We used decision analysis to simulate risk-reducing strategies in BRCA1/2 mutation carriers and to compare resulting survival probability and causes of death.We developed a Monte Carlo model of breast screening with annual mammography plus magnetic resonance imaging (MRI) from ages 25 to 69 years, prophylactic mastectomy (PM) at various ages, and/or prophylactic oophorectomy (PO) at ages 40 or 50 years in 25-year-old BRCA1/2 mutation carriers.With no intervention, survival probability by age 70 is 53% for BRCA1 and 71% for BRCA2 mutation carriers. Unfortunately, Mr. Kurian has not spoken about his children till now. Women with BRCA1 or BRCA2 (BRCA1/2) mutations face difficult decisions about managing their high risks of breast and ovarian cancer. 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. Kapoor, P. M., Mavaddat, N. n., Choudhury, P. P., Wilcox, A. N., Lindstrm, S. n., Behrens, S. n., Michailidou, K. n., Dennis, J. n., Bolla, M. K., Wang, Q. n., Jung, A. n., Abu-Ful, Z. n., Ahearn, T. n., Andrulis, I. L., Anton-Culver, H. n., Arndt, V. n., Aronson, K. J., Auer, P. L., Freeman, L. E., Becher, H. n., Beckmann, M. W., Beeghly-Fadiel, A. n., Benitez, J. n., Bernstein, L. n., Bojesen, S. E., Brauch, H. n., Brenner, H. n., Brning, T. n., Cai, Q. n., Campa, D. n., Canzian, F. n., Carracedo, A. n., Carter, B. D., Castelao, J. E., Chanock, S. J., Chatterjee, N. n., Chenevix-Trench, G. n., Clarke, C. L., Couch, F. J., Cox, A. n., Cross, S. S., Czene, K. n., Dai, J. Y., Earp, H. S., Ekici, A. CDH1 mutations are an indication for total gastrectomy in these patients. He was an Arjay Miller Scholar. 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. Lincoln, S. E., Kobayashi, Y., Anderson, M. J., Yang, S., Desmond, A. J., Mills, M. A., Nilsen, G. B., Jacobs, K. B., Monzon, F. A., Kurian, A. W., Ford, J. M., Ellisen, L. W. Precision Medicine in Breast Cancer Care: An Early Glimpse of Impact. Conclusion Heterogeneous enhancement patterns of tumor-adjacent parenchyma at MR imaging are associated with the tumor necrosis signaling pathway and poor survival in breast cancer. View details for DOI 10.1158/1940-6207.CAPR-21-0164. Mitani, A. 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. epithelial ovarian cancer. Genetic testing is important for breast and ovarian cancer risk reduction and treatment, yet little is known about its evolving use.SEER records of women of age 20 years diagnosed with breast or ovarian cancer from 2013 to 2017 in California or Georgia were linked to the results of clinical germline testing through 2019. A Trial Using Novel Markers to Predict Malignancy in Elevated-Risk Women. These may be useful in the patient's decision-making process and impact uptake of risk-management options. Both groups cited non-coverage of genetic counseling as a major barrier to testing. We report lavage of fluid-yielding and non-fluid-yielding ducts in women at high inherited breast cancer risk.A pilot breast cancer screening study including ductal lavage was conducted in 75 women at high inherited risk, 56 (74.7%) of whom had BRCA1/2 mutations. Latina women with low-education/high-nSES had lower all-cause mortality [HR 0.70 (0.54-0.90)] and non-significant lower mortality was observed for Asian American women, regardless of their education and nSES. Among these and an additional 23 mutation-positive individuals enrolled from our clinics, most of the mutations (92%) were consistent with the spectrum of cancer(s) observed in the patient or family, suggesting that these results are clinically significant. Non-fluid-yielding ducts, and atypia from non-fluid-yielding ducts, are more common in patients with prior cancer and chemotherapy. Linking electronic health records to better understand breast cancer patient pathways within and between two health systems. and help prevent the tumor from returning. 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. Sorscher and A.B. Information regarding NAC, adjuvant chemotherapy (aCT), breast conserving surgery (BCS), bilateral mastectomy (BLM), and unilateral mastectomy (ULM) was abstracted from the medical records. Yuan, Y., Van Dyke, A., Kurian, A. W., Negoita, S., Petkov, V. I. Multivariate models evaluated correlates of missing work for >1 month and stopping work altogether versus missing work for 1 month.In this diverse sample, most patients (62%) underwent lumpectomy; 16% underwent unilateral mastectomy (8% with reconstruction); and 23% underwent bilateral mastectomy (19% with reconstruction). BRCA1/2 mutation carriers were enrolled from cancer genetics clinics in Hong Kong and California according to standardized entry criteria. For more information, please contact Annabel Castaneda, 650-498-7977. What Was Actress Katherine Macgregor Cause Of Death? This multi-institutional, multidisciplinary approach may be useful for organizations to frame responses as similar legislation is passed across the United States. Hartman, A. R., Daniel, B. L., Kurian, A. W., Mills, M. A., Nowels, K. W., Dirbas, F. M., Kingham, K. E., Chun, N. M., Herfkens, R. J., Ford, J. M., Plevritis, S. K. Ductal lavage of non-fluid yielding ducts in BRCA1 and BRCA2 mutation carriers and other women at high genetic risk for breast cancer, Kurian, A. W., Mills, M. A., Nowels, K. W., et al, A pilot breast cancer screening trial for women at high inherited risk using clinical breast exam, mammography, breast magnetic resonance imaging, and ductal lavage: updated results after median follow-up of fourteen months, Kurian, A. W., Daniel, B. L., Mills, M. A., et al, Identification of ductal atypia with MR galactography. Crying Through Grief: Bindi Irwins Emotional Reaction to the Death of. Wu, A. H., Gomez, S. L., Vigen, C., Kwan, M. L., Keegan, T. H., Lu, Y., Shariff-Marco, S., Monroe, K. R., Kurian, A. W., Cheng, I., Caan, B. J., Lee, V. S., Roh, J. M., Sullivan-Halley, J., Henderson, B. E., Bernstein, L., John, E. M., Sposto, R. A Population-Based Observational Study of First-Course Treatment and Survival for Adolescent and Young Adult Females with Breast Cancer. Patients identified their oncologists (n=504) of whom 304 responded to surveys (60%). This is equivalent to an absolute reduction of 95 invasive breast cancers, and 42 breast cancer deaths per 1,000 high-risk women. The California Breast Density Information Group identified key elements and implications of the law, researching scientific evidence needed to develop a robust response. Lincoln, S. E., Nussbaum, R. L., Kurian, A. W., Nielsen, S. M., Das, K. n., Michalski, S. n., Yang, S. n., Ngo, N. n., Blanco, A. n., Esplin, E. D. Abstract P6-08-02: 21-gene recurrence score results according to germline pathogenic variants in BRCA1, BRCA2, PALB2, ATM, CHEK2 and Lynch Syndrome genes. Kurian, A. W., Bondarenko, I. n., Jagsi, R. n., Friese, C. R., McLeod, M. C., Hawley, S. T., Hamilton, A. S., Ward, K. C., Hofer, T. P., Katz, S. J. View details for DOI 10.6004/jnccn.2021.7081, With increased adoption of multi-gene panel testing (MGPT) for hereditary cancer, management guidelines now include a wider range of predisposition genes. Lee, K. L., Janz, N. K., Zikmund-Fisher, B. J., Jagsi, R. n., Wallner, L. P., Kurian, A. W., Katz, S. J., Abrahamse, P. n., Hawley, S. T. Racial/ethnic differences in multiple-gene sequencing results for hereditary cancer risk. Limited English Proficiency and Disparities in Health Care Engagement Among Patients With Breast Cancer. Satisfaction with chemotherapy decisions was high and did not differ between those who did (mean [SD], 4.3 [0.08] on a 1- to 5-point scale) or did not (4.4 [0.03]) obtain a second opinion (P=.29). Addressing barriers requires refining HCP-indicated populations (82%); developing evidence of actionability (82%) and pathogenicity/penetrance (64%); creating infrastructure and standards for informing and recontacting patients (45%); separating research from clinical use in the hybrid clinical-research setting (44%); and adjusting coverage frameworks (18%). 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. Hall, M., Hughes, E., Handorf, E., Gutin, A., Allen, B., Hartman, A., Kurian, A. W. Clinical use of the 21-gene assay and patient experiences in early-stage breast cancer. Benefits and harms varied by individual characteristics.The addition of risk-reducing medication to screening could further decrease the risk of breast cancer death. The proposed hybrid method integrates semantic term embedding with distributional semantics, producing a context-aware vector representation of unstructured mammography reports. 7 Richest Indian CEOs in the world -. Compared with cisgender heterosexual patients, those from SGM groups were hypothesized to have disparities in 1 or more of these quality metrics.Ninety-two patients from SGM groups were matched to 92 cisgender heterosexual patients (n=184). Development of a Mobile Health App (TOGETHERCare) to Reduce Cancer Care Partner Burden: Product Design Study. Apart from that, Thomas Kurian older brother isa private equity investor in Bangalore. There are concerns that multigene panel testing compared with BRCA1/ 2-only testing after diagnosis of breast cancer may lead to unnecessary patient worry about cancer because of more ambiguous results.Patients with breast cancer diagnosed from 2013 to 2015 and accrued from SEER registries in Georgia and Los Angeles were surveyed (n = 5,080; response rate, 70%), and responses were merged with SEER data and germline genetic testing and results. Recurrence risk perception and quality of life after treatment of breast cancer, Hawley, S., Janz, N., Jagsi, R., Griffith, K., Friese, C., Kurian, A. W., et al. View details for DOI 10.1093/jamiaopen/ooz040, View details for PubMedCentralID PMC6994019, View details for DOI 10.2217/pme-2019-0045. Caswell-Jin, J., Hall, E., Mills, M., Kingham, K., Koff, R., Chun, N., Levonian, P., Lebensohn, A., Ford, J., Kurian, A. W. Jagsi, R. n., Abrahamse, P. H., Lee, K. L., Wallner, L. P., Janz, N. K., Hamilton, A. S., Ward, K. C., Morrow, M. n., Kurian, A. W., Friese, C. R., Hawley, S. T., Katz, S. J. Breast cancer molecular subtypes defined by joint hormone receptor (HR, estrogen receptor [ER] and/or progesterone receptor [PR]) and HER2 status were assessed. A Phase 2, 2-Stage, 2-Cohort Study of Talazoparib (BMN 673), in Locally Advanced and/or Metastatic Breast Cancer Patients With BRCA Mutation (ABRAZO Study). The effects of sociodemographic factors and treatment facility size on GCC differ by subtype. The model was trained jointly on manually curated data from 670 patients and NLP-curated data of 8062 patients. The Trial Assigning Individualized Options for Treatment (TAILORx) found chemotherapy could be omitted in many women with hormone receptor-positive, HER2-negative, node-negative breast cancer and 21-gene recurrence scores (RS) 11-25, but left unanswered questions. To evaluate patient experiences with decisions regarding radiation therapy (RT) for ductal carcinoma in situ (DCIS), and to assess clinician views on the role of RT for DCIS with favorable features in the present era.A sample of women with newly diagnosed breast cancer from the population-based Georgia and Los Angeles County Surveillance, Epidemiology, and End Results (SEER) registries were sent surveys approximately 2months after undergoing breast-conserving surgery (BCS), with a 70% response rate. Allison W. Kurian, M.D., M.Sc. Thomas Kurian is an Indian-American business executive and Chief Executive Officer of Google Cloud since 2019. The app was developed incorporating quality-of-life surveys and symptom reporting, as well as resources on home survivor care. Advances in the evaluation and treatment of breast cancer have made the clinical decision-making context much more complex. On multivariable analysis, factors associated with CPM included younger age (per 5-year increase: odds ratio [OR], 0.71; 95% CI, 0.65-0.77), white race (black vs white: OR, 0.50; 95% CI, 0.34-0.74), higher educational level (OR, 1.69; 95% CI, 1.20-2.40), family history (OR, 1.63; 95% CI, 1.22-2.17), and private insurance (Medicaid vs private insurance: OR, 0.47; 95% CI, 0.28-0.79). 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