Publications by authors named "Couch F"

Purpose: Over 50% of households in the United States have at least one musician-many musicians are also breast cancer survivors. This group has not been well studied, and given the level of fine sensory-motor skill required for musicianship, we hypothesized that musicians experience unique manifestations of breast cancer treatment toxicities.

Methods: A nine-item Musical Toxicity Questionnaire (MTQ) was distributed to patients who had consented to participate in the Mayo Clinic Breast Cancer Registry.

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Purpose: To study the association between clinicopathologic characteristics of ductal carcinoma in situ (DCIS) and risk of subsequent invasive breast cancer (IBC).

Methods: We conducted a case-control study nested in a multicenter, population-based cohort of 8175 women aged ≥ 18 years with DCIS diagnosed between 1987 and 2016 and followed for a median duration of 83 months. Cases (n = 497) were women with a first diagnosis of DCIS who developed a subsequent IBC ≥ 6 months later; controls (2/case; n = 959) were matched to cases on age at and calendar year of DCIS diagnosis.

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Germline BRCA2 loss-of function variants, which can be identified through clinical genetic testing, predispose to several cancers. However, variants of uncertain significance limit the clinical utility of test results. Thus, there is a need for functional characterization and clinical classification of all BRCA2 variants to facilitate the clinical management of individuals with these variants.

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Background: The 313-variant polygenic risk score (PRS) provides a promising tool for clinical breast cancer risk prediction. However, evaluation of the PRS across different European populations which could influence risk estimation has not been performed.

Methods: We explored the distribution of PRS across European populations using genotype data from 94,072 females without breast cancer diagnosis, of European-ancestry from 21 countries participating in the Breast Cancer Association Consortium (BCAC) and 223,316 females without breast cancer diagnosis from the UK Biobank.

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The tumor suppressor CHEK2 encodes the serine/threonine protein kinase CHK2 which, upon DNA damage, is important for pausing the cell cycle, initiating DNA repair, and inducing apoptosis. CHK2 phosphorylation of the tumor suppressor BRCA1 is also important for mitotic spindle assembly and chromosomal stability. Consistent with its cell-cycle checkpoint role, both germline and somatic variants in CHEK2 have been linked to breast and other cancers.

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Background: Retrospective studies suggest that some breast cancer survivors report treatment-associated hair loss or thinning years after their diagnosis. This study investigates frequency and perceptions of alopecia persisting 6 years after patients' breast cancer diagnoses.

Methods: Breast cancer survivors participating in the Mayo Clinic Breast Disease Registry (MCBDR) were mailed a survey 6 years after diagnosis.

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Purpose: This study evaluates real-world outcomes, toxicities, and prescribing patterns of PARP inhibitors (PARPis) for the treatment of metastatic breast cancer (MBC).

Patients And Methods: Electronic health records of 62 MBC patients treated with olaparib (n = 48) or talazoparib (n = 14) at Mayo Clinic System between 2017 and 2022 were analyzed. Time-to-treatment-failure (TTF) was assessed utilizing the Kaplan-Meier method.

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Purpose: To determine the relationship between germline pathogenic variants (PV) in cancer predisposition genes and the risk of ductal carcinoma in situ (DCIS).

Experimental Design: Germline PV frequencies in breast cancer predisposition genes (ATM, BARD1, BRCA1, BRCA2, CDH1, CHEK2, PALB2, RAD51C, and RAD51D) were compared between DCIS cases and unaffected controls and between DCIS and invasive ductal breast cancer (IDC) cases from a clinical testing cohort (n = 9,887), a population-based cohort (n = 3,876), and the UK Biobank (n = 2,421). The risk of contralateral breast cancer (CBC) for DCIS cases with PV was estimated in the population-based cohort.

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Article Synopsis
  • Known genetic risk factors account for about one-third of familial endometrial cancer cases, but the link between rare germline copy number variants (CNVs) and cancer risk is not well understood.
  • A study analyzed DNA from over 4,000 endometrial cancer patients and nearly 18,000 controls, finding that the cancer group had a significantly higher number of CNVs.
  • The research identified 141 gene loci potentially related to endometrial cancer risk, highlighting a specific area (16p11.2) with recurrent deletions that could help further investigations into genetic susceptibility.
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Prior studies have suggested the existence of reduced penetrance pathogenic variants (RPPVs) in BRCA1 and BRCA2 (BRCA) which pose challenges for patient counseling and care. Here, we sought to establish RPPVs as a new category of variants. Candidate BRCA RPPVs provided by two large clinical diagnostic laboratories were compiled to identify those with the highest likelihood of being a RPPV, based on concordant interpretations.

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  • Pathogenic variants (PVs) in certain genes like BRCA1 and BRCA2 increase breast cancer risk, but it's unclear how risk varies based on the type and location of these variants.
  • This study analyzed breast cancer risks associated with different PV types and locations using data from 12 US studies and clinical cohorts involving over 64,000 women.
  • Results showed that women with specific exon PTVs had higher breast cancer risks, lower rates of ER-negative breast cancer, and were diagnosed at younger ages compared to those with other variants, with these patterns observed across multiple cohorts.
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Purpose: Most breast biopsies are diagnosed as benign breast disease (BBD), with 1.5- to fourfold increased breast cancer (BC) risk. Apart from pathologic diagnoses of atypical hyperplasia, few factors aid in BC risk assessment of these patients.

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  • Researchers are studying drugs called replication checkpoint modulators (RCMs) that could help treat tough ovarian cancer, but they are not very effective by themselves.
  • When these drugs are used on cancer cells, they change certain proteins inside the cells, which makes them struggle to divide and can lead to cell death.
  • The study shows that these drugs can help shrink tumors even in stubborn cases, meaning they could be useful for patients with this type of cancer.
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Background: Eyebrow and eyelash loss, known as madarosis, can occur after breast cancer-directed therapy. The purpose of this study was to ascertain the proportion of breast cancer survivors who experience madarosis, contributing factors, and associations between this symptom and quality of life.

Methods: Breast cancer survivors were invited to participate in an ongoing longitudinal cohort study as a part of the Mayo Clinic Breast Disease Registry (MCBDR).

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The authors have withdrawn this manuscript because they identified problems with how some figure panels were processed. Those experiments will be repeated before deposition of a new manuscript. Therefore, the authors do not wish this work to be cited as reference for the project.

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Article Synopsis
  • The ClinGen Hereditary Breast, Ovarian, and Pancreatic Cancer Variant Curation Expert Panel (HBOP VCEP) created specific guidelines for interpreting variants in the ATM gene, modifying the American College of Medical Genetics and Association for Molecular Pathology (ACMG/AMP) guidelines.
  • A pilot study testing 33 variants showed strong agreement between the VCEP classifications and existing ClinVar data, though some conflicting interpretations were clarified.
  • Overall, the modified rules led to 85% of the variants being classified more definitively, significantly enhancing the reliability of genetic interpretations related to the ATM gene.
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  • Clinical genetic testing helps find cancer risks by identifying gene changes, but some of these changes are confusing because we don't know what they mean (called VUS).
  • Researchers studied a huge number of breast cancer patients and healthy people to understand these confusing gene changes better.
  • They found that their method of analyzing data closely matches what other experts say about which gene changes are harmless or harmful, giving more information about 785 unclear changes.
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Article Synopsis
  • - The study aimed to enhance breast cancer risk modeling by integrating pathogenic variants (PVs) in specific genes, a polygenic risk score (PRS), and an epidemiologic risk score (ERS) using data from over 23,000 breast cancer cases and controls.
  • - The results showed that postmenopausal women with no PVs but high ERS had a 4.4-fold increase in breast cancer risk, while some CHEK2 PV carriers had a predicted lifetime risk below 20%, indicating potential over-screening in certain groups.
  • - The findings suggest that combining these risk factors can improve risk assessment and possibly lead to more tailored screening and prevention strategies for breast cancer.
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The co-occurrence of germline and somatic oncogenic alterations is frequently observed in breast cancer, but their combined biologic and clinical significance has not been evaluated. To assess the role of germline-somatic interactions on outcomes in routine practice, we developed an integrated clinicogenomic pipeline to analyze the genomes of over 4,500 patients with breast cancer. We find that germline (g) -associated tumors are enriched for loss-of-function mutations and manifest poor outcomes on standard-of-care, front-line CDK4/6 inhibitor (CDK4/6i) combinations.

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Background: Ductal carcinoma in situ (DCIS) is a non-obligate precursor to invasive breast cancer (IBC). Studies have indicated differences in DCIS outcome based on race or ethnicity, but molecular differences have not been investigated.

Methods: We examined the molecular profile of DCIS by self-reported race (SRR) and outcome groups in Black (n = 99) and White (n = 191) women in a large DCIS case-control cohort study with longitudinal follow up.

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Article Synopsis
  • Mutations in the BRCA1 and BRCA2 genes significantly increase breast cancer risk and are present in about 5% of unselected breast cancer patients.
  • Breast cancer associated with these mutations has unique characteristics and responds better to specific treatments like PARP inhibitors and platinum-based therapies, while showing less sensitivity to CDK4/6 inhibitors.
  • Challenges in identifying patients with these mutations due to low genetic testing rates are discussed, along with current guidelines for testing and the need for timely determination of mutation status to optimize treatment strategies.
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Objective: Whether or not women who harbor a germline pathogenic variant ('mutation') in the BRCA1 or BRCA2 genes are at elevated risk of developing endometrial cancer is yet to be determined.

Methods: We conducted a prospective analysis of 4959 BRCA mutation carriers with no prior history of cancer (except for breast or melanoma) and an intact uterus.

Results: After a mean of 6.

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  • The ENIGMA research consortium focuses on determining the clinical significance of variants in hereditary breast and ovarian cancer genes, specifically BRCA1 and BRCA2, and evolved from an external expert panel to an internal Variant Curation Expert Panel (VCEP) to enhance alignment with FDA recognized classification processes.
  • The VCEP reviewed existing classification criteria and utilized statistical methods to assess evidence strength, testing new specifications on variants and updating documentation for better user clarity.
  • Analysis led to refined classifications for variants—resolving uncertainties and maintaining confidence in others—while revealing gaps in both ENIGMA's research and ACMG/AMP criteria, ultimately improving the classification process for BRCA1 and BRCA2 variants.
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  • The Advocate-BREAST project aims to enhance the breast cancer patient experience through targeted education and patient-centered research.* -
  • A survey sent to nearly 7,000 breast cancer survivors revealed high satisfaction with care but identified significant concerns regarding symptoms and support, particularly around issues like sexual dysfunction and emotional health.* -
  • Patients expressed a need for better psychological support and clear educational resources, leading to proposed Quality Improvement projects focusing on holistic care and wellness programs.*
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  • - The study, Advocate-BREAST80+, assessed the needs of breast cancer patients aged 80 and older (P80+) compared to younger patients (P80-).
  • - A survey was conducted with 6,918 participants from the Mayo Clinic Breast Disease Registry, finding that P80+ were less likely to receive certain therapies and were significantly less satisfied with information about side effects and management.
  • - While P80+ reported lower anxiety levels, they were much less involved in clinical trials and showed little interest in participating in future studies, highlighting a need for improved education and support for this age group.
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