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). In a multivariable model, triple negative (RH 2.85, 95% CI 2.50-3.24) and HR-/HER2+ (RH 1.60, 95% CI 1.37-1.87) had worse, while HR+/HER2+ had similar, risk of all-cause death compared to HR+/HER2- breast cancer.De novo metastatic breast cancer was more likely to be HER2+. Further research is necessary to explore the risk management preferences of patients with inherited cancer predisposition, and to incorporate these preferences into clinical care. The estimated relative contributions associated with screening vs treatment varied by molecular subtype: for ER+/ERBB2-, 36% (model range, 24%-50%) vs 64% (model range, 50%-76%); for ER+/ERBB2+, 31% (model range, 23%-41%) vs 69% (model range, 59%-77%); for ER-/ERBB2+, 40% (model range, 34%-47%) vs 60% (model range, 53%-66%); and for ER-/ERBB2-, 48% (model range, 38%-57%) vs 52% (model range, 44%-62%).In this simulation modeling study that projected trends in breast cancer mortality rates among US women, decreases in overall breast cancer mortality from 2000 to 2012 were associated with advances in screening and in adjuvant therapy, although the associations varied by breast cancer molecular subtype. Morrow, M. n., Abrahamse, P. n., Hofer, T. P., Ward, K. C., Hamilton, A. S., Kurian, A. W., Katz, S. J., Jagsi, R. n. NCCN Guidelines (R) Insights Genetic/Familial High-Risk Assessment: Breast and Ovarian, Version 2.2017 Featured Updates to the NCCN Guidelines. Because coronary artery disease remains the primary cause of death for women, any intervention to reduce breast cancer risk must be weighed against comorbidities and interventions affecting cardiovascular risk reduction. Ruth, K. S., Day, F. R., Hussain, J., Martnez-Marchal, A., Aiken, C. E., Azad, A., Thompson, D. J., Knoblochova, L., Abe, H., Tarry-Adkins, J. L., Gonzalez, J. M., Fontanillas, P., Claringbould, A., Bakker, O. A total of 242 participants (12%) carried one or more pathogenic variant (positive), 689 (34%) carried one or more variant of uncertain significance (VUS), and 1,069 (53%) carried no pathogenic variants or VUS (negative). View details for DOI 10.1016/j.celrep.2019.07.057. View details for DOI 10.1007/s10900-015-0052-y, View details for DOI 10.1016/j.stamet.2015.06.001, View details for Web of Science ID 000361262400006. The immune system is critical in modulating cancer progression, but knowledge of immune composition, phenotype, and interactions with tumor is limited. 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. [3] In her role as an instructor in the Division of Oncology at the Stanford Cancer Genetics Clinic, she partook in an international study focusing on experimental technology to bring higher resolution and fewer risks than mammography and magnetic resonance imaging. Fifty-eight percent of adopters were small payers. Next-generation sequencing promises major advancements in precision medicine but faces considerable challenges with insurance coverage. Ling, A. Y., Kurian, A. W., Caswell-Jin, J. L., Sledge, G. W., Shah, N. H., Tamang, S. R. Can precision medicine help achieve the goal of reducing care when the risks exceed the benefits? Cox proportional hazards regression models were fit to data to estimate hazards ratios (HRs) and 95% confidence intervals (CIs) for overall and breast cancer-specific mortality. 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. Women's perceived risk of distant recurrence (0-100%) was categorized into subgroups: overestimation, reasonably accurate, and zero risk. A., Teo, S. H., Teras, L. R., Terry, M. B., Toland, A. E., Tomlinson, I., Truong, T., Tseng, C. C., Untch, M., Vachon, C. M., van den Ouweland, A. M., Wang, S. S., Weinberg, C. R., Wendt, C., Winham, S. J., Winqvist, R., Wolk, A., Wu, A. H., Yamaji, T., Zheng, W., Ziogas, A., Pharoah, P. D., Dunning, A. M., Easton, D. F., Pettitt, S. J., Lord, C. J., Haider, S., Orr, N., Fletcher, O. RATIONALE: Learning about how patients make decisions about using chemoprevention may help The impact of these disruptions on patient experiences remain relatively understudied. MSH6 protein loss was detected in two cases (12.5%); (95% CI: 2.2%-37.3%) and PMS2 protein loss was detected in two cases (12.5%); (95% CI: 2.2%-37.3%). 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. 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%). (HER2-positive), locally advanced or metastatic breast cancer. Here, we implemented computationally efficient, penalized, logistic regression models (lasso, elastic net, stepwise) to individual level genotype data and a Bayesian framework with continuous shrinkage, "select and shrink for summary statistics" (S4), to summary level data for epithelial non-mucinous ovarian cancer risk prediction. 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. Recreational physical activity (RPA) is associated with improved survival after breast cancer (BC) in average-risk women, but evidence is limited for women who are at increased familial risk because of a BC family history or BRCA1 and BRCA2 pathogenic variants (BRCA1/2 PVs).We estimated associations of RPA (self-reported average hours per week within 3 years of BC diagnosis) with all-cause mortality and second BC events (recurrence or new primary) after first invasive BC in women in the Prospective Family Study Cohort (n = 4610, diagnosed 1993-2011, aged 22-79 years at diagnosis). Both patients and clinicians agreed that the decision tool could improve patient-doctor encounters (mean scores 4.50 and 4.69, on a 1-5 scale). 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. Trends in genetic testing and results for women diagnosed with breast cancer or ovarian cancer, 2013-2017, Development of a breast cancer risk assessment model for ATM mutation carriers incorporating tyrer-cuzick and a polygenic risk score (PRS). 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. Larger studies are needed to identify risk factors and prognostic significance associated with atypia and non-fluid-yielding ducts in high-risk populations, and define their role as biomarkers. Weight is more informative than BMI for predicting breast cancer risk, consistent with non-adipose as well as adipose tissue being etiologically relevant. After Princeton, Kurian started his career with McKinsey & Company as a consultant serving clients in the software, telecommunications, and financial services industries for 6 years in London and Brussels. The mean (SD) age was 61.8 (12) years at the time of the survey. breast cancer 2008-2009 showed initial safety,tolerability and good bioavailability of both These challenges are especially important to address in oncology in which next-generation tumor sequencing (NGTS) holds a particular promise, guiding the use of life-saving or life-prolonging therapies. 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. Little is known about this process for racially and ethnically diverse individuals or for those with mutations in moderate risk genes. Richard Marks. Data on surgical decisions, motivations for those decisions, and knowledge were included in the analysis. The practice of genetic testing for hereditary breast and/or ovarian cancer (HBOC) is rapidly evolving owing to the recent introduction of multigene panels. There was no significant mortality difference compared with bilateral mastectomy (HR, 1.02 [95% CI, 0.94-1.11]; 10-year mortality, 18.8% [95% CI, 18.6%-19.0%]). We classified EHR encounters data according to typical periods of the cancer care episode (screening, diagnosis, treatment) and posttreatment surveillance, as well as by facility used to better characterize patterns of care for patients seen at both organizations.We identified a "treated" cohort consisting of women receiving interventions for their initial cancer diagnosis, and classified their encounters over time across multiple dimensions (type of care, provider of care, and timing of care with respect to their cancer diagnosis). Gupta, T., Purington, N., Liu, M., Han, S., Sledge, G., Schapira, L., Kurian, A. 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. 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. 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. hydrochloride, cyclophosphamide, and paclitaxel are more effective with or without disease and who have had no prior platinum therapy for metastatic disease. 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. Evidence-based guidelines recommend cascade genetic counseling and testing for hereditary cancer syndromes, providing relatives the opportunity for early detection and prevention of cancer. [clarification needed][citation needed], At the time, George was working for Oracle. The proportion of mastectomies that were nipple-sparing increased over time (1988, 0.2%; 2013, 5.1%) and with neighborhood socioeconomic status, and decreased with age and stage. Rodriguez, G. M., Ferguson, J. M., Kurian, A., Bondy, M., Patel, M. I. Only 10/28 (36%) patients with a VUS with a clinically significant conflict had a documented discussion by a provider about the conflict. However, little is known about how chemotherapy use and oncologists' recommendations have changed in recent years.We surveyed 5080 women (70% response rate) diagnosed with breast cancer between 2013 and 2015 and accrued through two Surveillance, Epidemiology, and End Results registries (Georgia and Los Angeles) about chemotherapy receipt and their oncologists' chemotherapy recommendations. A., Mebirouk, N., Menon, U., Miller, A., Milne, R. L., Minlikeeva, A., Modugno, F., Montagna, M., Moysich, K. B., Munro, E., Nathanson, K. L., Neuhausen, S. L., Nevanlinna, H., Yie, J. N., Nielsen, H. R., Nielsen, F. C., Nikitina-Zake, L., Odunsi, K., Offit, K., Olah, E., Olbrecht, S., Olopade, O. I., Olson, S. H., Olsson, H., Osorio, A., Papi, L., Park, S. K., Parsons, M. T., Pathak, H., Pedersen, I. S., Peixoto, A., Pejovic, T., Perez-Segura, P., Permuth, J. Each imaging subtype was associated with specific dysregulated molecular pathways that can be therapeutically targeted.Imaging subtypes provide complimentary value to established histopathological or molecular subtypes, and may help stratify breast cancer patients. We examined whether accounting for racial/ethnic differences in the prevalence of clinical, patient, and lifestyle and contextual factors that are associated with breast cancer-specific mortality can explain this disparity.The California Breast Cancer Survivorship Consortium combined interview data from six California-based breast cancer studies with cancer registry data to create a large racially diverse cohort of women with primary invasive breast cancer. Being affected by any cancer was associated with a higher probability of being a BRCA2, rather than a BRCA1, PV carrier (OR, 3.23; 95% CI, 2.81-3.70; P, View details for DOI 10.1001/jamaoncol.2020.2134. A., Sickles, E. A., Brenner, J., Lindfors, K. K., Joe, B. N., Leung, J. T., Feig, S. A., Ojeda-Fournier, H., Kurian, L. W., Love, E., Ryan, L., Ikeda, D. M. Chromosomal copy number alterations (CNAs) for risk assessment of ductal carcinoma in situ (DCIS). The objective of this study was to assess patients' perspectives regarding the impact of COVID-19 on their experiences, including their cancer care, emotional and mental health, and social determinants of health, and to evaluate whether these outcomes differed by cancer stage.MATERIALS AND METHODS: We conducted a survey among adults with cancer across the United States from April 1, 2020 to August 26, 2020 using virtual snowball sampling strategy in collaboration with professional organizations, cancer care providers, and patient advocacy groups. hormone receptor-positive breast cancer. Patient records were reviewed to determine whether germline follow-up testing would have been recommended by current guidelines.Among 2023 eligible patients, 1085 were female (53.6%), and the median age at cancer diagnosis was 56 (range, 0-92) years. 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. A., Aittomki, K. n., Alducci, E. n., Andrulis, I. L., Barkardottir, R. B., Barroso, A. n., Barrowdale, D. n., Benitez, J. n., Bonanni, B. n., Borg, A. n., Buys, S. S., Calds, T. n., Caligo, M. A., Capalbo, C. n., Campbell, I. n., Chung, W. K., Claes, K. B., Colonna, S. V., Cortesi, L. n., Couch, F. J., de la Hoya, M. n., Diez, O. n., Ding, Y. C., Domchek, S. n., Easton, D. F., Ejlertsen, B. n., Engel, C. n., Evans, D. G., Feliubadal, L. n., Foretova, L. n., Fostira, F. n., Gczi, L. n., Gerdes, A. M., Glendon, G. n., Godwin, A. K., Goldgar, D. E., Hahnen, E. n., Hogervorst, F. B., Hopper, J. L., Hulick, P. J., Isaacs, C. n., Izquierdo, A. n., James, P. A., Janavicius, R. n., Jensen, U. 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. Measures included the Illness Mindset Questionnaire and Functional Assessment of Cancer Therapy-General (FACT-G).Two hundred seventy-three survivors (74% breast/26% gynecologic) who were on average 3.9 years post-diagnosis (SD = 4.2), Mage 55 (SD = 12) completed the survey (response rate 80%). Population-Based Trends From California. The risk of CBC was estimated for PV carriers in each gene compared with women without PVs in a multivariate proportional hazard regression analysis accounting for the competing risk of death and adjusting for patient and tumor characteristics. adjuvant chemotherapy. Thomas Kurian is an Indian-American business executive and Chief Executive Officer of Google Cloud since 2019. 3-Hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, known as "statins," are appealing candidate agents for breast cancer chemoprevention because of their demonstrated safety after decades of widespread use. Lonning, P., Nikolaienko, O., Pan, K., Kurian, A. W., Eikesdal, H., Pettinger, M., Anderson, G. L., Prentice, R. L., Chlebowski, R. T., Knappskog, S. A case-control study of healthcare disparities in sex and gender minority patients with breast cancer. View details for DOI 10.1097/XCS.0000000000000647. Choi, Y. H., Terry, M. B., Daly, M. B., MacInnis, R. J., Hopper, J. L., Colonna, S. n., Buys, S. S., Andrulis, I. L., John, E. M., Kurian, A. W., Briollais, L. n. Genetic/Familial High-Risk Assessment: Breast, Ovarian, and Pancreatic, Version 2.2021, NCCN Clinical Practice Guidelines in Oncology. The result of the study revealed that fewer than a quarter of the patients studied underwent genetic testing for cancer-associated mutations, thus highlighting gaps between national guidelines for testing and actual testing practices. Yet extant data come from clinical trials and health care claims, which may be biased. View details for DOI 10.1200/JCO.2014.58.5885 Shumway, D. A., McLeod, C. M., Morrow, M. n., Li, Y. n., Kurian, A. W., Sabolch, A. n., Hamilton, A. S., Ward, K. C., Katz, S. J., Hawley, S. T., Jagsi, R. n. Breast and Ovarian Cancer Penetrance Estimates Derived From Germline Multiple-Gene Sequencing Results in Women. 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). 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. evaluate the safety, tolerability, pharmacokinetics and feasibility of trastuzumab emtansine This study describes the diagnostic yield and patient experiences of MGPT in diverse populations.This multicenter, prospective cohort study enrolled participants from three cancer genetics clinics-University of Southern California Norris Comprehensive Cancer Center, Los Angeles County and University of Southern California Medical Center, and Stanford Cancer Institute-who met testing guidelines or had a 2.5% or greater probability of a pathogenic variant (N = 2,000). Monoclonal View details for DOI 10.1093/jamia/ocw161. 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. 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). Inclusion of genetic ancestry in polygenic risk prediction presents an opportunity for more personalized treatment decisions for women of varying and mixed ancestries. Benchmark Method for Cost Computations Across Health Care Systems: Cost of Care per Patient per Day in Breast Cancer Care. We used multinomial logistic regression to evaluate the associations between neighborhood factors and obesity, and Cox proportional hazards regression to examine associations between neighborhood factors and mortality. Re: Cascade Genetic Testing of Relatives for Hereditary Cancer Risk: Results of an Online Initiative Response, Primary care provider-reported involvement in breast cancer treatment decisions. However, SPLC risk factors have not been established and the impact of tobacco smoking remains controversial. Serrurier, K. M., Hwang, J., McGuire, J. P., Lichtensztajn, D., Griffin, A. C., Gomez, S., Kurian, A. W., Melisko, M. E., Rugo, H. S. A young woman with bilateral breast cancer: identifying a genetic cause and implications for management. Participants Also assessed was the association between second opinion and chemotherapy use, adjusting for chemotherapy indication and propensity for receiving a second opinion. The prevalence of PVs in CHEK2 was higher in non-Hispanic White than Black patients (1.29% vs 0.38%; P, View details for DOI 10.1001/jamaoncol.2021.1492. Multiple phase 1 and 2 prevention studies of statins for breast cancer risk reduction are ongoing. The CBCSC represents a large and racially/ethnically diverse cohort of breast cancer patients from California. Kurian, A. W., Hughes, E., Bernhisel, R., Probst, B., Lanchbury, J., Wagner, S., Gutin, A., Caswell-Jin, J., Rohan, T. E., Shadyab, A. H., Manson, J. E., Lane, D., Stefanick, M. L. Clinicopathologic features of invasive breast cancer (BC) diagnosed in carriers of germline PALB2, CHEK2 and ATM pathogenic variants. . Respondents from both safety-net clinics and AMCs reported that they are increasingly ordering panels instead of single-gene tests, and tests were ordered primarily from a few commercial laboratories. Significantly more patients in the intervention group compared with the control group had knowledge regarding the probability of a BRCA1 and/or BRCA2 pathogenic variant (35.8% vs 24.4%; P View details for DOI 10.1200/JCO.2015.63.5524. These findings provide insight into the mechanisms that govern ovarian ageing, when they act, and how they might be targeted by therapeutic approaches to extend fertility and prevent disease. The goal of this study was to determine the effect on overall survival and progression free primary breast cancer who have completed definitive local treatment and neoadjuvant or Automatic Inference of BI-RADS Final Assessment Categories from Narrative Mammography Report Findings. Extending endocrine therapy from 5 to 10years is recommended for women with invasive estrogen receptor (ER)-positive breast cancers. Finally, we assessed the extent of variant-specific pleiotropy among cancers at known and newly identified cancer susceptibility loci.We observed wide-spread but modest genome-wide genetic correlations across cancers. Stanford is currently not accepting patients for this trial. AYAs also were more likely to be diagnosed with stage III/IV disease and high-grade tumors than were older women. There were few differences between states. Worry in the long-term survivorship period was higher among those with unmet need for discussion (48.7% v 24.9%; P The Effect of Patient and Contextual Characteristics on Racial/Ethnic Disparity in Breast Cancer Mortality. This portion of the NCCN Guidelines includes recommendations regarding diagnostic criteria and management of patients with Cowden Syndrome/PTEN hamartoma tumor syndrome. Conclusion: Nab-paclitaxel and paclitaxel monotherapy showed similar efficacy, suggesting their interchangeability as 1L treatments for mTNBC. B., Dakhil, S. R., Manola, J., Ford, J. M. Chemotherapy (CTX) treatment patterns for early-stage breast cancer (ESBC): Changing use of anthracyclines (A). However, he is an expert when it comes to his married life, wife and even children. These NCCN Guidelines Insights summarize major discussion points of the 2015 NCCN Genetic/Familial High-Risk Assessment: Breast and Ovarian panel meeting. Little is known about different ways of assessing risk of distant recurrence following cancer treatment (e.g., numeric or descriptive). Kurian, A. W., Newton Thompson, R., Gaw, A. F., Arai, S., Ortiz, R., Garber, A. M. Clinical implications of conflicting variant interpretations in the cancer genetics clinic. The major limitation of this work was the small sample size, even pooling data from all 1059 studies. Triple-negative tumors (ER-/PR-/HER2-) have been reported to be more common among younger women, but occurrence of the spectrum of breast cancer subtypes in adolescent and young adult (AYA) women aged between 15 and 39 years is otherwise poorly understood.Data regarding all 5,605 AYA breast cancers diagnosed in California during the period 2005 to 2009, including ER and PR status (referred to jointly as hormone receptor (HR) status) and HER2 status, was obtained from the population-based California Cancer Registry. View details for DOI 10.1200/JCO.2006.06.3081, View details for Web of Science ID 000244384000006. Furthermore, additional familial testing would be considered for those with first-degree relatives (42 [72%] of 58; 95% CI, 59.8%-82.2%) based on potential management changes for mutation-positive relatives. Many patients desired to talk to providers about the financial impact of cancer (15.2% of whites, 31.1% of blacks, 30.3% of Latinas, and 25.4% of Asians). This multi-institutional, multidisciplinary approach may be useful for organizations to frame responses as similar legislation is passed across the United States. Gallagher, S., Hughes, E., Kurian, A. W., Domchek, S. M., Garber, J., Probst, B., Morris, B., Tshiaba, P., Meek, S., Rosenthal, E., Roa, B., Slavin, T. P., Wagner, S., Weitzel, J., Gutin, A., Lanchbury, J. S., Robson, M. Performance of the IBIS/Tyrer-Cuzick model of breast cancer risk by race and ethnicity in the Women's Health Initiative. Stanford is currently not accepting patients for this trial. Schackmann, E. A., Vinayak, S., Kurian, A. W., et al. Epidemiological studies provide strong evidence for a role of endogenous sex hormones in the aetiology of breast cancer. Cheng, I., Shariff-Marco, S., Koo, J., Monroe, K. R., Yang, J., John, E. M., Kurian, A. W., Kwan, M. L., Henderson, B. E., Bernstein, L., Lu, Y., Sposto, R., Vigen, C., Wu, A. H., Gomez, S. L., Keegan, T. H. Treatment Decision Making and Genetic Testing for Breast Cancer: Mainstreaming Mutations. A multivariate analysis found that mean total MICRA scores were significantly higher (more uncertainty/distress) among high- and moderate-risk PV carriers (29.7 and 24.8, respectively) than those with a VUS or negative results (17.4 and 16.1, respectively). KURIAN, George Thomas 1931-PERSONAL: Born August 4, 1931, in Changanacherry, India; naturalized U.S. citizen; married August 22, 1966; wife's name Annie; children . To test for the association with breast cancer risk, we carried out follow-up genotyping in 90,916 cases and 89,893 controls from the Breast Cancer Association Consortium. We identified 1886 MBC patients, 512 (27.1%) of whom were de novo MBC patients and 1374 (72.9%) were recurrent MBC patients. , and interactions with tumor is limited major advancements in precision medicine but faces considerable challenges with insurance.! 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