Multi-step processing, including deep-learning-based segmentation, revealed variability in the composition of tumor-immune populations across individuals, reconciled by overall immune infiltration and enriched co-occurrence of immune subpopulations and checkpoint expression. A., Schackmann, E. A., Wapnir, I., Carlson, R. W., Sparano, J. Vinayak, S., Schwartz, E. J., Jensen, K., Lipson, J., Alli, B., McPherson, L., Fernandez, A. M., Sharma, V. B., Staton, A., Mills, M. A., Schackmann, E. A., Telli, M. L., Kardashian, A., Ford, J. M., Kurian, A. W. electronic publication ahead of print, October 30, Impact of breast cancer subtypes on three-year survival among adolescent and young adult women. Stanford is currently not accepting patients for this trial. Secondary analyses examined associations by race/ethnicity, age at primary breast cancer diagnosis, menopausal status, and tumor estrogen receptor (ER) status.Germline BRCA1, BRCA2, and CHEK2 PV carriers with breast cancer were at significantly elevated risk (hazard ratio > 1.9) of CBC, whereas only the PALB2 PV carriers with ER-negative breast cancer had elevated risks (hazard ratio, 2.9). Roberts, M. C., Kurian, A. W., Petkov, V. I. However, only one half (50.6%) of those not tested received any discussion about genetics. Stanford is currently not accepting patients for this trial. determined in previous studies of participants with mBC and the safety data to date suggest As Google lays off 12,000 employees . 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%]). II cohort will permit extended assays of tolerability, initial estimates of efficacy, and the Kurian, A. W., Bernhisel, R. n., Larson, K. n., Caswell-Jin, J. L., Shadyab, A. H., Ochs-Balcom, H. n., Stefanick, M. L. Genetic Testing and Results in a Population-Based Cohort of Breast Cancer Patients and Ovarian Cancer Patients. View details for Web of Science ID 000207843700006. O'Mara, A., Kurian, A., Benedict, C., Diver, E. Constitutional BRCA1 Methylation and Risk of Incident Triple-Negative Breast Cancer and High-grade Serous Ovarian Cancer. DL detected seven women with cellular atypia, including one woman who had a normal MRI and mammogram.Breast MRI identified high-grade DCIS and high-risk lesions that were missed by mammography. This study will also assess the acceptability, feasibility and cost-effectiveness of using personalised risk estimates in clinical care. Before linking the data sets, Community patients appeared to receive less intervention than University patients (mastectomy: 37.6% vs 43.2%; chemotherapy: 35% vs 41.7%; magnetic resonance imaging: 10% vs 29.3%; and genetic testing: 2.5% vs 9.2%). Patient regret and prophylactic surgery use were low, and patients appropriately encouraged relatives to be tested for clinically relevant results. Results did not vary by diagnosis year.Among patients with high genetic risk, clinicians' recommendations, potential treatment implications, and protections against discrimination were motivating factors to undergo genetic testing, but fewer than half recalled clinicians providing all this information, and this did not improve over time. RSNA, 2013 Online supplemental material is available for this article. "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. Yet little is known about how doctors approach these discussions.A weighted random sample of newly diagnosed early-stage breast cancer patients identified through SEER registries of Los Angeles and Georgia (2013-2015) was sent surveys about~2months after surgery (Phase 2, N=3930, RR 68%). Hormone therapy using Multiple-gene sequencing is entering practice, but its clinical value is unknown. Since their inception in 2000, the Cancer Intervention and Surveillance Network (CISNET) breast cancer models have collaborated to use a nationally representative core of common input parameters to represent key components of breast cancer control in each model. In a multivariable model adjusted for age and subtype, there was no interaction between family history extent and PV prevalence for any gene except PALB2 (P = .037).Extent of family cancer history is not differentially associated with PVs across established breast cancer susceptibility genes and cannot be used to personalize genes selected for testing. Clinical Focus Cancer > Breast Cancer Cancer Genetics Breast Cancer Risk For more information, please contact Naheed Mangi, 650-723-0658. Hispanic respondents were less likely to have told a healthcare provider about their results than NHW (29% vs. 68%, p < .0001). The current article reports preliminary results from a screening protocol using high-quality magnetic resonance imaging (MRI), ductal lavage (DL), clinical breast examination, and mammography to identify early malignancy and high-risk lesions in women at increased genetic risk of breast carcinoma.Women with inherited BRCA1 or BRCA2 mutations or women with a >10% risk of developing breast carcinoma at 10 years, as estimated by the Claus model, were eligible. Lowry, K. P., Geuzinge, H., Stout, N. K., Alagoz, O., Hampton, J. M., Kerlikowske, K., Miglioretti, D. L., Schecter, C., Sprague, B. L., Trentham-Dietz, A., Tosteson, A. All statistical models and summary estimates were weighted to be representative of the target population.Receipt of CPM was the primary dependent variable for analysis and was measured by a woman's self-report of her treatment.Of the 3631 women selected to receive the survey, 2578 (71.0%) responded and 2402 of these respondents who did not have bilateral disease and for whom surgery type was known constituted the final analytic sample. 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). Each asymptomatic patient did well postoperatively, and no patient has recurred. Other hospital characteristics were not associated with survival.African American women may benefit significantly from breast cancer care in ACS program hospitals; however, most did not receive initial care at such facilities. Women with germline BRCA1 and BRCA2 mutations have five- to 20-fold increased risks of developing breast and ovarian cancer. He also receivedan MBA fromStanford Universitys Graduate School of Business. [9] This resulted in the development of an online tool that helps people with BRCA mutations make preventive care decisions. Methods A population-based sample of patients with breast cancer diagnosed in 2014 to 2015 and identified by two SEER registries (Georgia and Los Angeles) were surveyed about genetic testing experiences (N = 3,672; response rate, 68%). Kurian, A. W., Abrahamse, P., Hamilton, A. S., Deapen, D., Gomez, S., Morrow, M., Berek, J. S., Katz, S. J., Ward, K. C. Impact of disruptions in breast cancer control due to the COVID-19 pandemic on breast cancer mortality in the United States: Estimates from collaborative simulation modeling. We identified de novo MBC patients from CCR and extracted information on distant recurrences from patient notes in EMR. View details for DOI 10.1016/j.currproblcancer.2016.09.007, View details for Web of Science ID 000390980500005. Cancer 2017. Studies that incorporate genetic and other risk factors, particularly among Hispanic women, are essential to improve breast cancer-risk prediction. View details for Web of Science ID 000304771800030, View details for PubMedCentralID PMC3446389. Statins are one of the most widely prescribed drug classes in the USA. Powell, A. Crymson Rose is the beautiful girlfriend of CeedDee Lamb. Monoclonal different epithelial ovarian cancer screening strategies that use CA125 and add HE4 as either progesterone receptor (PR)-negative, and human epidermal growth factor receptor 2 View details for DOI 10.1200/JCO.2006.06.3081, View details for Web of Science ID 000244384000006. Kurian, A. W., Hartman, A. R., Mills, M. A., Ford, J. M., Daniel, B. L., Plevritis, S. K. Ductal lavage of fluid-yielding and non-fluid-yielding ducts in BRCA1 and BRCA2 mutation carriers and other women at high inherited breast cancer risk. [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. 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. 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. To summarize evidence on the prevalence and spectrum of BRCA1 and BRCA2 BRCA1/2 mutations across racial and ethnic groups and discuss implications for clinical practice.The prevalence of BRCA1/2 mutations is comparable among breast cancer patients of African, Asian, white, and Hispanic descent: approximately 1-4% per gene. We identified 31 potential novel loci with the lead variant showing an association with breast cancer risk at P, View details for DOI 10.1038/s41467-020-15046-w, View details for PubMedCentralID PMC7057957. GCC was found for 81.7% of YAs. 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. What Was Actress Katherine Macgregor Cause Of Death? Multiple phase 1 and 2 prevention studies of statins for breast cancer risk reduction are ongoing. The only independent predictor of BCS after NAC was care at a NCI-designated center (OR 1.28, CI 1.10-1.49), and of BLM, age <40 years versus 50 to 64 years (OR 2.59, CI 2.21-3.03), or residence in the highest socioeconomic neighborhood quintile versus lowest (OR 2.10, CI 1.67-2.64).NAC use remains low. Price, E. R., Hargreaves, J., Lipson, J. Few studies have reported an increased risk of cancer incidence or decreased survival with statin use, though this type of association has been more commonly reported for cutaneous cancers. 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. Reducing this cancer burden involves identification of high-risk individuals and personalized risk management. With these tumor features, a woman like this will have a 28% probability of having an RS 16-20, 18% RS 21-25, and 11% RS 26+. 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. HLA imputation was performed using SNP2HLA on 10,886 quality-controlled variants within the 15-55Mb region on chromosome 6. placebo in postmenopausal women with estrogen receptor positive locally advanced or Kurian, A. W., Mills, M. A., Jaffee, M., Sigal, B. M., Chun, N. M., Kingham, K. E., Collins, L. C., Nowels, K. W., Plevritis, S. K., Garber, J. E., Ford, J. M., Hartman, A. R. Histologic types of epithelial ovarian cancer: have they different risk factors? test the tolerability and efficacy of AZD0530 (also called saracatinib) when used together Kurian, A. W., Bondarenko, I., Jagsi, R., McLeod, C., Hawley, S. T., Hamilton, A. S., Ward, K. C., Katz, S. J. Survivors who scored <8 on ISI were categorized as "good sleepers," survivors with ISI 8 were categorized as "bad sleepers. To examine whether interpersonal aspects of patient-clinician interactions, such as patient-perceived medical discrimination, clinician mistrust, and treatment decision-making contribute to racial/ethnic/educational disparities in breast cancer care.A telephone interview was administered to 542 Asian/Pacific Islander (API), Black, Hispanic, and White women identified through the Greater Bay Area Cancer Registry, ages 20 and older diagnosed with a first primary invasive breast cancer. Lastly, we determined whether synergistic drug pairs found in the EHRs were enriched among synergistic drug pairs from gene-expression data using a method similar to gene set enrichment analysis.From EHRs, we discovered 3 drug-class pairs associated with lower mortality: anti-inflammatories and hormone antagonists, anti-inflammatories and lipid modifiers, and lipid modifiers and obstructive airway drugs. Sposto, R., Keegan, T. H., Vigen, C., Kwan, M. L., Bernstein, L., John, E. M., Cheng, I., Yang, J., Koo, J., Kurian, A. W., Caan, B. J., Lu, Y., Monroe, K. R., Shariff-Marco, S., Gomez, S. L., Wu, A. H. Statin use and all-cancer survival: prospective results from the Women's Health Initiative. This multicenter, randomized, double-blind study evaluated the efficacy, safety, and Wapnir, I., Kurian, A. W., Lichtensztajn, D., Clarke, C. A., Gomez, S. Higher peripheral lymphocyte count to predict survival in triple-negative breast cancer (TNBC). cancer. More effective physician-patient communication about CPM is needed to reduce potential overtreatment. At Google, Thomas Kurian is at the helm of a major cloud player, but one that lags two bigger rivals, Amazon and Microsoft . BRCA1/2 However, controversy remains about the clinical validity and actionability of genetic testing in a broader patient population. Shared decision-making is a strategy that aims to maximize patient autonomy by integrating the values and preferences of the patient with the biomedical expertise of the physician. Ahearn, T. U., Zhang, H., Michailidou, K., Milne, R. L., Bolla, M. K., Dennis, J., Dunning, A. M., Lush, M., Wang, Q., Andrulis, I. L., Anton-Culver, H., Arndt, V., Aronson, K. J., Auer, P. L., Augustinsson, A., Baten, A., Becher, H., Behrens, S., Benitez, J., Bermisheva, M., Blomqvist, C., Bojesen, S. E., Bonanni, B., Brresen-Dale, A. L., Brauch, H., Brenner, H., Brooks-Wilson, A., Brning, T., Burwinkel, B., Buys, S. S., Canzian, F., Castelao, J. E., Chang-Claude, J., Chanock, S. J., Chenevix-Trench, G., Clarke, C. L., Colle, J. M., Cox, A., Cross, S. S., Czene, K., Daly, M. B., Devilee, P., Drk, T., Dwek, M., Eccles, D. M., Evans, D. G., Fasching, P. A., Figueroa, J., Floris, G., Gago-Dominguez, M., Gapstur, S. M., Garca-Senz, J. Compared with the patient-mediated approach, direct relative contact resulted in significantly higher uptake of genetic counseling for all relatives (63% [95% CI, 49 to 75] v 35% [95% CI, 24 to 48]) and genetic testing for first-degree relatives (62% [95% CI, 49 to 73] v 40% [95% CI, 32 to 48]). Surgeons had practiced a mean (SE) of 20.9 (0.6) years, and 28.9% (107 of 370) treated more than 50 cases of new breast cancer per year. We received paired pre- and posttest responses for 2172 patients (response rate=14.3%). 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. Expanding and validating this approach in both additional cross-sectional and longitudinal cohorts may enable improved risk stratification and risk-appropriate treatment in DCIS. Genetically-predicted vigorous activity was associated with lower risk of pre/perimenopausal breast cancer (OR=0.62; 95% CI 0.45 to 0.87,3 vs. 0 self-reported days/week), with consistent estimates for most case-groups. We evaluated this mechanism of resistance in newly diagnosed BRCA1/2-mutant breast cancer patients with poor response to neoadjuvant platinum-based therapy.PrECOG 0105 was a phase II neoadjuvant study of gemcitabine, carboplatin and iniparib in patients with stage I-IIIA triple-negative or BRCA1/2 mutation-associated breast cancer (n=80). View details for DOI 10.1001/jamaoncol.2016.5652, View details for Web of Science ID 000397491400018. Schackmann, E. A., Munoz, D. F., Mills, M. A., Plevritis, S. K., Kurian, A. W. Information technology interventions to improve cancer care: a report from the American Society of Clinical Oncology Quality Care Symposium. B., Eliassen, A. H., Engel, C., Fasching, P. A., Figueroa, J., Flyger, H., Gago-Dominguez, M., Gao, C., Garca-Closas, M., Garca-Senz, J. These 6 Accessories Will Elevate Your, Australian Celebrities Playing Casino Games. To address this knowledge gap, the California Breast Cancer Survivorship Consortium (CBCSC) harmonized and pooled interview information (e.g., demographics, family history of breast cancer, parity, smoking, alcohol consumption) from six California-based breast cancer studies and assembled corresponding cancer registry data (clinical characteristics, mortality), resulting in 12,210 patients (6,501 non-Latina Whites, 2,060 African Americans, 2,032 Latinas, 1,505 Asian Americans, 112 other race/ethnicity) diagnosed with primary invasive breast cancer between 1993 and 2007. The coronavirus disease 2019 (COVID-19) pandemic has disrupted breast cancer control through short-term declines in screening and delays in diagnosis and treatments. View details for DOI 10.1016/j.cancergencyto.2007.08.009, View details for Web of Science ID 000251478000001, View details for Web of Science ID 000250506100043. 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). Multiple imputation was used to fill in missing receptor status. Whether this is optimal awaits the results of clinical trials addressing the utility of RS testing in selected subgroups. We compared model fits using the Akaike Information Criterion (AIC) and nested models using the likelihood ratio test. Wu, J., Cao, G., Sun, X., Lee, J., Rubin, D. L., Napel, S., Kurian, A. W., Daniel, B. L., Li, R. Higher Absolute Lymphocyte Counts Predict Lower Mortality from Early-Stage Triple-Negative Breast Cancer. Guidelines focus on syndromes associated with an increased risk of breast and/or ovarian cancer and are intended to assist with clinical and shared decision-making. BRCA1/2 mutation carriers were enrolled from cancer genetics clinics in Hong Kong and California according to standardized entry criteria. 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. View details for PubMedID 33426465 Three months post genetic testing, communication of results was very high; 30% reported a family member underwent genetic testing. 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. bevacizumab. Recent epidemiologic evidence suggests that prediagnosis physical activity is associated with survival in women diagnosed with breast cancer. Methods: We conducted semi-structured interviews with 11 major US payers, covering >160 million lives. Daly, M. B., Pilarski, R., Berry, M., Buys, S. S., Farmer, M., Friedman, S., Garber, J. E., Kauff, N. D., Khan, S., Klein, C., Kohlmann, W., Kurian, A., Litton, J. K., Madlensky, L., Merajver, S. D., Offit, K., Pal, T., Reiser, G., Shannon, K. M., Swisher, E., Vinayak, S., Voian, N. C., Weitzel, J. N., Wick, M. J., Wiesner, G. L., Dwyer, M., Darlow, S. Reply to Comment on 'Statin use and all-cancer survival: prospective results from the Women's Health Initiative'. Positive patients were twice as likely as negative/VUS patients (83% v 41%; P < .001) to encourage their relatives to be tested.In a racially/ethnically and socioeconomically diverse cohort, MGPT increased diagnostic yield. Ultimately, 1466 women (61.6%) received BCS, 508 (21.2%) underwent UM, and 428 (17.3%) received CPM. The authors assessed the frequency and severity of toxicities; correlated toxicity severity with unscheduled health care use (clinic visits, emergency department visits/hospitalizations) and physical health; and examined patient, tumor, and treatment factors associated with reporting increased toxicity severity.The overall survey response rate was 71%. View details for DOI 10.1158/1055-9965.EPI-15-0055, View details for DOI 10.1001/jama.2015.8088. A Phase II Clinical Trial of PM01183 in BRCA 1/2-Associated or Unselected Metastatic Breast Cancer. Pathogenic germline variants were detected in 617 patients (30.5%; 95% CI, 28.5%-32.6%) and were prevalent across patient ages (1-85 years) and cancer types, including cancers known to be strongly associated with germline variance (eg, breast, colorectal) as well as others (eg, renal, lung, and bladder). BRCA1 PVs and CHEK2 p.Ile157Thr were not associated with clinically relevant risks (OR < 2) of ILC. View details for DOI 10.1007/s12609-015-0181-4. For each 3-month period (quarter) from 2000 to 2018, we applied both models to infer recurrence status for that quarter. Jagsi, R., Abrahamse, P., Lee, K., Wallner, L. P., Janz, N. K., Hamilton, A. S., Ward, K. C., Morrow, M., Kurian, A. W., Friese, C., Hawley, S. T., Katz, S. J. Home Uncategorized thomas kurian wife allison. Kurian, A. W., Ward, K. C., Hamilton, A. S., Deapen, D. M., Abrahamse, P., Bondarenko, I., Li, Y., Hawley, S. T., Morrow, M., Jagsi, R., Katz, S. J. Halley, M., May, S., Rendle, K., Frosch, D., Kurian, A. W. Male breast cancer: a comparison between BRCA mutation carriers and non-carriers in Hong Kong, Southern China, Kwong, A., Chau, W., Law, F., Kurian, A. W., et al, A clinical trial of lovastatin for modification of biomarkers associated with breast cancer risk. hormone receptor-positive breast cancer. Mueller, S. H., Lai, A. G., Valkovskaya, M., Michailidou, K., Bolla, M. K., Wang, Q., Dennis, J., Lush, M., Abu-Ful, Z., Ahearn, T. U., Andrulis, I. L., Anton-Culver, H., Antonenkova, N. N., Arndt, V., Aronson, K. J., Augustinsson, A., Baert, T., Freeman, L. E., Beckmann, M. W., Behrens, S., Benitez, J., Bermisheva, M., Blomqvist, C., Bogdanova, N. V., Bojesen, S. E., Bonanni, B., Brenner, H., Brucker, S. Y., Buys, S. S., Castelao, J. E., Chan, T. L., Chang-Claude, J., Chanock, S. J., Choi, J. Y., Chung, W. K., Colonna, S. V., Cornelissen, S., Couch, F. J., Czene, K., Daly, M. B., Devilee, P., Drk, T., Dossus, L., Dwek, M., Eccles, D. M., Ekici, A. We identified putative regulatory elements that enhanced cell-type-specific transcription from the IGFBP5 promoter at both signals (30- to 40-fold increased expression by the putative regulatory element at signal 2, 2- to 3-fold by the putative regulatory element at signal 3). The responses of particpants who tested positive were analyzed by race/ethnicity and by level of cancer risk (high vs. moderate). Breast cancer metastasis accounts for most of the deaths from breast cancer. () RSNA, 2017 Online supplemental material is available for this article. The analytic sample was limited to 538 respondents with unilateral DCIS. 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