The authors measured relative risks of second contralateral breast cancer (CBC) and breast cancer death using Fine and Gray multivariable regression modeling adjusted for the competing risk of death and death from another cause, respectively, and potential confounding factors. Multivariable logistic regression models accounting for family history were used to examine the association between pathogenic mutations and breast or ovarian cancer. Cause-specific competing risk regression was applied to evaluate an association between BM risk and the mode of PLC detection-i.e., LDCT screen-detected versus non-LDCT screen-detected. Thomas Kurian is 51. The communication behaviors of study participants who carry a gene mutation were analyzed 3 months after disclosure of genetic test results. First reporting hospitals were classified by hospital type-National Cancer Institute (NCI) -designated cancer center, American College of Surgeons (ACS) Cancer Program, other-and hospital composition of the neighborhood socioeconomic status and race/ethnicity of patients with cancer. Petkov, V., Kurian, A. W., Jakubowski, D. M., Shak, S. Abstract P6-08-07: Polygenic breast cancer risk modification in carriers of high and intermediate risk gene mutations. Idos, G. E., Kurian, A. W., Ricker, C., Sturgeon, D., Culver, J. O., Kingham, K. E., Koff, R., Chun, N. M., Rowe-Teeter, C., Lebensohn, A. P., Levonian, P., Lowstuter, K., Partynski, K., Hong, C., Mills, M. A., Petrovchich, I., Ma, C. S., Hartman, A. R., Allen, B., Wenstrup, R. J., Lancaster, J. M., Brown, K., Kidd, J., Evans, B., Mukherjee, B., McDonnell, K. J., Ladabaum, U., Ford, J. M., Gruber, S. B. African American PV carriers had similarly elevated risks of CBC as non-Hispanic White PV carriers. Ninety-one percent spoke English at home, 70.1% had health insurance, and 67% had access to home internet. These findings emphasize the need to address challenges in personalized communication about genetic testing. In our analytic sample (N=927), we assessed factors correlated with both types of overestimation and report multivariable associations between overestimation and QoL (PROMIS physical & mental health) and frequent worry.30.4% of women substantially overestimated their risk of distant recurrence numerically and 14.7% descriptively. Sigal, B. M., Munoz, D. F., Kurian, A. W., Plevritis, S. K. Age-Specific Incidence of Breast Cancer Subtypes: Understanding the BlackWhite Crossover. 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. What are the treatment patterns and overall survival in patients with metastatic triple-negative breast cancer in US clinical practice? Several machine learning approaches have been developed for recurrence prediction in previous studies, but most of them use only structured electronic health records and only a small training dataset, with limited success in clinical application. Social determinants and lifestyle factors may explain some of the survival disparities for ER/PR+ BC.Addressing these factors may help reduce the higher mortality of African American women with ER/PR+ BC. The vectorized reports were utilized to train a supervised classifier to derive the BI-RADS assessment class. The authors incorporated records from the population-based California Cancer Registry and then linked EMR-California Cancer Registry data sets of Community and University patients.The authors initially identified 8210 University patients and 5770 Community patients; linked data sets revealed a 16% patient overlap, yielding 12,109 unique patients. Knowing the spectrum and frequency of the founder mutations in this population will assist in the development of a cost-effective rapid screening assay, which in turn facilitates genetic counseling and testing for the purpose of cancer risk assessment. Existing research examining barriers to addressing patients' sexual health concerns has focused on discrete characteristics of the provider-patient interaction without considering the broader context in which these interactions occur. Contribution of the Neighborhood Environment and Obesity to Breast Cancer Survival: The California Breast Cancer Survivorship Consortium. 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. Additional studies are required to quantify the penetrance of identified mutations and determine clinical utility. The 21-gene recurrence score (RS) assay stratifies early-stage, estrogen receptor-positive breast cancer by recurrence risk. Use of and mortality after bilateral mastectomy compared with other surgical treatments for breast cancer in California, 1998-2011. [3], Upon completing her fellowship, Kurian accepted a research scholar position supported by a Building Interdisciplinary Research Careers in Women's Health K12 award. Rafat, M., Aguilera, T. A., Vilalta, M., Bronsart, L. L., Soto, L. A., von Eyben, R., Golla, M. A., Ahrari, Y., Melemenidis, S., Afghahi, A., Jenkins, M. J., Kurian, A. W., Horst, K. C., Giaccia, A. J., Graves, E. E. Intratumoral Spatial Heterogeneity at Perfusion MR Imaging Predicts Recurrence-free Survival in Locally Advanced Breast Cancer Treated with Neoadjuvant Chemotherapy. Ultimately, 1466 women (61.6%) received BCS, 508 (21.2%) underwent UM, and 428 (17.3%) received CPM. Here, we propose a multiple-ancestry PRS (MA-PRS) that addresses these issues and may be useful in the development of equitable PRSs across other cancers and common diseases.Women referred for hereditary cancer testing were divided into consecutive cohorts for development (n = 189,230) and for independent validation (n = 89,126). Ricker, C., Koff, R., Qu, C., Culver, J. O., Sturgeon, D., Lowstuter, K., Hong, C. A., Allen, B., Rowe-Teeter, C., Lebensohn, A., Kingham, K., Chun, N., Levonian, P., Mills, M., Hartman, A., Ladabaum, U., McDonnell, K., Ford, J. M., Gruber, S., Kurian, A. W., Idos, G. Dynamic Strategy for Personalized Medicine: An Application to Metastatic Breast Cancer. The histologic types of epithelial ovarian cancer differ in clinical behavior, descriptive epidemiology, and genetic origins. We performed an evaluation of high-risk women's tolerance of a breast screening protocol using clinical breast examination, mammography, breast magnetic resonance imaging (MRI) and ductal lavage (DL), and of change in attitudes toward PM after screening.A questionnaire assessing tolerance of screening procedures and change in opinion towards PM was designed and administered to 43 study participants, after a median follow-up of 13 months. Staton, A. D., Kurian, A. W., Cobb, K., Mills, M. A., Ford, J. M. Magnetic resonance galactography: A feasibility study in women with prior atypical breast duct cytology. A., Ikeda, D. M., McPherson, L., Sharma, B., Kardashian, A., Schackmann, E., Kingham, K. E., Mills, M. A., West, D. W., Ford, J. M., Kurian, A. W. A Simulation Model to Predict the Impact of Prophylactic Surgery and Screening on the Life Expectancy of BRCA1 and BRCA2 Mutation Carriers. View details for DOI 10.1158/1078-0432.CCR-16-2174. Beesley, L. J., Bondarenko, I., Elliot, M. R., Kurian, A. W., Katz, S. J., Taylor, J. M. Predicted Chemotherapy Benefit for Breast Cancer Patients With Germline Pathogenic Variants in Cancer Susceptibility Genes. The model simulations replicated TAILORx design, and then tested treatment effects on 9-year distant recurrence-free survival (DRFS) in 14 new scenarios: eight subgroups defined by age (50 and >50years) and 21-gene RS (11-25/16-25/16-20/21-25); six different RS cut points among women ages 18-75 years (16-25, 16-20, 21-25, 26-30, 26-100); and 20-year follow-up. The changes in breast cancer incidence across the pandemic did not vary by demographic factors. Mantz, A. Model inputs were derived from clinical trials, large US cohort studies, registry, and claims data. HLA imputation was performed using SNP2HLA on 10,886 quality-controlled variants within the 15-55Mb region on chromosome 6. Their application to women of non-European ancestry has lagged because of the lack of a formal approach to incorporate genetic ancestry and ancestry-dependent variant frequencies and effect sizes. We compare three different approximate methods to solve our analytical model against standard medical practice and show significant potential benefit of the computed dynamic strategies to limit tumor growth and to reduce the number of time periods patients are given chemotherapy, with its attendant side effects. Pathogenic variants (PVs) in ATM are relatively common, but the scope and magnitude of risk remains uncertain. We have additionally conducted a literature review to include other Asian countries mainly in Central and Western Asia. The results in MINDACT and Asian women from BCAC were consistent.An increased PRS313 is associated with favorable tumor characteristics, but is not independently associated with prognosis. that atezolizumab can be safely combined with standard chemotherapy agents. (HER2-positive), locally advanced or metastatic breast cancer. Prevalence and predictors of second opinions from medical oncologists for early-stage breast cancer: Results from the iCanCare study. Those with paid sick leave were less likely to stop working (OR, 0.5), as were those with flexible schedules (OR, 0.3).Working patients who received more aggressive treatments were more likely to experience substantial employment disruptions. A., Teras, L. R., Terry, M. B., Torres, D., Troester, M. A., Vachon, C. M., van Deurzen, C. H., van Veen, E. M., Wagner, P., Weinberg, C. R., Wendt, C., Wesseling, J., Winqvist, R., Wolk, A., Yang, X. R., Zheng, W., Couch, F. J., Simard, J., Kraft, P., Easton, D. F., Pharoah, P. D., Schmidt, M. K., Garca-Closas, M., Chatterjee, N. Genetic Insights Into Biological Mechanisms Governing Human Ovarian Ageing, Multicancer hereditary syndrome testing: Genetic counselors' perspectives. [1][2] Kurian earned her Bachelor of Arts degree in Human Biology at Stanford University before earning her medical degree from Harvard Medical School. We assessed whether lifelong physical activity or sedentary time, assessed using genotype, may be causally associated with breast cancer risk overall, pre/post-menopause, and by case-groups defined by tumour characteristics.We performed two-sample inverse-variance-weighted MR using individual-level Breast Cancer Association Consortium case-control data from 130 957 European-ancestry women (69 838 invasive cases), and published UK Biobank data (n=91 105-377 234). Conclusion:These results may inform future treatment guidelines for breast cancer patients with a history of diabetes or MI. Kurian also was founder and president of the Society of Encyclopedists. The mean age was 54 years (range, 51-57 years). Ho, W. K., Tai, M. C., Dennis, J., Shu, X., Li, J., Ho, P. J., Millwood, I. Y., Lin, K., Jee, Y. H., Lee, S. H., Mavaddat, N., Bolla, M. K., Wang, Q., Michailidou, K., Long, J., Wijaya, E. A., Hassan, T., Rahmat, K., Tan, V. K., Tan, B. K., Tan, S. M., Tan, E. Y., Lim, S. H., Gao, Y. T., Zheng, Y., Kang, D., Choi, J. Y., Han, W., Lee, H. B., Kubo, M., Okada, Y., Namba, S., Park, S. K., Kim, S. W., Shen, C. Y., Wu, P. E., Park, B., Muir, K. R., Lophatananon, A., Wu, A. H., Tseng, C. C., Matsuo, K., Ito, H., Kwong, A., Chan, T. L., John, E. M., Kurian, A. W., Iwasaki, M., Yamaji, T., Kweon, S. S., Aronson, K. J., Murphy, R. A., Koh, W. P., Khor, C. C., Yuan, J. M., Dorajoo, R., Walters, R. G., Chen, Z., Li, L., Lv, J., Jung, K. J., Kraft, P., Pharoah, P. D., Dunning, A. M., Simard, J., Shu, X. O., Yip, C. H., Taib, N. A., Antoniou, A. C., Zheng, W., Hartman, M., Easton, D. F., Teo, S. H. Genetic insights into biological mechanisms governing human ovarian ageing. The 10-year cumulative incidence of CBC among postmenopausal PV carriers was 12% for BRCA1, 9% for BRCA2, and 4% for CHEK2.Women diagnosed with breast cancer and known to carry germline PVs in BRCA1, BRCA2, CHEK2, or PALB2 are at substantially increased risk of CBC and may benefit from enhanced surveillance and risk reduction strategies. Surgical treatment was strongly correlated with missing >1 month of work (odds ratio [OR] for bilateral mastectomy with reconstruction vs lumpectomy, 7.8) and with stopping work altogether (OR for bilateral mastectomy with reconstruction vs lumpectomy, 3.1). White, D. P., Kurian, A. W., Stevens, J. L., Liu, B., Brest, A. E., Petkov, V. I. Lnning, P. E., Nikolaienko, O., Pan, K., Kurian, A. W., Eikesdal, H. P., Pettinger, M., Anderson, G. L., Prentice, R. L., Chlebowski, R. T., Knappskog, S. Incident comorbidities after tamoxifen or aromatase inhibitor therapy in a racially and ethnically diverse cohort of women with breast cancer. hormone receptor-positive breast cancer. Greater genetically-predicted sedentary time was associated with higher hormone-receptor-negative tumour risk (OR=1.77; 95% CI 1.07 to 2.92 per-SD (~7% time spent sedentary)), with elevated estimates for most case-groups. 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. Itakura, H., Ikeda, D. M., Okamoto, S., Chen, S., Rister, B., Gude, D., Mattonen, S. A., Alkim, E., Todderud, J., Schueler, E., Rubin, D., Sledge, G. W., Kurian, A. W. Distribution of Global Health Measures From Routinely Collected PROMIS Surveys in Patients With Breast Cancer or Prostate Cancer. Potentially actionable results were disclosed to participants.In total, 198 women participated in the study: 174 had breast cancer and 57 carried germline BRCA1/2 mutations. metabolites are ongoing. We tested 1105 individuals using a 29-gene next-generation sequencing panel and observed 100% analytical concordance with traditional and reference data on >750 comparable variants. That was Google Cloud CEO Thomas Kurian's simple answer when I asked if he thought he'd achieved what he set out to do in his first year. The landscape of payment for genetic testing has been changing, with an increase in the number of laboratories offering testing, larger panel offerings, and lower prices. Recently, the National Lung Screening Trial (NLST) demonstrated the efficacy of low-dose computed tomography (LDCT) screening on LC mortality reduction. Specific focus was put on differences between settings. Exhaustive preoperative stomach evaluation was normal in each case, and the stomach and adjacent lymph nodes appeared normal at surgery. Besides having an incredible professional career, Thomas lives a joyful personal life. CDH1 mutations are an indication for total gastrectomy in these patients. 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. chemoprevention in women at increased risk for breast cancer. We focused on US payers because analyses of coverage approaches and policies in the large and complex US health care system may inform similar efforts in other countries. Out of the total compensation, he received $800,000 as a salary, $3,612,553 as a bonus, $69,380,000 as stock options, and $7,337 from other types of compensation. Approximately one-third (34.5% [1350 of 3910] of patients had an elevated risk of mutation carriage, and 27.0% (1056 of 3910) overall had genetic testing. 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. Goodness-of-fit tests showed that the MA-PRS was well calibrated and predicted BC risk accurately in the tails of the distribution for both European and non-European women.The MA-PRS uses genetic ancestral composition to expand the utility of polygenic risk prediction to non-European women. SM use for coping was associated with lower QOL (p, View details for DOI 10.1007/s11764-020-00959-8. The accuracy of mammography and breast MRI was estimated from published data in high-risk women. Gaps in integrating genetic testing into management of breast cancer. Roberts, M., Kurian, A. W., Petkov, V. I. Kurian, A. W., Canchola, A. J., Gomez, S. L. Prevalence of Lynch syndrome in women with mismatch repair-deficient ovarian cancer. Tao, L., Gomez, S. L., Keegan, T. H., Kurian, A. W., Clarke, C. A. Complete IHC data were available for 8,140 Asian women. In the 47 women, serum melatonin levels ranged from 0.6 to 62.6 pg/ml, with a median of 7.0 pg/ml.Our results suggest that it is possible to reliably measure melatonin in postmenopausal women in morning serum samples in large epidemiologic studies to evaluate the role of melatonin in cancer etiology or prognosis. These 750 variants included technically challenging classes of sequence and copy number variation that together represent a significant fraction (13.4%) of the pathogenic variants observed. Multigene testing in this setting is likely to alter near-term cancer risk assessment and management recommendations for mutation-affected individuals across a broad spectrum of cancer predisposition genes. Sharma, V. B., Kurian, A. W., Feldman, A., Ford, J. M. Cost-effectiveness of screening BRCA1/2 mutation carriers with breast magnetic resonance imaging. Bevacizumab may also stop the growth of breast cancer by blocking blood flow to the Conclusion Less than one half (43.5%) of patients with clinical indications received formal genetic counseling. To characterize patients' treatment and survivorship experiences, we reported the tumor features and treatments associated with risk-reducing interventions; for example, in most BRCA2 mutation carriers (81%), MRI screening diagnoses stage I, hormone receptor-positive breast cancers, which may not require chemotherapy.Cancer risk-reducing options for BRCA1/2 mutation carriers vary in their impact on cancer incidence, recommended treatments, quality of life, and survival. Kurian responded by saying that Google has increased its spending on sales and support staff by a factor of four over the last three years, although he didn't cite a specific number. For Asian Americans, no associations were seen. However, he is an expert when it comes to his married life, wife and even children. Early life and education [ edit] Kurian was born to two academic parents; Diana Chapman Walsh, the former President of Wellesley College, and Christopher T. Walsh, a biochemist at Harvard University. 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. We considered the following comorbidities: cerebrovascular accidents, congestive heart failure, dementia, depression/anxiety, diabetes mellitus, hyperlipidemia, myocardial infarction, non-alcoholic steatohepatitis, osteoporosis/fracture, peripheral vascular disease, and venous thromboembolism. Kurian, a year into his CEO role, is running NetApp at a time when this external array company par excellence is facing numerous threats: rampant all-flash . View details for DOI 10.1001/jama.2014.10707. B., Kurian, A. W., Domchek, S. M., Garber, J. n., Lancaster, J. n., Weitzel, J. N., Gutin, A. n., Lanchbury, J. S., Robson, M. n. Reply to Residual confounding threatens the validity of observational studies on breast cancer local therapy. Sexual health concerns represent one of the most frequently experienced and longest-lasting effects of breast cancer treatment, but research suggests that service providers rarely discuss sexual health with their patients. 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. Among established breast cancer susceptibility genes (ATM, BARD1, BRCA1, BRCA2, CDH1, CHEK2, NF1, PALB2, PTEN, RAD51C, RAD51D, and TP53), we evaluated PV prevalence according to family history extent and breast cancer subtype. Priority areas for future research include the clinical validity and clinical utility of emerging genetic tests; the accuracy of developing cancer risk prediction models; and the long-term outcomes of risk-adapted screening and prevention protocols, in terms of patients' experiences and survival. 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%). As survival with early-stage, hormone receptor (HR)-positive breast has improved, it is essential to understand the long-term risks of incident comorbidities with different adjuvant endocrine therapy (ET) options.Women treated with tamoxifen and/or an aromatase inhibitor (AI) for stages 1-3, HR-positive/HER2-negative breast cancer from 2000 to 2016 in either of two healthcare systems in the San Francisco Bay Area were included. View details for DOI 10.1001/jamaoncol.2022.7146. Dennis, J., Tyrer, J. P., Walker, L. C., Michailidou, K., Dorling, L., Bolla, M. K., Wang, Q., Ahearn, T. U., Andrulis, I. L., Anton-Culver, H., Antonenkova, N. N., Arndt, V., Aronson, K. J., Freeman, L. E., Beckmann, M. W., Behrens, S., Benitez, J., Bermisheva, M., Bogdanova, N. V., Bojesen, S. E., Brenner, H., Castelao, J. E., Chang-Claude, J., Chenevix-Trench, G., Clarke, C. L., Colle, J. M., Couch, F. J., Cox, A., Cross, S. S., Czene, K., Devilee, P., Drk, T., Dossus, L., Eliassen, A. H., Eriksson, M., Evans, D. G., Fasching, P. A., Figueroa, J., Fletcher, O., Flyger, H., Fritschi, L., Gabrielson, M., Gago-Dominguez, M., Garca-Closas, M., Giles, G. G., Gonzlez-Neira, A., Gunel, P., Hahnen, E., Haiman, C. A., Hall, P., Hollestelle, A., Hoppe, R., Hopper, J. L., Howell, A., Jager, A., Jakubowska, A., John, E. M., Johnson, N., Jones, M. E., Jung, A., Kaaks, R., Keeman, R., Khusnutdinova, E., Kitahara, C. M., Ko, Y. D., Kosma, V. M., Koutros, S., Kraft, P., Kristensen, V. N., Kubelka-Sabit, K., Kurian, A. W., Lacey, J. V., Lambrechts, D., Larson, N. L., Linet, M., Ogrodniczak, A., Mannermaa, A., Manoukian, S., Margolin, S., Mavroudis, D., Milne, R. L., Muranen, T. A., Murphy, R. A., Nevanlinna, H., Olson, J. E., Olsson, H., Park-Simon, T. W., Perou, C. M., Peterlongo, P., Plaseska-Karanfilska, D., Pylks, K., Rennert, G., Saloustros, E., Sandler, D. P., Sawyer, E. J., Schmidt, M. K., Schmutzler, R. K., Shibli, R., Smeets, A., Soucy, P., Southey, M. C., Swerdlow, A. 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H., kurian, A. W., Clarke, C... The communication behaviors of study participants who carry a gene mutation were analyzed 3 months disclosure! Incidence across the pandemic did not vary by demographic factors evaluation was normal in each case, and claims.! Was normal in each case, and genetic origins Survivorship Consortium women at increased risk for breast cancer US... At increased risk for breast cancer incidence across the pandemic did not by.