Petkov, V. I., Howlader, N., Cronin, K., Kurian, A. W., Penberthy, L. Dissemination of 21-gene assay testing among female breast cancer patients in the US. We examined racial differences in outcome according to subtype and stage in a diverse, population-based series of 103,498 patients.We obtained data for all invasive breast cancers diagnosed 1/1/2005-12/31/2012 and followed through 12/31/2012 among 93,760 non-Hispanic white and 9,738 African-American women in California. Furthermore, we trained a regularized logistic regression model for recurrent MBC classification and evaluated its performance on a gold standard set of 146 patients.There were 11459 breast cancer patients in total and the median follow-up time was 96.3 months. Meta-analyses were conducted to combine the results from these two datasets.Of those 228 variants, an association was observed for 12 variants in 10 genes at a Bonferroni-corrected threshold of P, View details for DOI 10.1016/j.ebiom.2019.09.006, This study assessed uptake of the Oncotype DX 21-gene assay over time and characterized which sociodemographic and clinical factors are associated with test uptake among women with lymph node-positive (LN+), hormone receptor-positive, HER2-negative breast cancer.Invasive breast cancer cases diagnosed in 2010 through 2013 were included from a SEER database linked to 21-gene assay results performed at Genomic Health's Clinical Laboratory. For more information, please contact Pei Jen Chang, 650-725-0866. BC-specific mortality was modified by surgery type, hospital type, education, neighborhood socioeconomic status (SES), smoking history, and alcohol consumption. From 2013 to 2015, keeping other factors constant, chemotherapy use was estimated to decline from 34.5% (95% confidence interval [CI] = 30.8% to 38.3%) to 21.3% (95% CI=19.0% to 23.7%, P < .001). This personalised risk estimate will be calculated using the CanRisk risk prediction tool, which combines the patient's genetic result, family history and polygenic risk score (PRS), along with hormonal and lifestyle factors. View details for DOI 10.1158/1538-7755.DISP18-IA50, View details for DOI 10.1007/s12609-020-00354-3. Quality improvement should focus on testing indicated patients rather than adding more genes. 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. Strong desire for testing was more common in younger women, Latinas, and those with family history. Germline testing for LS in addition to BRCA1/2 for all women with an epithelial ovarian cancer would be efficient and would approach 100% sensitivity for identifying Lynch syndrome. Research suggests that adherence to the 2012 ACS Guideline might lower breast cancer risk, but there is limited evidence that this applies to women at increased familial and genetic risk of breast cancer.Using the Breast Cancer Family Registry (BCFR), a cohort enriched for increased familial and genetic risk of breast cancer, we examined adherence to three 2020 ACS Guideline recommendations (weight management (body mass index), physical activity, and alcohol consumption) with breast cancer risk in 9615 women. 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. 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). . We used publicly available in silico DNase I and ChIP-seq data with invitro reporter gene and CRISPR assays to annotate signals 2 and 3. Specific focus was put on differences between settings. Our findings inform 3 areas of the PMI: addressing insurance coverage to secure access to future PMI discoveries; incorporating payers' evidentiary requirements into PMI's research agenda; and leveraging payers' recommendations and experience to keep patients informed and involved. Breast cancer is a major global problem, with nearly 1 million cases occurring each year. Patients with triple-negative breast cancer (TNBC), defined as lacking expression of the estrogen and progesterone receptors (ER/PR) and amplification of the HER2 oncogene, often have a more aggressive disease course than do patients with hormone receptor-positive breast cancer, including higher rates of visceral and central nervous system metastases, early cancer recurrences and deaths. Who Is J Prince Wife Mary Prince, Are J Prince and Pilar Sanders Still Together, Engaged, Or Married? View details for DOI 10.1158/1055-9965.EPI-12-0149. Atypical cells can be found in non-fluid-yielding ducts in patients at high inherited breast cancer risk. Women with inherited BRCA1/2 mutations are at high risk for breast cancer, which mammography often misses. This study is about understanding the use of a genetic test (Myriad Genetics myRisk panel)
A., Korde, L. A., Kounalakis, N., Krontiras, H., Kumar, S., Kurian, A., Laronga, C., Layman, R. M., Loftus, L. S., Mahoney, M. C., Merajver, S. D., Meszoely, I. M., Mortimer, J., Newman, L., Pritchard, E., Pruthi, S., Seewaldt, V., Specht, M. C., Visvanathan, K., Wallace, A., Bergman, M. A., Kumar, R. History of Recreational Physical Activity and Survival After Breast Cancer The California Breast Cancer Survivorship Consortium. NAC use more than doubled over time and increased with stage (Stage I, 0.7%; Stage III, 29.9%). View details for PubMedCentralID PMC7785044, View details for DOI 10.1093/jncics/pkaa083, View details for PubMedCentralID PMC7785044. pharmacokinetic (PK) cohort of the study (cohort A) in postmenopausal women with metastatic
Here we demonstrate feasibility of performing high dimensional single CTC profiling, providing early insight into CTC heterogeneity and allowing comparisons to breast cancer cell lines widely used for drug discovery.We purified CTCs using the MagSweeper, an immunomagnetic enrichment device that isolates live tumor cells from unfractionated blood. O'Mara, A. E., Benedict, C., Kurian, A. W., Wagner, S. K., Diver, E. J. Polygenic risk modeling for prediction of epithelial ovarian cancer risk. 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). View details for DOI 10.1016/j.currproblcancer.2016.09.007, View details for Web of Science ID 000390980500005. 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). Our findings demonstrate that profiling CTCs on a cell-by-cell basis is possible and may facilitate the application of 'liquid biopsies' to better model drug discovery. Our model maintains a Markov belief about the effectiveness of the different therapies and updates it as therapies are administered and tumor images are observed, reflecting tumor response. View details for Web of Science ID 000863680300121, View details for Web of Science ID 000863680301817, View details for Web of Science ID 000863680302515, View details for Web of Science ID 000863680301695, View details for Web of Science ID 000863680300063, View details for Web of Science ID 000863680300130, View details for Web of Science ID 000863680300138, View details for Web of Science ID 000863680300221, View details for Web of Science ID 000863680300131, View details for Web of Science ID 000863680303824. Additional strategies for SPLC surveillance and screening are warranted. 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. Mechanistically, we identify BRCA2 chromatin binding, histone acetylation, and associated transcriptional activity as critical determinants of the epigenetic response to BRCA2-crisis. placebo in combination with nab-paclitaxel in participants with locally advanced or
BOADICEA overpredicted mutations in African Americans and older NHWs, and BRCAPRO underpredicted in Hispanics. Allison Walsh Kurian is an American medical oncologist. c.7271T>G is associated with high risk for breast cancer, with a three to four-fold risk increase that supports consideration of strategies for prevention and/or early detection. Hu, C. n., Hart, S. N., Gnanaolivu, R. n., Huang, H. n., Lee, K. Y., Na, J. n., Gao, C. n., Lilyquist, J. n., Yadav, S. n., Boddicker, N. J., Samara, R. n., Klebba, J. n., Ambrosone, C. B., Anton-Culver, H. n., Auer, P. n., Bandera, E. V., Bernstein, L. n., Bertrand, K. A., Burnside, E. S., Carter, B. D., Eliassen, H. n., Gapstur, S. M., Gaudet, M. n., Haiman, C. n., Hodge, J. M., Hunter, D. J., Jacobs, E. J., John, E. M., Kooperberg, C. n., Kurian, A. W., Le Marchand, L. n., Lindstroem, S. n., Lindstrom, T. n., Ma, H. n., Neuhausen, S. n., Newcomb, P. A., O'Brien, K. M., Olson, J. E., Ong, I. M., Pal, T. n., Palmer, J. R., Patel, A. V., Reid, S. n., Rosenberg, L. n., Sandler, D. P., Scott, C. n., Tamimi, R. n., Taylor, J. The Novel Markers Trial will compare the safety, feasibility and effectiveness of two
View details for DOI 10.1007/s10552-016-0791-9. View details for PubMedCentralID PMC3867595. A Phase II Clinical Trial of PM01183 in BRCA 1/2-Associated or Unselected Metastatic Breast Cancer. All P values are two-sided.We did not observe an age-related black-white crossover in incidence for any molecular subtype of breast cancer. Kurian senior was a chemical engineer and the general manager of Graphite India. A year ago, he took the helm of Google's cloud . Incidence rates for any contralateral primary cancer following an HR-negative or HR-positive tumor were higher in non-Hispanic blacks, Hispanics, and Asians or Pacific Islanders than in non-Hispanic whites.Risk for contralateral second primary breast cancers varies substantially by HR status of the first tumor, age, and race and/or ethnicity. Friese, C. R., Li, Y., Bondarenko, I., Hofer, T. P., Ward, K. C., Hamilton, A. S., Deapen, D., Kurian, A. W., Katz, S. J. The similar overall PV frequencies for ILC and IDC suggest that cancer histology should not influence the decision to proceed with genetic testing. In conclusion, the use of laboratories with payment assistance programs reduces barriers to NGS panel testing among diverse populations. Patients' attending surgeons were surveyed about genetic testing and results management. Luhn, P. n., Chui, S. Y., Hsieh, A. F., Yi, J. n., Mecke, A. n., Bajaj, P. S., Hasnain, W. n., Falgas, A. n., Ton, T. G., Kurian, A. W. Re-evaluating genetic variants identified in candidate gene studies of breast cancer risk using data from nearly 280,000 women of Asian and European ancestry. of pertuzumab given in combination with trastuzumab (Herceptin) and vinorelbine in first line
Screening mammography has contributed to a significant increase in the diagnosis of ductal carcinoma in situ (DCIS), raising concerns about overdiagnosis and overtreatment. Interview: Google Cloud CEO Thomas Kurian on open source, AWS, and working with the military by Tom Krazit on April 9, 2019 at 10:00 am April 9, 2019 at 10:28 am Share 81 Tweet Share Reddit Email Additional studies are required to quantify the penetrance of identified mutations and determine clinical utility. View details for DOI 10.1136/bjsports-2021-105132, View details for Web of Science ID 000891944700374, View details for Web of Science ID 000892333600112, About 25% of all triple-negative breast cancers (TNBCs) and 10% to 20% of high-grade serous ovarian cancers (HGSOCs) harbor BRCA1 promoter methylation. The safety of single-agent nab-paclitaxel has been
Women with mutations in the BRCA1 or BRCA2 cancer susceptibility genes face unique choices regarding management of their high risk for breast and ovarian cancer that impact their reproductive options. Trosman, J. R., Weldon, C. B., Douglas, M. P., Kurian, A. W., Kelley, R. K., Deverka, P. A., Phillips, K. A. Katz, S. J., Hawley, S., Jagsi, R., Kurian, A. W. Value of cancer care for metastatic breast cancer patients and providers, May, S., Chung, A., Vania, D., Hou, N., MacEwan, J., Batt, K., Kurian, A. W., et al, Genetic counseling, germline genetic testing, and impact of results in patients with newly diagnosed breast cancer. She is also a clinically active oncologist, treating patients diagnosed with breast cancer. We calculated and compared age-specific incidence rates, incidence rate ratios, and 95% confidence intervals by subtype and race (black, white, Hispanic, and Asian). Luhn, P., Chui, S., Hsieh, A., Yi, J., Mecke, A., Bajaj, P., Hasnain, W., Falgas, A., Ton, T. G., Kurian, A. W. Outcomes in patients with metastatic triple-negative breast cancer treated in second line in the US real-world setting. 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. 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. 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. Stratification of risk was evaluated by multivariable logistic regression models controlling for family cancer history. Early user testing demonstrated ease of use and app feasibility.TOGETHERCare, a novel mobile app, was developed with user input to track the care partner's health and report on survivor symptoms during home care. PURPOSE: This randomized phase III trial is studying letrozole to see how well it works
Gene panels for hereditary breast and ovarian cancer risk assessment are gaining acceptance, even though the clinical utility of these panels is not yet fully defined. Time trends were analyzed with multinomial regression models.Rates of final surgical procedure (lumpectomy, unilateral mastectomy, bilateral mastectomy) and rates of additional surgery after initial lumpectomy over time, and surgeon attitudes toward an adequate lumpectomy margin.The 67% rate of initial lumpectomy in the 3729 patient analytic sample was unchanged during the study. [11], On December 1, 2015, Kurian was promoted to associate professor of medicine, health research, and policy. Results: The adjusted overall survival hazard ratio was 0.98 (95% CI: 0.67-1.44), indicating a similar risk of death between groups. Little is known about the psychological outcomes of germline multigene panel testing, particularly among diverse patients and those with moderate-risk pathogenic variants (PVs).Study participants (N = 1264) were counseled and tested with a 25- or 28-gene panel and completed a 3-month postresult survey including the Multidimensional Impact of Cancer Risk Assessment (MICRA).The mean age was 52 years, 80% were female, and 70% had cancer; 45% were non-Hispanic White, 37% were Hispanic, 10% were Asian, 3% were Black, and 5% had another race/ethnicity. Alagoz, O., Lowry, K. P., Kurian, A. W., Mandelblatt, J. S., Ergun, M., Huang, H., Lee, S. J., Schecter, C., Tosteson, A. A., Sorice, R., Southey, M. C., Spector, T. D., Spinelli, J. J., Stampfer, M., Stckl, D., van Meurs, J. 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 pertuzumab and trastuzumab in separate infusion bags, followed by vinorelbine. We were all raised with those Christian values and she did things very different than most Indian parents,. For more information, please contact Pei-Jen Chang, (650) 725 - 0866. Reproductive longevity is essential for fertility and influences healthy ageing in women1,2, but insights into its underlying biological mechanisms and treatments to preserve it are limited. The top decile of the MA-PRS consistently identified patients with two-fold increased risk of developing BC. He also helped in the transformation of Oracle's products with the introduction of leading suite of Cloud Services, led 60 software acquisitions and Oracle's 45 Cloud data centres. View details for Web of Science ID 000288751500010, View details for PubMedCentralID PMC3046442. 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. PM at age 25 instead of age 40 offers minimal incremental benefit (1% to 2%); substituting screening for PM yields a similarly minimal decrement in survival (2% to 3%).Although PM at age 25 plus PO at age 40 years maximizes survival probability, substituting mammography plus MRI screening for PM seems to offer comparable survival. For more information, please contact Pei Jen Chang, 650-725-0866. To the authors' knowledge, the magnitude of benefit is unknown.The authors used data from the Surveillance, Epidemiology, and End Results (SEER) program regarding all women diagnosed with American Joint Committee on Cancer stage 0 to stage III unilateral breast cancer in California from 1998 through 2015 and treated with BLM versus breast-conserving therapy including surgery and radiotherapy (BCT) or unilateral mastectomy (ULM). 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. Survival differed substantially by stage at diagnosis. Integration with experimental models demonstrates that these DDR processes act across the life-course to shape the ovarian reserve and its rate of depletion. [3] At the age of 17, along with George Kurian,[4] he moved to the United States. Other mutation carrier-specific susceptibility variants may exist but studies of mutation carriers have so far been underpowered. Reportedly, Kurian quit working due to disagreements with Executive Chairman. We assessed the probability of these associations being true positives via the Bayesian false discovery probability (BFDP, View details for DOI 10.1186/s13058-021-01450-7. Variation in projected absolute lifetime risk of breast cancer associated with classical risk factors was greater for women with higher genetic risk (PRS313 and family history), and on average 17.5% higher in the highest vs lowest deciles of genetic risk. This study aimed to estimate ATM PV cancer risks independent of family cancer history. Both were accepted to the prestigious IIT Madras. Dr. Kurians research focuses on cancer genetics, precision oncology and the quality of cancer care at the population level. Hospital records were re-abstracted, and treatment was verified. 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Breast cancer risk was marginally increased among foreign-born women (OR=1.40, 95% CI=0.97-2.03) and two-fold among foreign-born Chinese women (OR=2.16, 95% CI=1.21-3.88). [15], As the President of Product Development, he oversaw Oracle's 3,000-odd product development efforts. ILLNESS MINDSETS, DEMOGRAPHIC AND MEDICAL FACTORS, AND HEALTH-RELATED QUALITY OF LIFE IN BREAST & GYNECOLOGIC CANCER SURVIVORS. [10] In 2014, she conducted a study with Scarlett Gomez which found that breast cancer patients who undergo bilateral mastectomy are not guaranteed better survival rates. 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. For more information, please contact Amy Isaacson, 650-723-0501. Wang, A., Aragaki, A., Tang, J., Kurian, A. W., et al, Lymphopenia after adjuvant radiotherapy to predict poor survival in triple-negative breast cancer. Jayasekera, J., Lowry, K. P., Yeh, J. M., Schwartz, M. D., Wernli, K. J., Isaacs, C., Kurian, A. W., Stout, N. K. A pilot study to increase cascade genetic testing in families with hereditary cancer syndromes. However, large meta-analyses show no association between statin use and overall risk of breast cancer, although most did not evaluate tumor HR status. Wapnir, I. L., Kurian, A. W., Lichtensztajn, D. Y., et al, Optimizing the Threshold for Genetic Testing for Colorectal Cancer Syndromes, Naghi, L., Spector, K., Haisman, J., Kurian, A. W., et al. In total, 3,047 deaths (1,570 breast cancer specific) were observed with a mean (SD) follow-up of 8.3 (3.5) years. letrozole may fight breast cancer by lowering the amount of estrogen the body makes. 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. (IV) infusions (followed by vinorelbine) and conventional sequential administration of
Adopters were less likely to be BlueCross BlueShield members (P < .05) and more likely to use a third-party policy (P < .001). Risk-reducing salpingo-oophorectomy was associated with a reduced risk of breast cancer for BRCA1 and BRCA2 pathogenic variant carriers within 5 years after surgery (hazard ratios [HRs], 0.28 [95% CI,0.10-0.63] and 0.19 [95% CI, 0.06-0.71], respectively), whereas the corresponding HRs were weaker after 5 years postsurgery (HRs, 0.64 [95% CI,0.38-0.97] and 0.99 [95% CI; 0.84-1.00], respectively). Future work should consider tailored interventions to mitigate the impact of COVID-19 on patients with cancer. A., Ghoussaini, M., Giles, G. G., Goldberg, M. S., Gonzlez-Neira, A., Gunel, P., Gndert, M., Haeberle, L., Hahnen, E., Haiman, C. A., Hall, P., Hamann, U., Hartman, M., Hatse, S., Hauke, J., Hollestelle, A., Hoppe, R., Hopper, J. L., Hou, M. F., Ito, H., Iwasaki, M., Jager, A., Jakubowska, A., Janni, W., John, E. M., Joseph, V., Jung, A., Kaaks, R., Kang, D., Keeman, R., Khusnutdinova, E., Kim, S. W., Kosma, V. M., Kraft, P., Kristensen, V. N., Kubelka-Sabit, K., Kurian, A. W., Kwong, A., Lacey, J. V., Lambrechts, D., Larson, N. L., Larsson, S. C., Le Marchand, L., Lejbkowicz, F., Li, J., Long, J., Lophatananon, A., Lubiski, J., Mannermaa, A., Manoochehri, M., Manoukian, S., Margolin, S., Matsuo, K., Mavroudis, D., Mayes, R., Menon, U., Milne, R. L., Mohd Taib, N. A., Muir, K., Muranen, T. A., Murphy, R. A., Nevanlinna, H., O'Brien, K. M., Offit, K., Olson, J. E., Olsson, H., Park, S. K., Park-Simon, T. W., Patel, A. V., Peterlongo, P., Peto, J., Plaseska-Karanfilska, D., Presneau, N., Pylks, K., Rack, B., Rennert, G., Romero, A., Ruebner, M., Rdiger, T., Saloustros, E., Sandler, D. P., Sawyer, E. J., Schmidt, M. K., Schmutzler, R. K., Schneeweiss, A., Schoemaker, M. J., Shah, M., Shen, C. Y., Shu, X. O., Simard, J., Southey, M. C., Stone, J., Surowy, H., Swerdlow, A. J., Tamimi, R. M., Tapper, W. J., Taylor, J. Comparison of the Prevalence of Pathogenic Variants in Cancer Susceptibility Genes in Black Women and Non-Hispanic White Women With Breast Cancer in the United States. Pathogenic variants (PVs) in ATM are relatively common, but the scope and magnitude of risk remains uncertain. We therefore examined the effect of hospital characteristics on survival.Harmonized data pooled from 5 case-control and prospective cohort studies within the California Breast Cancer Survivorship Consortium were linked to the California Cancer Registry and the California Neighborhoods Data System. 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. Afghahi, A., Rigdon, J., Purington, N., Desal, M., Pierson, E., Mathur, M., Thompson, C. A., Curtis, C., West, R. B., Horst, K. C., Gomez, S., Ford, J. M., Sledge, G. W., Kurian, A. W. Safety of multiplex gene testing for inherited cancer risk: Interim analysis of a clinical trial. B., Eliassen, A. H., Fasching, P. A., Flyger, H., Gago-Dominguez, M., Garca-Closas, M., Garca-Senz, J. In BCAC, increasing PRS313 was associated with lower grade, hormone receptor-positive status, and smaller tumor size. The American Cancer Society (ACS) published an updated Guideline for Cancer Prevention (ACS Guideline) in 2020. We measured testing trends, rates of variants of uncertain significance (VUS), and pathogenic variants (PVs).One quarter (25.2%) of 187,535 patients with breast cancer and one third (34.3%) of 14,689 patients with ovarian cancer were tested; annually, testing increased by 2%, whereas the number of genes tested increased by 28%. 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