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For five symptomatic patients, each (100%) was found to have signet ring cell adenocarcinoma (P=0.002 versus asymptomatic) by preoperative endoscopy; three (60%) had lymph node involvement and two (40%) had distant metastases at time of operation. The California Breast Density Information Group identified key elements and implications of the law, researching scientific evidence needed to develop a robust response. cancer. He reports to . Low, Y. S., Daugherty, A. C., Schroeder, E. A., Chen, W., Seto, T., Weber, S., Lim, M., Hastie, T., Mathur, M., Desai, M., Farrington, C., Radin, A. For more information, please contact Pei Jen Chang, 650-725-0866. Blayney, D. W., Seto, T., Hoang, N., Lindquist, C., Kurian, A. W. Impact of COVID-19 on breast cancer care at a Bay Area academic center. of pertuzumab given in combination with trastuzumab (Herceptin) and vinorelbine in first line Cancer 2018;000:000-000. We describe our findings and discuss them in the context of PMI priorities. This is equivalent to an absolute reduction of 95 invasive breast cancers, and 42 breast cancer deaths per 1,000 high-risk women. Results are conflicting in Asian populations. In this review, we compiled data from 11 participating Asian countries (Bangladesh, Mainland China, Hong Kong SAR, Indonesia, Japan, Korea, Malaysia, Philippines, Singapore, Thailand and Vietnam), and from ethnic Asians residing in Canada and the USA. Preventive surgery after multiplex genetic panel testing (MGPT). Multiple imputation was used to fill in missing receptor status. Breast cancer patients' misunderstanding of their systemic cancer recurrence risk has consequences on decision-making and quality of life. The Case of Breast Cancer. The early months of the COVID-19 pandemic led to reduced cancer screenings and delayed cancer surgeries. A Florida man is charged with second degree human trafficking in Shelby County.32-year-old Korian Durell Thomas is being held in the Shelby County Jail on $180,000 bond. Neoadjuvant gemcitabine (1,000 mg/m(2) intravenously [IV] on days 1 and 8), carboplatin (area under curve of 2 IV on days 1 and 8), and iniparib (5.6 mg/kg IV on days 1, 4, 8, and 11) were administered every 21 days for four cycles, until the protocol was amended to six cycles. 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. These may be useful in the patient's decision-making process and impact uptake of risk-management options. View details for DOI 10.13063/2327-9214.1127, View details for PubMedCentralID PMC4435001. Linking electronic health records to better understand breast cancer patient pathways within and between two health systems. To quantify the potential benefit, we estimated reductions in absolute cancer-related deaths that could occur if cancers diagnosed after metastasis (stage IV) were instead diagnosed at earlier stages.We obtained stage-specific incidence and survival data from the Surveillance, Epidemiology, and End Results Program for 17 cancer types for all persons diagnosed ages 50 to 79 years in 18 geographic regions between 2006 and 2015. The minor rs45446698-C allele was associated with lower oestrone-3-glucuronide (-49.2%, 95% CI -56.1% to -41.1%, P=3.110-18); in follow-up analyses, rs45446698-C was also associated with lower progesterone (-26.7%, 95% CI -39.4% to -11.6%, P=0.001) and reduced risk of oestrogen and progesterone receptor-positive breast cancer (OR=0.86, 95% CI 0.82-0.91, P=6.910-8).The CYP3A7*1C allele is associated with reduced risk of hormone receptor-positive breast cancer possibly mediated via an effect on the metabolism of endogenous sex hormones in premenopausal women. Keegan, T. H., Kurian, A. W., Gali, K., Tao, L., Lichtensztajn, D. Y., Hershman, D. L., Habel, L. A., Caan, B. J., Gomez, S. L. Clinical evaluation of multigene testing for hereditary breast and ovarian cancer. Breast cancer subtypes were classified as ER or PR positive and HER2 negative (HR(+)/HER2(-)), ER or PR positive and HER2 positive (HR(+)/HER2(+)), ER and PR negative and HER2 positive (HR(-)/HER2(+)), and ER, PR, and HER2 negative (triple-negative). Z., Naderi, E., Andrulis, I. L., Arnold, A. M., Aronson, K. J., Augustinsson, A., Bandinelli, S., Barbieri, C. M., Beaumont, R. N., Becher, H., Beckmann, M. W., Benonisdottir, S., Bergmann, S., Bochud, M., Boerwinkle, E., Bojesen, S. E., Bolla, M. K., Boomsma, D. I., Bowker, N., Brody, J. View details for DOI 10.1158/1055-9965.EPI-21-0823. BRCA1/2 Imputing HLA genotypes from existing single-nucleotide polymorphism datasets is low-cost and efficient. () RSNA, 2017 Online supplemental material is available for this article. Jagsi, R., Hawley, S. T., Griffith, K. A., Janz, N. K., Kurian, A., Ward, K. C., Hamilton, S., Morrow, M., Katz, S. J. talazoparib (also known as BMN 673) in subjects with locally advanced or metastatic breast Our objective was to characterize trends in annual surveillance mammography participation among women with a personal history of breast cancer over a 13-year period.We examined annual surveillance mammography participation from 2004 to 2016 in a nationwide sample of commercially insured women with prior breast cancer. View details for PubMedID 35723570, View details for DOI 10.1093/jncics/pkac045. Cause-specific proportional hazards models estimated SPLC risk. View details for PubMedID 34224603. thomas kurian wife allison. EHRs provide real-world treatment and outcome patterns, while complementary biomolecular data, including disease-specific gene expression and drug-protein interactions, provide mechanistic understanding.We applied Group Lasso INTERaction NETwork (glinternet), an overlap group lasso penalty on a logistic regression model, with pairwise interactions to identify variables and interacting drug pairs associated with reduced 5-year mortality using EHRs of 9945 breast cancer patients. In this review, we summarize the current understanding of pathogenic germline gene mutations associated with TNBC and the early detection and prevention strategies for women at risk of developing this high-risk breast cancer subtype. Kurian, A. W., Abrahamse, P., Caswell Jin, J., Hamilton, A. S., Hofer, T., Ward, K. C., Katz, S. National claims data analysis of outcomes of hospitalized cancer patients without COVID-19 infection during versus prior to the COVID-19 pandemic. We used a multivariable model to test for interaction between affected gene and family history extent for ATM, BRCA1/2, CHEK2, and PALB2.A total of 34,865 women linked to genetic results. By using data from The Cancer Genome Atlas (TCGA), a radiogenomic map for the tumor-adjacent parenchymal tissue was created and molecular pathways associated with prognostic parenchymal imaging features were identified. 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%). BRCA1 PVs and CHEK2 p.Ile157Thr were not associated with clinically relevant risks (OR < 2) of ILC. Jayasekera, J., Lowry, K. P., Yeh, J. M., Schwartz, M. D., Wernli, K. J., Isaacs, C., Kurian, A. W., Stout, N. K. A pilot study to increase cascade genetic testing in families with hereditary cancer syndromes. 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. By modeling BRCA2-crisis invitro, we have derived insights into pre-neoplastic molecular alterations that may enhance the development of preventative therapies. In a simulation study, we demonstrate that the proposed sequential regression multiple imputation modifications result in reduced bias in the final analysis compared to standard sequential regression multiple imputation, with an approximation strategy involving inclusion of an offset in the imputation model performing the best overall. 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? Combined Asian and European PRSs (333 single-nucleotide variations) had a hazard ratio per SD of 1.53 (95% CI= 1.37-1.71) and an area under the receiver operating curve of 0.621 (95% CI= 0.608-0.635). View details for DOI 10.1038/s41431-021-00987-7, Germline copy number variants (CNVs) are pervasive in the human genome but potential disease associations with rare CNVs have not been comprehensively assessed in large datasets. 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. metastatic disease with disease progression > 8 weeks following the last dose of 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. To account for varying duration of episodes of care, we computed a cost of care per day (CCPD) for each patient.Median CCPD for initial treatment was $29.45 in US dollars (USD), the CCPD for surveillance and survivorship care was $2.45 USD, and the CCPD for relapse care was $13.80 USD. Reproductive longevity is essential for fertility and influences healthy ageing in women1,2, but insights into its underlying biological mechanisms and treatments to preserve it are limited. 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. Kwong, A., Chau, W., Law, F. F., Kurian, A., Ford, J. M., West, D. W., Ma, E. K. Feasibility evaluation of an online tool to guide decisions for BRCA1/2 mutation carriers. Tao, L., Chu, L., Wang, L. I., Moy, L., Brammer, M., Song, C., Green, M., Kurian, A. W., Gomez, S. L., Clarke, C. A. Rapid HRM mutation screening for a panel of the founder mutations were developed and validated.In this study, our findings suggest that BRCA mutations account for a substantial proportion of hereditary breast/ovarian cancer in Southern Chinese population. cancer that has spread to the lymph nodes (lymph node-positive) or cancer that has not spread Kwong, A., Ng, E. K., Law, F. B., Wong, H. N., Wa, A., Wong, C. L., Kurian, A. W., West, D. W., Ford, J. M., Ma, E. S. Genetic Polymorphisms as Predictors of Breast Cancer Risk, Identification of BRCA1/2 Founder Mutations in Southern Chinese Breast Cancer Patients Using Gene Sequencing and High Resolution DNA Melting Analysis. The major limitation of this work was the small sample size, even pooling data from all 1059 studies. Kurian, A. W., Canchola, A. J., Gomez, S. L. Prevalence of Lynch syndrome in women with mismatch repair-deficient ovarian cancer. This study aimed to examine the association between mindsets-established, but mutable beliefs that a person holds-and health-related quality of life in survivors of breast and gynecologic cancer.A cross-sectional survey study was conducted with breast and gynecologic cancer survivors. Interventions designed to overcome language and cultural barriers are essential to optimize the experience of patients with LEP. 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. Katz, S. J., Hawley, S. T., Jagsi, R., Kurian, A. W. Contralateral Prophylactic Mastectomy Decisions in a Population-Based Sample of Patients With Early-Stage Breast Cancer. Actual 10-year risk of distant recurrence after treatment was based on clinical factors for women with DCIS & low-risk invasive cancer (Stg 1A, ER+, HER2-, Gr 1-2). Liang, S., Richardson, M., Chen, T., Colocci, N., Kurian, A., de Briun, M., Chan, C., Chan, J. Twenty-one-gene recurrence score (RS) in germline (g)CHEK2 mutation-associated versus sporadic breast cancers (BC): A multi-site case-control study. Both groups found the tool easy to use, with SUS scores of 82.5-85 on a scale of 1-100; we did not observe differences according to patient age or gene mutation. Comparison of the Prevalence of Pathogenic Variants in Cancer Susceptibility Genes in Black Women and Non-Hispanic White Women With Breast Cancer in the United States. There is growing concern about overtreatment of breast cancer as outcomes have improved over time. Data on screening performance for mammography and MRI were estimated from published literature. Smoking pack-years (HR 1.18 per 10 pack-years; P<0.001) and smoking intensity (HR 1.30 per 10 cigarettes per day (CPD); P<0.001) were significantly associated with increased SPLC risk. Letrozole in Treating Postmenopausal Women Who Have Received Hormone Therapy for Hormone Receptor-Positive Breast Cancer, Neratinib +/- Fulvestrant in Metastatic HER2 Non-amplified But HER2 Mutant Breast Cancer, Olaparib as Adjuvant Treatment in Patients With Germline BRCA Mutated High Risk HER2 Negative Primary Breast Cancer. We trained the NLP models using 894 randomly selected patient records that were manually reviewed by clinical experts and evaluated model performance using 179 hold-out patients (20%) as a test set.The median follow-up time was 19 quarters (5 years) for the training set and 15 quarters (4 years) for the test set. Inclusion of genetic ancestry in polygenic risk prediction presents an opportunity for more personalized treatment decisions for women of varying and mixed ancestries. The model was trained jointly on manually curated data from 670 patients and NLP-curated data of 8062 patients. 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. Morra, A., Escala-Garcia, M., Beesley, J., Keeman, R., Canisius, S., Ahearn, T. U., Andrulis, I. L., Anton-Culver, H., Arndt, V., Auer, P. L., Augustinsson, A., Beane Freeman, L. E., Becher, H., Beckmann, M. W., Behrens, S., Bojesen, S. E., Bolla, M. K., Brenner, H., Brning, T., Buys, S. S., Caan, B., Campa, D., Canzian, F., Castelao, J. E., Chang-Claude, J., Chanock, S. J., Cheng, T. D., Clarke, C. L., Colonna, S. V., Couch, F. J., Cox, A., Cross, S. S., Czene, K., Daly, M. B., Dennis, J., Drk, T., Dossus, L., Dunning, A. M., Dwek, M., Eccles, D. M., Ekici, A. Data analyses were conducted using chi-square and t tests. Mandelblatt, J. S., Near, A. M., Miglioretti, D. L., Munoz, D. n., Sprague, B. L., Trentham-Dietz, A. n., Gangnon, R. n., Kurian, A. W., Weedon-Fekjaer, H. n., Cronin, K. A., Plevritis, S. K. Rapid detection ofBRCA1/2recurrent mutations in Chinese breast and ovarian cancer patients with multiplex SNaPshot genotyping panels. A., Head, B., Goldstein, L. J., Haley, B. Stanford is currently not accepting patients for this trial. 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'. mechanism has not yet been fully elucidated, however based on experiments on tumor cells George Kurian, who grew up in Bengaluru, has just been appointed CEO of the $6-billion, US-based computer storage and data management company NetApp.As remarkable as that is, the more remarkable part of this story is the near identical journeys that George and his twin brother Thomas Kurian, president of Oracle, have had. We identified two germline variants on chromosome 1, rs138569520 and rs146023652, significantly associated with breast cancer-specific survival (P=3.1910-8 and 4.4210-8). locally recurrent or metastatic breast cancer. compared with a placebo in treating postmenopausal women who have received hormone therapy 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%). View details for DOI 10.1007/s10689-012-9577-8. Google Cloud is turning to a traditional enterprise sales model as it . We discuss events leading to the wider availability of commercialized multiple-gene germline panel testing, the recent data that support using this powerful tool to improve cancer risk assessment and reduction strategies, and remaining challenges to clinical optimization of this new genetic technology. [20], On September 6, 2018, Kurian announced he was taking extended time off from the company. Rates by gene did differ: in particular, a higher percentage of whites than nonwhites carried pathogenic CHEK2 variants (3.8% vs. 1.0%; P=0.002). Over half of women reported that doctors used words and numbers to describe risk, while 24% used only words. For women aged 50years or older at breast cancer diagnosis, RS often exceeded the chemotherapy benefit threshold (26) with BRCA1 (71.7% vs 14.4% with none; P Kurian, A. W., Munoz, D. F., Rust, P., Schackmann, E. A., Smith, M., Clarke, L., Mills, M. A., Plevritis, S. K. Breast Cancer Risk for Noncarriers of Family-Specific BRCA1 and BRCA2 Mutations: Findings From the Breast Cancer Family Registry. Sub-analyses of the c.7271T>G missense PV were conducted. characteristics typical of the poly (ADP-ribose) polymerase (PARP) inhibitor class. 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. There was a mean DRFS hazard ratio of 1.79 (0.94) for endocrine vs chemoendocrine therapy among women ages 50years and younger with RS 16-25; the DFRS rates were 91.6% (0.04) for endocrine and 94.8% (0.01) for chemoendocrine therapy. In 1996, the brothers switched companies when George was hired by McKinsey, and Thomas, by Oracle [7]. Aredo, J. V., Luo, S. J., Gardner, R. M., Sanyal, N. n., Choi, E. n., Hickey, T. P., Riley, T. L., Huang, W. Y., Kurian, A. W., Leung, A. N., Wilkens, L. R., Robbins, H. A., Riboli, E. n., Kaaks, R. n., Tjnneland, A. n., Vermeulen, R. C., Panico, S. n., Le Marchand, L. n., Amos, C. I., Hung, R. J., Freedman, N. D., Johansson, M. n., Cheng, I. n., Wakelee, H. A., Han, S. S. A Population-Based Study of Genes Previously Implicated in Breast Cancer. Jayasekera, J., Sparano, J. Electronic medical records (EMR) and cancer registries contain complementary information on cancer diagnosis, treatment and outcome, yet are rarely used synergistically. Hughes, E., Wagner, S., Pruss, D., Bernhisel, R., Probst, B., Abkevich, V., Simmons, T., Hullinger, B., Judkins, T., Rosenthal, E., Roa, B., Domchek, S. M., Eng, C., Garber, J., Gary, M., Klemp, J., Mukherjee, S., Offit, K., Olopade, O. I., Vijai, J., Weitzel, J. N., Whitworth, P., Yehia, L., Gordon, O., Pederson, H., Kurian, A., Slavin, T. P., Gutin, A., Lanchbury, J. S. Physical activity, sedentary time and breast cancer risk: a Mendelian randomisation study. Clinically significant discrepancies between the lab provided test reports and other major commercial laboratories were identified, including differences between pathogenic/likely pathogenic (P/LP) and variant of uncertain significance (VUS) classifications, via review of ClinVar archives. test the tolerability and efficacy of AZD0530 (also called saracatinib) when used together Panel on Guidelines for Germline Mutation Testing In Breast Cancer, American Society of Clinical Oncology (2022 - Present), External Advisory Board Member, Basser Center for BRCA Research (2021 - Present), Associate Chief for Academic Affairs, Oncology Division, Stanford University (2020 - Present), Co-Leader, Population Sciences Program, Stanford Cancer Institute (2020 - Present), Steering Committee Member, CISNET Breast Cancer Working Group, National Cancer Institute (2020 - Present), Advisory Committee Member, California Cancer Registry (2019 - Present), Co-Investigator, Northern California Breast Cancer Family Registry (2018 - Present), Specialty Editor, Breast Cancer Advisory Panel, American Society of Clinical Oncology (2016 - Present), Working Group Member, ClinGen Hereditary Cancer Clinical Domain Working Group (2016 - Present), Editorial Board; Special Editor for Hereditary Breast Cancer Syndromes, Cancer.Net, American Society of Clinical Oncology (2015 - Present), Board of Directors Member, Facing Our Risk of Cancer Empowered (FORCE) (2015 - 2020), External Advisory Board Member, Cancer Genomics Program, Princess Margaret Hospital Cancer Centre (2015 - 2016), Lead Medical Oncology Investigator, Cancer Surveillance and Outcomes Research Team (CanSORT), University of Michigan School of Medicine (2014 - Present), Oncology Consultant, Breast Cancer Working Group, Cancer Intervention and Surveillance Modeling Network (CISNET), National Cancer Institute (2014 - Present), Panel on Clinical Guidelines Development for Breast Cancer Risk Reduction, National Comprehensive Cancer Network (2013 - Present), Director, Cancer Education Seminar, Stanford Division of Oncology (2013 - 2020), Track Leader, Cancer Prevention and Epidemiology, Scientific Program Committee, American Society of Clinical Oncology (2013 - 2014), Director, Stanford Women's Clinical Cancer Genetics Program (2012 - Present), Scientific Program Committee, Quality Care Symposium, American Society of Clinical Oncology (2012 - 2015), Advisory Committee, California HealthCare Foundation (2012 - 2014), Board of Directors, Santa Clara County, American Cancer Society (2011 - 2016), Scientific Program Committee, Cancer Prevention and Epidemiology, American Society of Clinical Oncology (2011 - 2014), Scientific Program Committee, Genetic and Molecular Epidemiology, American Association for Cancer Research (2011 - 2012), Panel on Clinical Guidelines Development for Genetic/ Familial Risk: Breast and Ovarian Cancer, National Comprehensive Cancer Network (2009 - Present), Career Development Subcommittee, American Society of Clinical Oncology (2008 - 2011), Program Committee, Professional Development, American Society of Clinical Oncology (2008 - 2011), Associate Director, Stanford Clinical Cancer Genomics Program (2007 - Present), Invited Researcher, Breast Cancer Research Foundation (2022), Komen Scholar, Susan G. Komen for the Cure (2022), Impact Award, National Consortium of Breast Centers (2021), Elected Member, American Society of Clinical Investigation (2020), Saul Rosenberg Faculty Teaching Award, Oncology Division, Stanford University School of Medicine (2019), R01 CA225697, Principal Investigator, National Cancer Institute (2018), Elizabeth Mayers Award for Outstanding Research, BRCA Foundation (2017), Oncology Division Teaching Award, Stanford University School of Medicine (2014), Suzanne Pride Bryan Award for Breast Cancer Research, Stanford University Cancer Institute (2013), New Clinical Investigator Award, Stanford University Cancer Institute (2011), Top 12 publications funded by the Epidemiology and Genomics Research Program, National Cancer Institute (2011), Translational Research Award, California Breast Cancer Research Program (2010), Jan Weimer Faculty Chair for Breast Oncology, Stanford University Cancer Institute (2008), Physician Faculty Scholars Award, Robert Wood Johnson Foundation (2008), Cornelius L. Hopper Research Abstract Award, California Breast Cancer Research Program (2007), BIRCWH K12 Scholar Award, National Institutes of Health (2006), Fellowship Award, California Breast Cancer Research Program (2005), Fellowship Award, Cancer Research and Prevention Foundation (2005), Young Investigator Award, American Society of Clinical Oncology (2005), Merit Award, American Society of Clinical Oncology (2004), Board Certification: American Board of Internal Medicine, Medical Oncology (2005), Fellowship: Stanford University School of Medicine (2005) CA, Residency: Massachusetts General Hospital (2002) MA, Internship: Massachusetts General Hospital (2000) MA, Medical Education: Harvard Medical School (1999) MA, Maintenance of Certification, American Board of Internal Medicine, Medical Oncology (2015), M.Sc., Stanford University, Epidemiology (2006), B.A., Honors, Stanford University, Human Biology (1995), Professor of Medicine (Oncology) and of Epidemiology and Population Health, FORCE: Facing Our Risk of Cancer Empowered, Cancer Genetics Hereditary Cancer Panel Testing, Genetic & Pathological Studies of BRCA1/BRCA2: Associated Tumors & Blood Samples, A Pharmacokinetic and Randomized Trial of Neoadjuvant Treatment With Anastrozole Plus AZD0530 in Postmenopausal Patients With Hormone Receptor Positive Breast Cancer. 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