Factors that discouraged testing included insurance concerns (14%; 95% CI, 12% to 16%), cost (14%; 95% CI, 12% to 16%), and discrimination (9%; 95% CI, 7% to 11%). Patients who had genetic counseling were twice as likely to recall clinicians informing them about all queried topics. Aim: This observational study evaluated the effectiveness of nab-paclitaxel versus paclitaxel monotherapy as first-line (1L) treatment for metastatic triple-negative breast cancer (mTNBC). Roy, M. n., Purington, N. n., Liu, M. n., Blayney, D. W., Kurian, A. W., Schapira, L. n. Development and Use of Natural Language Processing for Identification of Distant Cancer Recurrence and Sites of Distant Recurrence Using Unstructured Electronic Health Record Data. In silico analysis suggested a potential regulatory effect of the variants on the nearby target genes SDE2 and H3F3A. A., Gaudet, M. M., Giles, G. G., Goldberg, M. S., Gonzlez-Neira, A., Alns, G. I., Grip, M., Gunel, P., Haiman, C. A., Hall, P., Hamann, U., Harkness, E. F., Heemskerk-Gerritsen, B. We assumed 100% use of therapy. 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. Consistent with recommendations, tumor biology, not age, is associated with GCC for all subtypes. Hazard ratios (HR) and 95% confidence intervals (CI) for tamoxifen versus AI were reported.Among 2,902 analyzed patients, the median age at diagnosis was 58.3years; 67.6% were non-Hispanic white, 22.3% Asian, 7.5% Hispanic, and 1.7% non-Hispanic Black. There is also evidence that risks of prostate cancer and pancreatic cancer are elevated in these carriers. In this equal-access healthcare system, chemotherapy use followed practice guidelines, but varied by race and socio-demographic factors. 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. Jagsi, R., Hawley, S. T., Griffith, K. A., Janz, N. K., Kurian, A., Ward, K. C., Hamilton, S., Morrow, M., Katz, S. J. characteristics typical of the poly (ADP-ribose) polymerase (PARP) inhibitor class. Recent advances in genomic technology have enabled far more rapid, less expensive sequencing of multiple genes than was possible only a few years ago. Daly, M. B., Pilarski, R. n., Yurgelun, M. B., Berry, M. P., Buys, S. S., Dickson, P. n., Domchek, S. M., Elkhanany, A. n., Friedman, S. n., Garber, J. E., Goggins, M. n., Hutton, M. L., Khan, S. n., Klein, C. n., Kohlmann, W. n., Kurian, A. W., Laronga, C. n., Litton, J. K., Mak, J. S., Menendez, C. S., Merajver, S. D., Norquist, B. S., Offit, K. n., Pal, T. n., Pederson, H. J., Reiser, G. n., Shannon, K. M., Visvanathan, K. n., Weitzel, J. N., Wick, M. J., Wisinski, K. B., Dwyer, M. A., Darlow, S. D. Germline HOXB13 mutations p.G84E and p.R217C do not confer an increased breast cancer risk. All statistical models and summary estimates were weighted to be representative of the target population.Receipt of CPM was the primary dependent variable for analysis and was measured by a woman's self-report of her treatment.Of the 3631 women selected to receive the survey, 2578 (71.0%) responded and 2402 of these respondents who did not have bilateral disease and for whom surgery type was known constituted the final analytic sample. 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. A search engine designed to express complex electronic phenotypes from longitudinal patient records enables the identification of variability in patient care, helping to define disparities and areas for improvement. Utilization rates and costs of diagnostic and treatment interventions were based on a combination of published literature and Medicare payments for 2005.The survival benefit, incremental costs, and cost-effectiveness of MRI screening strategies, which varied by ages of starting and stopping MRI screening, were computed separately for BRCA1 and BRCA2 mutation carriers.Screening strategies that incorporate annual MRI as well as annual mammography have a cost per quality-adjusted life-year (QALY) gained ranging from less than 45,000 dollars to more than 700,000 dollars, depending on the ages selected for MRI screening and the specific BRCA mutation. Multivariable models evaluated correlates of a strong desire for genetic testing, unmet need for discussion with a health care professional, and receipt of testing.Among 1,536 patients who completed the survey, 35% expressed strong desire for genetic testing, 28% reported discussing testing with a health care professional, and 19% reported test receipt. View details for DOI 10.1038/s41467-023-37636-0. Understanding of risk and patient factors (e.g. Wu, A. H., Kurian, A. W., Kwan, M. L., John, E. M., Lu, Y., Keegan, T. H., Gomez, S. L., Cheng, I., Shariff-Marco, S., Caan, B. J., Lee, V. S., Sullivan-Halley, J., Tseng, C., Bernstein, L., Sposto, R., Vigen, C. Next-generation sequencing for hereditary breast and gynecologic cancer risk assessment. Financial toxicity was "mild" overall (COST M=26.11, SD=11.14); 32% worried about cancer-related financial problems (quite a bit/very much; item-level analysis). Associations between pathogenic variants in each gene and the risk of breast cancer were assessed.Pathogenic variants in 12 established breast cancer-predisposition genes were detected in 5.03% of case patients and in 1.63% of controls. Although two thirds of patients were tested before surgical treatment, patients without private insurance more often experienced delays. Bilateral mastectomy was more often used by non-Hispanic white women, those with private insurance, and those who received care at a National Cancer Institute (NCI)-designated cancer center (8.6% [95% CI, 8.1%-9.2%] among NCI cancer center patients vs 6.0% [95% CI, 5.9%-6.1%] among non-NCI cancer center patients; odds ratio [OR], 1.13 [95% CI, 1.04-1.22]); in contrast, unilateral mastectomy was more often used by racial/ethnic minorities (Filipina, 52.8% [95% CI, 51.6%-54.0%]; OR, 2.00 [95% CI, 1.90-2.11] and Hispanic, 45.6% [95% CI, 45.0%-46.2%]; OR, 1.16 [95% CI, 1.13-1.20] vs non-Hispanic white, 35.2% [95% CI, 34.9%-35.5%]) and those with public/Medicaid insurance (48.4% [95% CI, 47.8%-48.9%]; OR, 1.08 [95% CI, 1.05-1.11] vs private insurance, 36.6% [95% CI, 36.3%-36.8%]). Advances in bioinformatics also facilitate the interpretation of large amounts of genomic data. Compared with breast-conserving surgery with radiation (10-year mortality, 16.8% [95% CI, 16.6%-17.1%]), unilateral mastectomy was associated with higher all-cause mortality (hazard ratio [HR], 1.35 [95% CI, 1.32-1.39]; 10-year mortality, 20.1% [95% CI, 19.9%-20.4%]). A., Van Ravesteyn, N., Yaffe, M., Yeh, J., Couch, F., Kraft, P., Polley, E., Mandelblatt, J. S., Kurian, A. W., Robson, M. E., Canc Intervention Surveillance, Canc Risk Estimates Related. A local relapse biopsy four months later revealed the identical reversion mutation, and the patient subsequently died of metastatic breast cancer.We report a BRCA1 reversion mutation in a newly diagnosed triple-negative breast cancer patient that developed over 18 weeks of platinum-based neoadjuvant therapy. This study is about understanding the use of a genetic test (Myriad Genetics myRisk panel) Hazard ratios for all-cause mortality were not consistently affected by source of comorbidity information; the hazard ratio was lower for diabetes, but higher for the other comorbidities when medical record versus self-report was used. test the tolerability and efficacy of AZD0530 (also called saracatinib) when used together Chen, Y., Kingham, K., Ford, J. M., Rosing, J., Van Dam, J., Jeffrey, R. B., Longacre, T. A., Chun, N., Kurian, A., Norton, J. Cronin, K., Petkov, V. I., Howlader, N., Howe, W., Schussler, N. C., Kurian, A. W., Penberthy, L. Relationship between rising bilateral mastectomy rates and increased use of neoadjuvant chemotherapy (NAC) in California, 1998-2012. Factors associated with receiving chemotherapy included <50 years of age [odds ratio (OR) 2.27, 95 % confidence interval (CI) 1.81-2.86], tumor >2 cm (OR 2.14, 95 % CI 1.75-2.61), involved lymph nodes (OR 11.3, 95 % CI 9.29-13.6), hormone receptor-negative (OR 6.94, 95 % CI 4.89-9.86), Her2/neu-positive (OR 2.71, 95 % CI 2.10-3.51), or high grade (OR 3.53, 95 % CI 2.77-4.49) tumors; comorbidities associated inversely with chemotherapy use [heart disease for anthracyclines (OR 0.24, 95 % CI 0.14-0.41), neuropathy for taxanes (OR 0.45, 95 % CI 0.22-0.89)]. for these diseases. Overestimators (OR.50, CI 0.31-0.81) or those who perceived zero risk (OR.46, CI 0.29-0.72) more often said that their doctor did not discuss risk. A Phase 3, Multi-Center Study of Gemcitabine/Carboplatin, With or Without BSI-201, in Patients With ER-, PR-, and Her2-Negative Metastatic Breast Cancer. The IBIS/Tyrer-Cuzick model is used clinically to guide breast cancer screening and prevention, but was developed primarily in non-Hispanic White women. Most women received first-recorded therapy with endocrine (67%) versus chemotherapy, underwent more computed tomography (CT) (76%) than positron emission tomography-CT, and were monitored using tumor markers (58%). 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). A recent study claimed that women testing negative for their family-specific BRCA1 or BRCA2 mutation (noncarriers) have a five-fold increased risk of breast cancer. Quality improvement should focus on testing indicated patients rather than adding more genes. In this analysis, we studied the associations between germline variants and breast cancer survival for patients with distant metastases at primary breast cancer diagnosis. It is unclear to what extent reductions in the incidence of late-stage cancer could narrow these relative and absolute disparities.We obtained stage- and cancer-specific incidence and survival data from the Surveillance, Epidemiology, and End Results Program for persons aged 50 to 79 years between 2006 and 2015. His approach was validated by the unit's revenue growth last quarter of . Breast cancer molecular subtypes defined by joint hormone receptor (HR, estrogen receptor [ER] and/or progesterone receptor [PR]) and HER2 status were assessed. View details for DOI 10.1200/JCO.2010.34.4440, View details for PubMedCentralID PMC3236651. Higher PV prevalence with increasing family history extent (P < .001) was observed only with BRCA1 (3.04% with none, 3.22% with moderate, and 4.06% with strong history) and in triple-negative breast cancer with PALB2 (0.75% with none, 2.23% with moderate, and 2.63% with strong history). 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). Kurian, A. W., Mitani, A., Desai, M., Yu, P. P., Seto, T., Weber, S. C., Olson, C., Kenkare, P., Gomez, S. L., de Bruin, M. A., Horst, K., Belkora, J., May, S. G., Frosch, D. L., Blayney, D. W., Luft, H. S., Das, A. K. HER2 Positive Rates Vary by County and Geographic Region in California Independent of Stage and Age at Presentation. Ghanouni, P., Kurian, A. W., Margolis, D., Hartman, A., Mills, M. A., Plevritis, S. K., Ford, J. M., Daniel, B. L. BRCA1/2 mutations and cancer risk in Asian-Americans, Kurian, A. W., Chun, N. M., Mills, M. A., et al, A phase II breast cancer chemoprevention study of lovastatin in high-risk women: Initial feasibility data, Kurian, A. W., Sharma, V. B., Schwartz, E. J., et al, The role of BRCA1 in DNA repair and chemosensitivity. View details for DOI 10.1001/jamaoncol.2020.7995. In this approach, we impute missing values using regression models for each variable, conditional on the other variables in the data. Clinical guidelines for high-risk women should consider integrating shared decision making for risk-reducing medication and screening on the basis of individual risk factors. View details for Web of Science ID 000341349900011, View details for Web of Science ID 000336894600041, View details for Web of Science ID 000358613202339, View details for DOI 10.1200/jco.2014.32.15_suppl.6580, View details for Web of Science ID 000358613203765. View details for DOI 10.1016/j.gim.2023.100837. Surgery after initial lumpectomy to obtain more widely clear margins is common and may lead to mastectomy.To describe surgeons' approach to surgical margins for invasive breast cancer, and changes in postlumpectomy surgery rates, and final surgical treatment following a 2014 consensus statement endorsing a margin of "no ink on tumor. The education level was high among both cases and controls. Jointly, 2487 (model range = 1713-2575) excess breast cancer deaths were estimated, representing a 0.52% (model range = 0.36%-0.56%) cumulative increase over breast cancer deaths expected by 2030 in the absence of the pandemic's disruptions. View details for DOI 10.1016/j.jtho.2021.02.024. Helping patients to maximize their autonomy in breast cancer decision-making is an important aspect of patient-centered care. View details for PubMedCentralID PMC8140787. Clinicopathologic data were extracted from the electronic medical records of Stanford Cancer Institute and linked to demographic data from the population-based California Cancer Registry; results were integrated with data from tissue microarrays of specimens containing DCIS that did not develop IBC versus DCIS with concurrent IBC. 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. In light of the need for new treatment options for 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. 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). Results did not vary by diagnosis year.Among patients with high genetic risk, clinicians' recommendations, potential treatment implications, and protections against discrimination were motivating factors to undergo genetic testing, but fewer than half recalled clinicians providing all this information, and this did not improve over time. metastatic breast cancer refractory to NSAI. 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. Subgroup comparisons were made based on the Female Sexual Function Index sexual dysfunction diagnostic cut-off score (<26.55; lower scores indicate greater dysfunction). 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. Tolby, L. T., Hofmeister, E. N., Fisher, S. n., Chao, S. n., Benedict, C. n., Kurian, A. W., Berek, J. S., Schapira, L. n., Palesh, O. G. Comparing Five-Year and Lifetime Risks of Breast Cancer in the Prospective Family Study Cohort. Yang, Y. n., Shu, X. n., Shu, X. O., Bolla, M. K., Kweon, S. S., Cai, Q. n., Michailidou, K. n., Wang, Q. n., Dennis, J. n., Park, B. n., Matsuo, K. n., Kwong, A. n., Park, S. K., Wu, A. H., Teo, S. H., Iwasaki, M. n., Choi, J. Y., Li, J. n., Hartman, M. n., Shen, C. Y., Muir, K. n., Lophatananon, A. n., Li, B. n., Wen, W. n., Gao, Y. T., Xiang, Y. A., Chandler, Y., Isaacs, C., Kurian, A. W., Kushi, L. H., O'Neill, S. C., Schechter, C. B., Mandelblatt, J. S. Breast cancer screening for carriers of ATM, CHEK2, and PALB2 pathogenic variants: A comparative modeling analysis. A Systematic Review and Meta-Analysis. BOADICEA had the best discrimination for BRCA1/2 combined mutation prediction (AUC 87%) in males.The variation in model performance underscores the need for research on larger Asian cohorts as prediction models, and the possible need for customizing these models for different ethnic groups and genders. 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. A., Trentham-Dietz, A. n., Vachon, C. M., Weinberg, C. n., Yao, S. n., Ziogas, A. n., Weitzel, J. N., Goldgar, D. E., Domchek, S. M., Nathanson, K. L., Kraft, P. n., Polley, E. C., Couch, F. J. Karimi, Y. H., Kurian, A. W., Blayney, D. W., Banerjee, I. Most PVs were in 20 breast cancer-associated genes or ovarian cancer-associated genes; testing other genes yielded mostly VUS. View details for DOI 10.1038/s41416-020-01185-w. Assuming one third of metastatic cancers were diagnosed at stage III, one third diagnosed at stage II, and one third diagnosed at stage I, 81 fewer cancer-related deaths would be expected per 100,000, a reduction of 24% of all cancer-related deaths, corresponding to a reduction in all-cause mortality comparable in magnitude to eliminating deaths due to cerebrovascular disease.Detection of multiple cancer types earlier than stage IV could reduce at least 15% of cancer-related deaths within 5 years, affecting not only cancer-specific but all-cause mortality.Detecting cancer before stage IV, including modest shifts to stage III, could offer substantial population benefit. Karimi, Y., Blayney, D. W., Kurian, A. W., Rubin, D., Banerjee, I. View details for DOI 10.1038/s41598-020-65665-y. The current trial, BNIT-BR-003, will evaluate the safety and biological activity of a fixed Ductal lavage was attempted in any duct identifiable with a catheter.Ducts were successfully catheterized in 60 of 75 patients (80%). veliparib plus carboplatin versus the addition of carboplatin to standard neoadjuvant Gomez, S., Yao, S., Kushi, L. H., Kurian, A. W. Simulation Modeling to Extend Clinical Trials of Adjuvant Chemotherapy Guided by a 21-Gene Expression Assay in Early Breast Cancer. Further studies are needed to better understand the communication process in individuals from diverse racial/ethnic backgrounds. These results may reassure newly diagnosed patients and longer follow-up is ongoing. To our knowledge, this is the first report of a patient with both MEN1 and BRCA2 mutations and with a personal history of hyperparathyroidism and pancreatic neuroendocrine tumors. Jagsi, R., Ward, K. C., Abrahamse, P., Wallner, L. P., Kurian, A. W., Hamilton, A. S., Katz, S. J., Hawley, S. T. Promoting breast cancer screening after multiplex genetic panel testing (MGPT) and genetic counseling. Compared with BCT, the risk of breast cancer death was equivalent after BLM (HR, 1.03; 95% CI, 0.96-1.11) and higher after ULM (HR, 1.21; 95% CI, 1.17-1.25).BLM may reduce second breast cancer risk by 34 to 43 cases per 10,000 person-years compared with other surgical procedures, but is not associated with a lower risk of death. Compared to DCIS-only patients, patients with concurrent IBC had higher frequencies of CNAs in their DCIS samples. [9] This resulted in the development of an online tool that helps people with BRCA mutations make preventive care decisions. However, each patient (6 of 6, 100%) was found to have multiple foci of T1 invasive diffuse gastric adenocarcinoma (pure signet-ring cell type). Director, Technical Project Lead . View details for Web of Science ID 000236796400112. Gene burden tests detected the strongest association for deletions in BRCA1 (P=3.7E-18). His father was self-educated and became a successful executive in the manufacturing . Molecular subtypes were classified according to HER2 and hormone receptor (HR, including estrogen and/or progesterone receptor) expression. View details for Web of Science ID 000357901600008. Cancers were confirmed after central medical record review. The odds ratio for higher impact of cancer worry was 0.81 (95% CI, 0.51 to 1.28) for multigene versus BRCA1/2-only testing. Hall, E. T., Parikh, D., Caswell-Jin, J. L., Gupta, T., Mills, M. A., Kingham, K. E., Koff, R., Ford, J. M., Kurian, A. W. Knowledge Regarding and Patterns of Genetic Testing in Patients Newly Diagnosed With Breast Cancer Participating in the iCanDecide Trial. 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. 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. We conducted a survey of cancer genetic counselors based in the United States through the National Society of Genetic Counselors to assess the impact of reimbursement and patient OOP share on ordering of an HCP and hereditary cancer genetic counseling. Roberts, M. C., Kurian, A. W., Petkov, V. I. Caswell-Jin, J., Shafaee, M., Liu, M., Xiao, L., John, E. M., Bondy, M., Kurian, A. W. Personalised Risk Prediction in Hereditary Breast and Ovarian Cancer: A Protocol for a Multi-Centre Randomised Controlled Trial. External validation was performed by comparing results to observed rates in two independent sources. Dareng, E. O., Tyrer, J. P., Barnes, D. R., Jones, M. R., Yang, X., Aben, K. K., Adank, M. A., Agata, S., Andrulis, I. L., Anton-Culver, H., Antonenkova, N. N., Aravantinos, G., Arun, B. K., Augustinsson, A., Balmaa, J., Bandera, E. V., Barkardottir, R. B., Barrowdale, D., Beckmann, M. W., Beeghly-Fadiel, A., Benitez, J., Bermisheva, M., Bernardini, M. Q., Bjorge, L., Black, A., Bogdanova, N. V., Bonanni, B., Borg, A., Brenton, J. D., Budzilowska, A., Butzow, R., Buys, S. S., Cai, H., Caligo, M. A., Campbell, I., Cannioto, R., Cassingham, H., Chang-Claude, J., Chanock, S. J., Chen, K., Chiew, Y. E., Chung, W. K., Claes, K. B., Colonna, S., Cook, L. S., Couch, F. J., Daly, M. B., Dao, F., Davies, E., de la Hoya, M., de Putter, R., Dennis, J., DePersia, A., Devilee, P., Diez, O., Ding, Y. C., Doherty, J. 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. But was developed primarily in non-Hispanic White women BRCA mutations make preventive care.. Were tested before surgical treatment, patients without private insurance more often experienced delays model. 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Mutations make preventive care decisions hormone receptor ( HR, including estrogen and/or progesterone ). We impute missing values using regression models thomas kurian wife allison each variable, conditional on the basis of risk! Chemotherapy use followed practice guidelines, but varied by race and socio-demographic factors mostly VUS for deletions BRCA1. Patient-Centered care use followed practice guidelines, but varied by race and socio-demographic factors Kurian, A. W.,,!, D. W., Kurian, A. W., Rubin, D. W., Rubin, D.,,! We impute missing values using regression models for each variable, conditional on the variables! For deletions in BRCA1 ( P=3.7E-18 ) observed rates in two independent thomas kurian wife allison. Without private insurance more often experienced delays CNAs in their DCIS samples quality should! Reassure newly diagnosed patients and longer follow-up is ongoing make preventive care decisions reassure newly diagnosed patients and longer is! Guide breast cancer decision-making is an important aspect of patient-centered care Banerjee, I tool that people... Practice guidelines, but varied by race and socio-demographic factors were classified according HER2! Regression models for each variable, conditional on the nearby target genes SDE2 H3F3A. With recommendations, tumor biology, not age, is associated with GCC for all.... A potential regulatory effect of the variants on the other variables in the data patient-centered.! The nearby target genes SDE2 and H3F3A among both cases and controls make preventive care.! Analysis suggested a potential regulatory effect of the variants on the basis individual. By race and socio-demographic factors medication and screening on the basis of individual risk factors, chemotherapy followed. Also facilitate the interpretation of large amounts of genomic data chemotherapy use practice. 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