis, C., Plaseska-Karanfilska, D., Presneau, N., Pylkas, K., Radice, P., Rennert, G., Romero, A., Roylance, R., Saloustros, E., Sawyer, E. J., Schmutzler, R. K., Schwentner, L., Scott, C., See, M., Shah, M., Shen, C., Shu, X., Siesling, S., Slager, S., Sohn, C., Southey, M. C., Spinelli, J. J., Stone, J., Tapper, W. J., Tengstrom, M., Teo, S., Terry, M., Tollenaar, R. M., Tomlinson, I., Troester, M. A., Vachon, C. M., van Ongeval, C., van Veen, E. M., Winqvist, R., Wolk, A., Zheng, W., Ziogas, A., Easton, D. F., Hall, P., Schmidt, M. K., NBCS Collaborators, ABCTB Investigators, kConFab Investigators. To identify novel breast cancer subtypes by extracting quantitative imaging phenotypes of the tumor and surrounding parenchyma, and to elucidate the underlying biological underpinnings and evaluate the prognostic capacity for predicting recurrence-free survival (RFS).We retrospectively analyzed dynamic contrast-enhanced magnetic resonance imaging data of patients from a single-center discovery cohort (n=60) and an independent multi-center validation cohort (n=96). Zeidman, A., Benedict, C., Tolby, L., Zion, S., Fisher, S., Kurian, A. W., Berek, J. S., Woldeamanuel, Y., Schapira, L., Palesh, O. Roberts, M. C., Kurian, A. W., Petkov, V. I. Wapnir, I. L., Kurian, A. W., Lichtensztajn, D. Y., et al, Optimizing the Threshold for Genetic Testing for Colorectal Cancer Syndromes, Naghi, L., Spector, K., Haisman, J., Kurian, A. W., et al. Dr. Kurian's research has been supported by the National Cancer Institute, Susan G. Komen for the Cure, the American Society of Clinical Oncology, the California Breast Cancer Research Program, the Cancer Research and Prevention Foundation, the Robert Wood Johnson Foundation, the Breast Cancer Research Foundation and the BRCA Foundation.As Director of the Stanford Womens Clinical Cancer Genetics Program, Dr. Kurian focuses her clinical practice on women at high risk for developing breast and gynecologic cancers. Ninety-one percent spoke English at home, 70.1% had health insurance, and 67% had access to home internet. As an oncologist and epidemiologist, I aim to understand cancer burden and improve treatment quality at the population level. Most women who were influenced by "communication with a clinician" had reasonably accurate recurrence estimates (68%). Unique associations include an inverse relation of serous cancer risk to body mass index, a positive relation of mucinous cancer risk to cigarette smoking, and a weakly positive relation of endometrioid cancer risk to body mass index. Breast cancer is a common manifestation of an underlying genetic susceptibility to cancer, and 5% to 10% of all breast cancers are associated with a germline mutation in a known risk allele. Karimi, Y., Purington, N., Liu, M., Kurian, A. W., Sledge, G. W., Blayney, D. W. Linking insurance claims across time to characterize treatment, monitoring, and end-of-life care in metastatic breast cancer. My research employs methods from the population sciences, in collaboration the Surveillance, Epidemiology and End Results (SEER) Program. In a model adjusting only for age and study, breast cancer-specific hazard ratios relative to Whites were 1.69 (95% CI 1.46 - 1.96), 1.00 (0.84 - 1.19), and 0.52 (0.33 - 0.85) for African Americans, Latinas, and Asian Americans respectively. Seventeen patients [28.3% (18.5-40.9%)] had atypical cells. B., Itakura, H. Contributions of screening, early-stage treatment, and metastatic treatment to breast cancer mortality reduction by molecular subtype in US women, 2000-2017. This study aimed to evaluate the association of the PRS313 with clinicopathologic characteristics of, and survival following, breast cancer.Women with invasive breast cancer were included, 98,397 of European ancestry and 12,920 of Asian ancestry, from the Breast Cancer Association Consortium (BCAC), and 683 women from the European MINDACT trial. View details for DOI 10.1200/JCO.22.00303, View details for DOI 10.3949/ccjm.89a.21114, Multi-cancer gene panels for hereditary cancer syndromes (hereditary cancer panels, HCPs) are widely available, and some laboratories have programs that limit patients' out-of-pocket (OOP) cost share. Associations between HLA alleles and the risk of subtypes of breast cancer (ER-positive, ER-negative, HER2-positive, HER2-negative, early-stage, and late-stage) were examined.We did not observe associations between any HLA allele and breast cancer risk at P, View details for DOI 10.1007/s12282-022-01366-w, Mammographic density (MD) phenotypes, including percent density (PMD), area of dense tissue (DA), and area of non-dense tissue (NDA), are associated with breast cancer risk. Payers' coverage decision making on NGTS is challenging because this revolutionary technology pushes the very boundaries of the underlying framework used in coverage decisions. Sixteen pathogenic variants were identified in ATM, BLM, CDH1, CDKN2A, MUTYH, MLH1, NBN, PRSS1, and SLX4 among 141 women without BRCA1/2 mutations. Cox proportional hazards models provided estimates of the relative hazard ratio for mortality from all causes, breast cancer, and causes other than breast cancer associated with recent recreational physical activity (i.e., in the 10 years before diagnosis). Shak, S., Roberts, M., Miller, D., Kurian, A. W., Petkov, V., Penberthy, L. Kurian, A. W., Bondarenko, I., Jagsi, R., et al, Idos, G., Kurian, A. W., Ricker, C., et al. 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. Oakley-Girvan, I., Divi, V., Palesh, O., Daniels, J., Goldman Rosas, L., O'Brien, D., Davis, S. W., Kamal, A. H., Kurian, A. W., Longmire, M. R. Psychosocial outcomes following germline multigene panel testing in an ethnically and economically diverse cohort of patients. Approximately one-third (34.1%) of the surgeon variation was explained by patient volume and surgeon attitudes about genetic testing and counseling. We conducted a survey of cancer genetic counselors based in the United States through the National Society of Genetic Counselors to assess the impact of reimbursement and patient OOP share on ordering of an HCP and hereditary cancer genetic counseling. Similar patterns were seen with pathogenic variants in other breast cancer-associated genes (ATM, CDH1, CHEK2, NBN, NF1, PALB2, PTEN, and TP53) but not with variants of uncertain significance.Women with pathogenic variants in BRCA1/2 and other breast cancer-associated genes were found to have distinct patterns of breast cancer treatment; these may be less concordant with practice guidelines, particularly for radiotherapy and chemotherapy. Background:The role of comorbidities in survival of breast cancer patients has not been well studied, particularly in non-white populations. Triple-negative tumors (ER-/PR-/HER2-) have been reported to be more common among younger women, but occurrence of the spectrum of breast cancer subtypes in adolescent and young adult (AYA) women aged between 15 and 39 years is otherwise poorly understood.Data regarding all 5,605 AYA breast cancers diagnosed in California during the period 2005 to 2009, including ER and PR status (referred to jointly as hormone receptor (HR) status) and HER2 status, was obtained from the population-based California Cancer Registry. Most respondents (84%, 114/135) indicated clinical indications and patients' requests as important in selecting and ordering HCPs, while 42%, 57/135, considered reimbursement and patient OOP share factors important. We evaluated the effects of 5 years of risk-reducing medication (tamoxifen/aromatase inhibitors) with annual screening mammography magnetic resonance imaging (MRI) compared with no screening, MRI, or risk-reducing medication. 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. Wapnir, I. L., Kingham, K. E., Mills, M., Ford, J. M., Kurian, A. W. Screening for founder and recurrent BRCA mutations in Hong Kong and US Chinese populations. High WHR (quartile 4 vs. quartile 1) was associated with breast cancer mortality in Asian Americans (HR = 2.21, 95% CI: 1.21, 4.03; P for trend = 0.01), whereas no associations were found in African Americans, Latinas, or non-Latina whites. We identified 1886 MBC patients, 512 (27.1%) of whom were de novo MBC patients and 1374 (72.9%) were recurrent MBC patients. Elevated transcript levels of genes associated with metastasis NPTN, S100A4, S100A9, and with epithelial mesenchymal transition: VIM, TGF1, ZEB2, FOXC1, CXCR4, were striking compared to cell lines. 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. It is He played a key role in bringing Oracle 9i application server to market. What are the treatment patterns and overall survival in patients with metastatic triple-negative breast cancer in US clinical practice? Women who were initially diagnosed with HR-negative tumors when younger than 30 years had greatly elevated risk of HR-negative contralateral tumors, compared with the general population (SIR = 169, 95% CI = 106 to 256, AR = 77 per 10 000 PY). 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. Results may guide women with BRCA1/2 mutations in their choices between prophylactic surgery and breast screening sample! ; 21.5 % ) ] had atypical cells [ 28.3 % ( 18.5-40.9 % ) ] had atypical.! 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