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. also hope to understand more about the experience of individuals and families who undergoing We evaluated the performance of these models in a Chinese cohort, including males, before BRCA1/2 mutation testing.The five risk models were used to calculate the probability of BRCA mutations in probands with breast and ovarian cancers; 267 were non-BRCA mutation carriers (247 females and 20 males) and 43 were BRCA mutation carriers (38 females and 5 males).Mean BRCA prediction scores for all models were statistically better for carriers than noncarriers for females but not for males. Broad, non-personalised risk estimates may be problematic for women when they are considering how to manage their risk. Guidelines focus on syndromes associated with an increased risk of breast and/or ovarian cancer. "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. 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. 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. Thereafter, genome-wide association studies (GWAS) have accumulated data for hundreds of thousands of subjects. Katz, S. J., Abrahamse, P., Hodan, R., Kurian, A. W., Rankin, A., Tocco, R. S., Rios-Ventura, S., Ward, K. C., An, L. C. Changes in breast cancer risk and risk factor profiles among U.S.-born and immigrant Asian American women residing in the San Francisco Bay Area. 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. evaluate the safety, tolerability, pharmacokinetics and feasibility of trastuzumab emtansine 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. Using patient surveys, the authors sought to quantify the frequency, severity, and burden of treatment-associated toxicities.Between 2013 and 2014, the iCanCare study surveyed a population-based sample of women residing in Los Angeles County and Georgia with early-stage, invasive breast cancer. Gallagher, S., Hughes, E., Kurian, A. W., Domchek, S. M., Garber, J., Probst, B., Morris, B., Tshiaba, P., Rosenthal, E., Roa, B., Wagner, S., Gutin, A., Weitzel, J. N., Lanchbury, J., Robson, M. E. Development and validation of natural language processing (NLP) algorithm for detection of distant versus local breast cancer recurrence and metastatic site. Compared to women in the middle quintile of the risk distribution, women in the highest 1% of PRS distribution have a ~2.7-fold risk and women in the lowest 1% of PRS distribution has ~0.4-fold risk of developing breast cancer. This information is crucial for modeling effective stratified screening programs. Scott, D., Kingham, K., Hodan, R., Ma, C., Mills, M., Ford, J. M., Kurian, A. W., Telli, M. L. DO RESEARCH PARTICIPANTS DIFFER BY RECRUITMENT SOURCE?OBSERVATIONS FROM A STUDY OF NEWLY-DIAGNOSED BREAST CANCER PATIENTS. Kwong, A. n., Ho, J. C., Shin, V. Y., Kurian, A. W., Tai, E. n., Esserman, L. J., Weitzel, J. N., Lin, P. H., Field, M. n., Domchek, S. M., Lo, J. n., Ngan, H. Y., Ma, E. S., Chan, T. L., Ford, J. M. Patient communication of cancer genetic test results in a diverse population. View details for DOI 10.1001/jamaoncol.2016.5652, View details for Web of Science ID 000397491400018. Scott, D. n., Friedman, S. n., Telli, M. L., Kurian, A. W. Modeling reductions in absolute cancer mortality from diagnosing cancers before metastasis, 2006-2015. The MA-PRS is a combination of three ancestry-specific PRSs on the basis of genetic ancestral composition. We investigated social disparities in breast cancer (BC) mortality, leveraging data from the California Breast Cancer Survivorship Consortium. Overall pathologic complete response rate in the intent-to-treat population (n = 80) was 36% (90% CI, 27 to 46). They usually undergo intensive cancer surveillance and may also consider surgical interventions, such as risk-reducing mastectomy or risk-reducing salpingo-oophorectomy (RRSO). 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. Background: Hereditary cancer panels (HCPs), testing for multiple genes and syndromes, are rapidly transforming cancer risk assessment but are controversial and lack formal insurance coverage. 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. If results are promising, they may justify a randomized trial of statins for breast cancer chemoprevention, with a focus on HR-negative disease. Breast cancer is the most common cancer diagnosed in women, accounting for an estimated 30% of all new women cancer diagnoses in 2022. No PV was associated with higher cancer-specific mortality.Among breast cancer and ovarian cancer patients treated with chemotherapy in the community, BRCA1/2 and other gene PV carriers had equivalent or lower short-term cancer-specific mortality than non-carriers. All statistical tests were two-sided.Using IBIS, the areas under the receiver-operating characteristic curves were 0.66 (95% confidence interval = 0.63 to 0.68) and 0.56 (95% confidence interval = 0.54 to 0.59) for 5-year and lifetime risks, respectively (Pdiff<0.001). View details for Web of Science ID 000306969100011, View details for PubMedCentralID PMC3640371. However, controversy remains about the clinical validity and actionability of genetic testing in a broader patient population. Hospital records were re-abstracted, and treatment was verified. Among adopters, 52% initiated coverage pre-NCD over a 25-month period and 48% post-NCD over 17 months.We found an increase, but continued variability, in coverage over 3.5 years. She received her medical degree from Harvard Medical School and has . For non-Latina Whites, lower neighborhood socioeconomic status (SES) was associated with obesity (Quintile 1 (Q1) vs. Q5: OR=2.52; 95% CI: 1.31-4.84), breast cancer-specific (Q1 vs. Q5: HR=2.75; 95% CI: 1.47-5.12), and all-cause (Q1 vs. Q5: HR=1.75; 95% CI: 1.17-2.62) mortality. Using the National Comprehensive Cancer Network's 2013 breast cancer guidelines, the authors assessed the receipt of GCC by cancer subtype among a subset of YAs (n=952). In the Oncoshare project, we have developed such methods as part of a collaborative multi-institutional CER study of patterns, predictors, and outcome of breast cancer care. She completed her residency training in Internal Medicine at the Massachusetts General Hospital and her medical fellowship in Medical Oncology at Stanford University, where she was simultaneously earning a master's degree in Epidemiology. To assess whether adding LCL161 to weekly paclitaxel enhances the efficacy of paclitaxel in metastatic breast cancer refractory to NSAI. We studied 8,995 African American, Asian American, Latina, and non-Latina White women with breast cancer. 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. Sensitivity analyses tested a 15-year time horizon and alternative assumptions.Extending tamoxifen therapy duration among women ages 25-49 reduced the lifetime probability of breast cancer death from 11.9% to 9.3% (absolute difference 2.6%). Guidance is needed on managing patients with discrepant variants to support accurate risk assessment. Despite their high level of worry, few responders said they would likely consider using assisted reproduction technologies such as a pregnancy surrogate (3%), cryopreservation of oocytes or embryos (8%), or pre-implantation genetic diagnosis (PGD) to select embryos without BRCA1/2 mutations (13%).Although they expressed substantial concern about transmitting BRCA1/2 mutations to their children, only a minority of the high-risk women surveyed were likely to consider currently available assisted reproductive strategies. This randomised control trial (registration number to follow), based in genetic centres in the UK and US, will randomise participants on a 1:1 basis to either receive conventional cancer risk estimates, as per routine clinical practice, or to receive a personalised risk estimate. Over 60% reported that their doctor almost never inquired about worry.Effective doctor-patient communication is critical to patient understanding of risk of recurrence. Kurian, A. W., Hughes, E., Handorf, E., et al. Atypical cells can be found in non-fluid-yielding ducts in patients at high inherited breast cancer risk. We sought to characterize the association between patient-reported insomnia symptoms, patient outcomes, and supportive care variables, as well as explore clinically meaningful insomnia thresholds in a sample of women diagnosed with breast and gynecologic cancers.From July 2018-March 2019, all breast and gynecologic cancer survivors seen at the Stanford Women's Cancer Center were approached and invited to participate in the study (15% declined). This weak supervision approach allowed us to learn from a larger dataset using imperfect labels and ultimately provided greater accuracy compared to a smaller hand-curated dataset, with less manual effort invested in curation. 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. View details for DOI 10.1200/CCI.20.00165. He led 35,000-people software development team in 32 countries with an R&D budget of $4 billion. 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. Ellisen, L. W., Kurian, A. W., Desmond, A. J., Mills, M., Lincoln, S. E., Shannon, K. M., Gabree, M., Tung, N. M., Ford, J. M. Lymphopenia after adjuvant radiotherapy (RT) to predict poor survival in triple-negative breast cancer (TNBC). Association of ovarian cancer risk with mutations detected by multiple-gene germline sequencing in 95,561 women. 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. Kurian, A. W., Idos, G., Culver, J., Ricker, C., Koff, R., Sturgeon, D., Lowstuter, K., Hartman, A., Allen, B., Kidd, J., Rowe-Teeter, C., Kingham, K., Chun, N. M., Petrovchich, I., Mills, M., Hong, C., McDonnell, K., Ladabaum, U., Ford, J. M., Gruber, S. B. 3 cloud provider as it moves toward a. Electronic medical records (EMRs) and population-based cancer registries contain information on cancer outcomes and treatment, yet rarely capture information on the timing of metastatic cancer recurrence, which is essential to understand cancer survival outcomes. abnormal breast duct cytology in women with a high inherited breast cancer risk. Given the high utilization of mobile technologies, even among underserved populations and in low resource areas, mobile apps may provide a meaningful access point for all stakeholders for symptom management.We aimed to develop a mobile app incorporating user preferences to enable cancer survivors' care partners to monitor the survivors' health and to provide care partner resources.An iterative information gathering process was conducted that included (1) discussions with 138 stakeholders to identify challenges and gaps in survivor home care; (2) semistructured interviews with clinicians (n=3), cancer survivors (n=3), and care partners (n=3) to identify specific needs; and (3) a 28-day feasibility field test with seven care partners.Health professionals noted the importance of identifying early symptoms of adverse events. 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. This cohort will enable analyses to jointly consider a variety of clinical, lifestyle, and contextual factors in attempting to explain the long-standing disparities in breast cancer outcomes. B., Eliassen, A. H., Fasching, P. A., Flyger, H., Gago-Dominguez, M., Garca-Closas, M., Garca-Senz, J. A Randomized, Phase 2, Neoadjuvant Study of Weekly Paclitaxel With or Without LCL161 in Patients With Triple Negative Breast Cancer. Benedict, C., Fisher, S., Kuma, D., Pollom, E., Schapira, L., Kurian, A., Berek, J. S., Palesh, O. Relative to screening with mammography alone, the cost per QALY gained by adding MRI from ages 35 to 54 years is 55,420 dollars for BRCA1 mutation carriers, 130,695 dollars for BRCA2 mutation carriers, and 98,454 dollars for BRCA2 mutation carriers who have mammographically dense breasts.Breast MRI screening is more cost-effective for BRCA1 than BRCA2 mutation carriers. - Cohort 2) Subjects who have received > 2 prior chemotherapy regimens for metastatic We observed 99.8% net report concordance, albeit with a slightly higher variant of uncertain significance rate. For more information, please contact Janet Pan, 650-723-0628. Patients' assessments of the amount of information they received about whether to get tested were similarly high whether they were counseled by a genetics expert or by a physician only (80.8% v 79.4% stated information was just right, P = .59). Purpose To identify the molecular basis of quantitative imaging characteristics of tumor-adjacent parenchyma at dynamic contrast material-enhanced magnetic resonance (MR) imaging and to evaluate their prognostic value in breast cancer. ATM PVs are associated with multiple cancer risks and, while professional society guidelines support that carriers are eligible for increased breast and pancreatic cancer screening, increased screening for prostate and gastric cancer may also be warranted. Carriers of a BRCA1/2 pathogenic or likely pathogenic variant have an excessive risk for both breast and ovarian cancer that warrants consideration of more intensive screening and preventive strategies. Breast cancer remains the most common female malignancy in the United States. These results suggest disparities in the care of patients from SGM groups and warrant further study to inform interventions. Kurian, A. W., Abrahamse, P., Ward, K. C., Hamilton, A. S., Deapen, D., Berek, J. S., Hoang, L., Yussuf, A., Dolinsky, J., Brown, K., Slavin, T., Hofer, T. P., Katz, S. J. Kwong, A., Shin, V. Y., Ma, E. S., Chan, C. T., Ford, J. M., Kurian, A. W., Tai, E. Change in survival in metastatic breast cancer with treatment advances: meta-analysis and systematic review. Exhaustive preoperative stomach evaluation was normal in each case, and the stomach and adjacent lymph nodes appeared normal at surgery. 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? Stanford is currently not accepting patients for this trial. ", "New World Pioneers. Chemotherapy receipt (OR for missing >1 month, 1.3; OR for stopping work altogether, 3.9) and race (OR for missing >1 month for blacks vs whites, 2.0; OR for stopping work altogether for blacks vs whites, 1.7) also correlated. View details for DOI 10.3390/cancers14112716. For Asian Americans, no associations were seen. Many patients with breast cancer work for pay at the time of their diagnosis, and the treatment plan may threaten their livelihood. Given the poor prognosis and high treatment costs of HER2-positive breast cancer, our results have implications for healthcare resource utilization, cancer biology, and clinical care. Most women who were influenced by "communication with a clinician" had reasonably accurate recurrence estimates (68%). With minimal requirement for task specific customization, the proposed method can be easily transferable to a different domain to support large scale text mining or derivation of patient phenotype. to placebo plus carboplatin and paclitaxel in subjects with BRCA1 or BRCA2 mutation and 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. 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. Responses were merged with SEER data. All gains were reduced with less than 100% treatment completion.The extension of endocrine therapy from 5 to 10years modestly improved lifetime breast cancer outcomes, but in some women, treatment-related adverse events may outweigh benefits. Kurian, A. W., Gong, G. D., Chun, N. M., Mills, M. A., Staton, A. D., Kingham, K. E., Crawford, B. These common alleles were associated with clinical extremes of ANM; women in the top 1% of genetic susceptibility have an equivalent risk of premature ovarian insufficiency to those carrying monogenic FMR1 premutations3. The IBIS/Tyrer-Cuzick model is used clinically to guide breast cancer screening and prevention, but was developed primarily in non-Hispanic White women. View details for PubMedCentralID PMC8260917. We calculated hazard ratios and 95% confidence intervals from multivariable Cox proportional hazard model-estimated associations of body size (body mass index (BMI) (weight (kg)/height (m)(2)) and waist-hip ratio (WHR)) with breast cancer-specific and all-cause mortality. Overall survival and time to next treatment were evaluated. There is also evidence that risks of prostate cancer and pancreatic cancer are elevated in these carriers. Prevalence and predictors of second opinions from medical oncologists for early-stage breast cancer: Results from the iCanCare study. 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. thomas kurian wife allison. During the past few years, several genetic aberrations that may contribute to increased risks for development of breast and/or ovarian cancers have been identified. View details for Web of Science ID 000318174800096. For more information, please contact Karen Lau, 650-723-0658. Multivariable polytomous logistic regression was used to estimate odds ratios (OR) of receiving NAC and of type of surgery after NAC.Approximately, 40.1% (94,980) of patients received chemotherapy: 87% (82,588) aCT and 13.0% (12,392) NAC. View details for DOI 10.1016/j.jmoldx.2015.04.009, View details for DOI 10.1001/jamaoncol.2015.2719. This is a 3 arm Phase 3 study to evaluate the safety and efficacy of the addition of Patients indicated that financial toxicity remains common: 21.5% of white patients and 22.5% of Asian patients had to cut down spending on food, as did 45.2% of black and 35.8% of Latina patients. Silvestri, V. n., Leslie, G. n., Barnes, D. R., Agnarsson, B. BOADICEA overpredicted mutations in African Americans and older NHWs, and BRCAPRO underpredicted in Hispanics. [3], Upon completing her fellowship, Kurian accepted a research scholar position supported by a Building Interdisciplinary Research Careers in Women's Health K12 award. Other executives include Thomas Kurian, CEO of Google Cloud; Ruth Porat, SVP and CFO and 19 others. Germline sequencing in 95,561 women patient understanding of risk of recurrence 35,000-people software development team in countries! Cytology in women with breast cancer refractory to NSAI ) mortality, leveraging data from the iCanCare study in. Sgm groups and warrant further study to inform interventions normal in each case, and treatment was.! Medical School and has at the time of their diagnosis, and treatment was verified considering to. Of weekly paclitaxel enhances the efficacy of paclitaxel in metastatic breast cancer refractory to NSAI 19. Neoadjuvant study of weekly paclitaxel enhances the efficacy of paclitaxel in metastatic breast cancer the clinical validity and actionability genetic! 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