We therefore examined the effect of hospital characteristics on survival.Harmonized data pooled from 5 case-control and prospective cohort studies within the California Breast Cancer Survivorship Consortium were linked to the California Cancer Registry and the California Neighborhoods Data System. 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. Clinical guidelines recommend breast-conserving surgery (BCS) with radiation as a viable alternative to mastectomy for treatment of early-stage breast cancer. To provide more conclusive evidence regarding the role of HOXB13 in breast cancer susceptibility, we here evaluated the association between HOXB13 mutations and increased breast cancer risk within 81 studies of the international Breast Cancer Association Consortium containing 68,521 invasive breast cancer patients and 54,865 controls. Mean age was 34 years; 66% were BRCA1 mutation carriers and 34% were BRCA2 mutation carriers. 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. B., Eliassen, A. H., Engel, C., Evans, D. G., Fasching, P. A., Fletcher, O., Flyger, H., Gago-Dominguez, M., Gao, Y. T., Garca-Closas, M., Garca-Senz, J. Variation in surgeon attitudes about genetic testing and counseling may explain a substantial amount of this association. A force to reckon with in the tech space, Thomas Kurian amassed a net worth of Rs 10,600 crore in 2019 . Zhou, R., Kozlov, A., Chen, S., Okamoto, S., Ikeda, D. M., DeMartini, W., Kurian, A. W., Sledge, G. W., Telli, M. L., Lee, K., Mantz, A. Clinical impact of multi-gene panel testing for hereditary breast and ovarian cancer risk assessment. Among metastatic tumors, those that were HER2+ had better survival than other subtypes. He also completed an interventional cardiology fellowship and a nuclear cardiology . From 2013 to 2015, keeping other factors constant, chemotherapy use was estimated to decline from 34.5% (95% confidence interval [CI] = 30.8% to 38.3%) to 21.3% (95% CI=19.0% to 23.7%, P < .001). Notably, failing to impute cases with missing receptor status leads to overestimation of survival because those with missing receptor status tend to have worse prognostic features. "This was a population-based cohort survey study of 7303 eligible women ages 20 to 79 years with stage I and II breast cancer diagnosed in 2013 to 2015 and identified from the Georgia and Los Angeles County, California, Surveillance, Epidemiology, and End Results registries. Drugs in the network were scored according to their association with breast cancer individually or in pairs. As an oncologist and epidemiologist, I aim to understand cancer burden and improve treatment quality at the population level. 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). Thus, PRS313 has no role in the clinical management of primary breast cancer at the time of diagnosis. Compared to DCIS-only patients, patients with concurrent IBC had higher frequencies of CNAs in their DCIS samples. Gallagher, S., Hughes, E., Wagner, S., Tshiaba, P., Rosenthal, E., Roa, B. We examined whether PV carriers received more intensive regimens (HR-positive, HER2-negative: 3 drugs including an anthracycline; TNBC: 4 drugs including an anthracycline and platinum) and/or less standard breast cancer agents (a platinum). Weldon, C. B., Trosman, J. R., Liang, S. Y., Douglas, M. P., Scheuner, M. T., Kurian, A., Schaa, K. L., Roscow, B., Erwin, D., Phillips, K. A. Rodriguez, G. M., Ferguson, J. M., Kurian, A., Bondy, M., Patel, M. I. Telli, M. L., Jensen, K. C., Vinayak, S., Kurian, A. W., Lipson, J. I'm a writer. Allison W. Kurian, M.D., M.Sc. Little is known about its long-term performance in a racially/ethnically diverse population.The Women's Health Initiative study enrolled postmenopausal women from 1993-1998. clinical exam or radiology will be randomized to either neoadjuvant treatment with Breast cancer is a major global problem, with nearly 1 million cases occurring each year. Shariff-Marco, S. n., Ellis, L. n., Yang, J. n., Koo, J. n., John, E. M., Keegan, T. H., Cheng, I. n., Monroe, K. R., Vigen, C. n., Kwan, M. L., Lu, Y. n., Bernstein, L. n., Wu, A. H., Gomez, S. L., Kurian, A. W. Abstract IA50: Genetic testing, treatment and mortality after diagnosis of breast cancer or ovarian cancer: The SEER-GeneLINK Initiative, Health Disparities in Germline Genetic Testing for Cancer Susceptibility. Women with germline BRCA1 and BRCA2 mutations have five- to 20-fold increased risks of developing breast and ovarian cancer. Regression models examined factors associated with chemotherapy recommendations and receipt by the RS and subgroups.There were 1527 patients with stage I/II, estrogen receptor/progesterone receptor-positive, human epidermal growth factor 2-negative disease: 778 received an RS (62.6% of patients with node-negative, favorable disease, 24.3% of patients with node-negative, unfavorable disease, and 13.0% of patients with node-positive disease; P, View details for Web of Science ID 000394719100007. Latina women with low-education/high-nSES had lower all-cause mortality [HR 0.70 (0.54-0.90)] and non-significant lower mortality was observed for Asian American women, regardless of their education and nSES. This was evident for women with a first-degree family history of breast cancer (HR=0.68, 95% CI: 0.50-0.93), women without BRCA1 or BRCA2 pathogenic variants (HR=0.71, 95% CI: 0.53-0.95), postmenopausal women (HR=0.63, 95% CI: 0.44-0.89), and for risk of ER+breast cancer (HR=0.63, 95% CI: 0.40-0.98).Adherence to the 2020 ACS Guideline recommendations for BMI, physical activity, and alcohol consumption could reduce breast cancer risk for postmenopausal women and women at increased familial risk. The Changing Landscape of Genetic Testing for Inherited Breast Cancer Predisposition. Unpaired posttest responses were received in 168 additional patients with positive results. To the authors' knowledge, the magnitude of benefit is unknown.The authors used data from the Surveillance, Epidemiology, and End Results (SEER) program regarding all women diagnosed with American Joint Committee on Cancer stage 0 to stage III unilateral breast cancer in California from 1998 through 2015 and treated with BLM versus breast-conserving therapy including surgery and radiotherapy (BCT) or unilateral mastectomy (ULM). Aim: This observational study evaluated the effectiveness of nab-paclitaxel versus paclitaxel monotherapy as first-line (1L) treatment for metastatic triple-negative breast cancer (mTNBC). The reduction was much greater for women with positive nodes (31%; CI 21-41%), larger tumor (30% for tumor size >2cm; CI 22-38%), or younger age (22% for <50years; CI 9-35%).RS substantially changed chemotherapy treatment selections with the largest influence among patients with less favorable pre-test prognosis. Factors associated with receiving chemotherapy included <50 years of age [odds ratio (OR) 2.27, 95 % confidence interval (CI) 1.81-2.86], tumor >2 cm (OR 2.14, 95 % CI 1.75-2.61), involved lymph nodes (OR 11.3, 95 % CI 9.29-13.6), hormone receptor-negative (OR 6.94, 95 % CI 4.89-9.86), Her2/neu-positive (OR 2.71, 95 % CI 2.10-3.51), or high grade (OR 3.53, 95 % CI 2.77-4.49) tumors; comorbidities associated inversely with chemotherapy use [heart disease for anthracyclines (OR 0.24, 95 % CI 0.14-0.41), neuropathy for taxanes (OR 0.45, 95 % CI 0.22-0.89)]. For more information, please contact Mary Chen, (650) 723 - 8686. A., Sirota, M., Kenkare, P., Thompson, C. A., Yu, P. P., Gomez, S. L., Sledge, G. W., Kurian, A. W., Shah, N. H. Protective Effects of Statins in Cancer: Should They Be Prescribed for High-Risk Patients? Kurian, A. W., Mitani, A., Desai, M., Yu, P. P., Seto, T., Weber, S. C., Olson, C., Kenkare, P., Gomez, S. L., de Bruin, M. A., Horst, K., Belkora, J., May, S. G., Frosch, D. L., Blayney, D. W., Luft, H. S., Das, A. K. HER2 Positive Rates Vary by County and Geographic Region in California Independent of Stage and Age at Presentation. 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). The NCCN Guidelines Insights summarize the panel's discussion and most recent recommendations regarding risk management for carriers of moderately penetrant genetic mutations associated with breast and/or ovarian cancer. 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. Purpose Genetic testing for breast cancer risk is evolving rapidly, with growing use of multiple-gene panels that can yield uncertain results. George & Thomas Kurian - identical twins, identical super-success. Second breast cancers are rare, and their reduction should be weighed against the harms associated with BLM. Why did Google Cloud CEO Diane Greene Quit? For more information, please contact Pei-Jen Chang, (650) 725 - 0866. Potential actionability of these findings was determined based on current management guidelines, precision therapy labels, and clinical trial eligibility criteria. Statins are one of the most widely prescribed drug classes in the USA. The study sample (N = 1,711) comprised patients with indications for formal genetic risk evaluation. Asian respondents were less likely than NHW to encourage family members to undergo testing (OR = 0.1, p = .03); but Asian family members were more likely to undergo testing (OR = 8.0, p = .03). Afghahi, A., Forgo, E., Mitani, A. Our findings suggest that physical activity is beneficial for overall survival regardless of race/ethnicity. mutations are significant risk factors for hereditary breast and ovarian cancer (HBOC), its mutation frequency in HBOC of Chinese ethnicity is around 9%, in which nearly half are recurrent mutations. View details for DOI 10.1158/1055-9965.EPI-15-1326. View details for DOI 10.1016/j.celrep.2019.07.057. Ransohoff, K. J., Stefanick, M. L., Li, S. n., Kurian, A. W., Wakelee, H. n., Wang, A. n., Paskett, E. n., Han, J. n., Tang, J. Y. However, epidemiologic studies on circulating melatonin are limited because melatonin is secreted at night, yet most epidemiologic studies collect blood during the day when melatonin levels are very low, and assays are lacking that are ultrasensitive to detect low levels of melatonin reliably.To assess the performance of a refined radioimmunoassay in measuring morning melatonin among women.We used morning serum samples from 47 postmenopausal women ages 48-80 years without a history of breast cancer who participated in the San Francisco Bay Area Breast Cancer Study, including 19 women who had duplicate measurements. Ellisen, L., Kurian, A. W., Desmond, A. J., et al. Well, the statement proves that they are already a father to their children. 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. Gruber, J. J., Chen, J. n., Geller, B. n., Jger, N. n., Lipchik, A. M., Wang, G. n., Kurian, A. W., Ford, J. M., Snyder, M. P. Magnitude of reduction in risk of second contralateral breast cancer with bilateral mastectomy in patients with breast cancer: Data from California, 1998 through 2015. This approach may be adaptable to other cancer sites and could help to unlock the potential of EMRs for research on real-world cancer outcomes. Previously, Mr. Kurian went toIndian Institute of Technology Madras where he studied for six months. Sequencing results were confirmed by in-house developed full high resolution DNA melting (HRM) analysis. Comparative effectiveness research (CER) using observational data requires informatics methods for the extraction, standardization, sharing, and integration of data derived from a variety of electronic sources. Relative risks were lower after BLM (hazard ratio [HR], 0.10; 95% CI, 0.07-0.14) and higher after ULM (HR, 1.07; 95% CI, 1.02-1.13) versus BCT. We evaluated survival after nipple-sparing mastectomy versus non-nipple-sparing mastectomy in a population-based cancer registry.We conducted an observational study using the California Cancer Registry, considering all stage 0-III breast cancers diagnosed in California from 1988 to 2013. The four recurrent BRCA2 mutations (c.2808_2811delACAA, c.3109C>T, c.7436_7805del370 and c.9097_9098insA) accounted for 40% (16/40) of all BRCA2 mutations. SM use for coping was associated with lower QOL (p, View details for DOI 10.1007/s11764-020-00959-8. 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. Breast cancer risk was marginally increased among foreign-born women (OR=1.40, 95% CI=0.97-2.03) and two-fold among foreign-born Chinese women (OR=2.16, 95% CI=1.21-3.88). postmenopausal women after failure of prior NSAI therapy, the purpose of this Phase III study Along with educational level and use of internet support groups, uncertain results on genomic testing predicted second opinion use. Sanyal, J. n., Tariq, A. n., Kurian, A. W., Rubin, D. n., Banerjee, I. n. A case-only study to identify genetic modifiers of breast cancer risk for BRCA1/BRCA2 mutation carriers. Hereditary diffuse gastric cancer (HDGC) is an autosomal dominant cancer syndrome. Characterization of the Cancer Spectrum in Men With Germline BRCA1 and BRCA2 Pathogenic Variants: Results From the Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA). Ghataorhe, P., Kurian, A. W., Pickart, A., Trapane, P., Norton, J. Caswell-Jin, J., Sun, L., Munoz, D., Lu, Y., Li, Y., Huang, H., Hampton, J. M., Song, J., Jayasekera, J., Schechter, C., Alagoz, O., Stout, N. K., Trentham-Dietz, A., Mandelblatt, J. S., Berry, D. A., Lee, S. J., Huang, X., Kurian, A. W., Plevritis, S. Ancestry-specific risk of triple-negative breast cancer (TNBC) associated with germline pathogenic variants (PV) in hereditary cancer (CA) predisposition genes. Results were similar for breast cancer-specific survival, except that African Americans and non-Hispanic Whites living in high-SES neighborhoods had similar survival.Strategies to address the underlying factors that may influence treatment intensity and adherence, such as comorbidities and logistical barriers, should be targeted at low-SES non-Hispanic White and all African American patients. For ER-/PR- disease, BC-specific mortality did not differ by race/ethnicity and associations of race/ethnicity with BC-specific mortality varied only by neighborhood SES among African American women.Racial/ethnic survival disparities are more striking for ER/PR+ than ER-PR- BC. Studies that incorporate genetic and other risk factors, particularly among Hispanic women, are essential to improve breast cancer-risk prediction. 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. [12] In this role, she collaborated with doctors at Emory University and the University of Michigan to study 83,000 women diagnosed with breast or ovarian cancer in California and Georgia between 2013 and 2014. Non-fluid-yielding ducts, and atypia from non-fluid-yielding ducts, are more common in patients with prior cancer and chemotherapy. Participants included women of European ancestry between the ages of 18 and 84 years.Multivariable logistic regression was used to examine the association of the 86-SNV score with invasive breast cancer after adjusting for age, ancestry, and personal and/or family cancer history. We prospectively enrolled 1046 individuals who were appropriate candidates for HBOC evaluation and who lacked BRCA1/2 mutations.We carried out multigene panel testing on all participants, then determined the clinical actionability, if any, of finding non-BRCA1/2 mutations in these and additional comparable individuals.We evaluated the likelihood of (1) a posttest management change and (2) an indication for additional familial testing, considering gene-specific consensus management guidelines, gene-associated cancer risks, and personal and family history.Among 1046 study participants, 40 BRCA1/2-negative patients (3.8%; 95% CI, 2.8%-5.2%) harbored deleterious mutations, most commonly in moderate-risk breast and ovarian cancer genes (CHEK2, ATM, and PALB2) and Lynch syndrome genes. I lead a large population-based study, "Genetic testing, treatment use, and mortality after diagnosis of breast and ovarian cancer: the Georgia-California GeneLINK Initiative" (R01 CA225697), of genetic testing results linked to SEER registry data, with the aim of understanding the epidemiology, treatment and survival implications of cancer susceptibility gene mutations at the population level. View details for Web of Science ID 000618737701065, View details for Web of Science ID 000618737701241, View details for Web of Science ID 000618737700112, View details for Web of Science ID 000618737700120, View details for Web of Science ID 000618737700114. In a study published in the Journal of Clinical Oncology, she specifically addressed how computer models failed in predicting the presence of dangerous genetic mutations in Asian women compared to white women. 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. Results: Barriers to HCP coverage included poor fit with coverage frameworks (100%); insufficient evidence (100%); departure from pedigree/family history-based testing toward genetic screening (91%); lacking rigor in the HCP hybrid research/clinical setting (82%); and patient transparency and involvement concerns (82%). Kurian, A. W., Li, Y., Hamilton, A. S., Ward, K. C., Hawley, S. T., Morrow, M., McLeod, M. C., Jagsi, R., Katz, S. J. That brings you down to earth.. Molecular subtypes were categorized according to tumor expression of hormone receptor (HR, based on estrogen and progesterone receptors) and human epidermal growth factor receptor 2 (HER2). Giving chemotherapy after surgery may kill any tumor cells that remain after surgery Future research should identify the aspects of ACS program hospitals that are associated with higher survival and evaluate strategies by which to enhance access to and use of high-quality hospitals, particularly among African American women. Ricker, C. N., Koff, R. B., Qu, C. n., Culver, J. n., Sturgeon, D. n., Kingham, K. E., Lowstuter, K. n., Chun, N. M., Rowe-Teeter, C. n., Lebensohn, A. n., Levonian, P. n., Partynski, K. n., Lara-Otero, K. n., Hong, C. n., Petrovchich, I. M., Mills, M. A., Hartman, A. R., Allen, B. n., Ladabaum, U. n., McDonnell, K. n., Ford, J. M., Gruber, S. B., Kurian, A. W., Idos, G. E. Measuring serum melatonin in postmenopausal women: Implications for epidemiologic studies and breast cancer studies. No other incident comorbidity risk varied between users of tamoxifen versus AIs.In a diverse, multi-institutional, contemporary breast cancer cohort, the only incident comorbidity that differed between ET options was osteoporosis, a known side effect of AIs. 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%). , ( 650 ) 723 - 8686 P. thomas kurian wife allison Rosenthal, E., Mitani,.! N = 1,711 ) comprised patients with indications for formal genetic risk evaluation cardiology fellowship and nuclear... Risk evaluation resolution DNA melting ( HRM ) analysis formal genetic risk evaluation research real-world... A viable alternative to mastectomy for treatment of early-stage breast cancer at the population level for cancer. Drugs in the clinical management of primary breast cancer Predisposition, Forgo E.... E., Mitani, a tech space, Thomas Kurian amassed a net worth Rs! 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