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Monique A. de Bruin, James M. Ford, and Allison W. Kurian

took no medications and had no family history of breast or ovarian cancer. Review of systems was unremarkable. On physical examination, she was a well-appearing woman. Breasts were symmetric without dimpling or retraction. Her right breast had several

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Demetra Hypatia Hufnagel, Sumit Tushar Mehta, Chinyere Ezekwe, Alaina J. Brown, Alicia Beeghly-Fadiel, and Lauren Shore Prescott

among patients with ovarian cancer (500 mL) and lowest among those with vulvar and vaginal cancers (100 mL). Table 1. Patient and Treatment Characteristics Prevalence of Anemia and Anemia Characteristics A total of 857 patients had

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Eve Henry, Victor Villalobos, Lynn Million, Kristin C. Jensen, Robert West, Kristen Ganjoo, Alexandra Lebensohn, James M. Ford, and Melinda L. Telli

/Familial High-Risk Assessment: Breast and Ovarian Cancer recommend TP53 testing for individuals with multiple primary tumors, 2 of which belong to the LFS tumor spectrum (ie, sarcoma, breast cancer, adrenocortical carcinoma, brain tumor, leukemia, lung

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Yvonne Bombard, Peter B. Bach, and Kenneth Offit

testing for mutations in BRCA1 or BRCA2 in unaffected women to identify those at significantly elevated risk for developing breast and ovarian cancer, 6 and screening patients with newly diagnosed colorectal cancer for mutations in mismatch repair

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Stanford Hospital and Clinics

Recent advances in molecular genetics have identified several genes associated with inherited susceptibility to cancer and have provided a means to begin identifying individuals and families with an increased risk of cancer. This rapid expansion of knowledge about cancer genetics has implications for all aspects of cancer management, including prevention, screening, and treatment. These guidelines specifically address hereditary breast/ovarian cancer syndrome (HBOC), Li-Fraumeni syndrome, and Cowden syndrome. These guidelines were developed understanding that much of our knowledge of how the rapidly emerging field of molecular genetics can be applied clinically is preliminary and that flexibility is needed when applying these guidelines to individual families.

For the most recent version of the guidelines, please visit NCCN.org

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Jeffrey Crawford, David C. Dale, Nicole M. Kuderer, Eva Culakova, Marek S. Poniewierski, Debra Wolff, and Gary H. Lyman

This study was undertaken to describe the relationship between the occurrence and timing of neutropenic events and chemotherapy treatment in a community-based population of patients with cancer. The study included 2962 patients with breast, lung, colorectal, lymphoma, and ovarian cancers from a prospective U.S. registry of patients initiating a new chemotherapy regimen. Detailed patient-, disease-, and treatment-related data, including toxicities, were captured at baseline, the beginning of each cycle, and each midcycle blood draw for up to 4 cycles of treatment. Primary outcomes included febrile neutropenia (FN), severe neutropenia without fever/infection, and relative dose intensity (RDI). Thirty-seven percent of patients were aged 65 years or older, 43.5% had an Eastern Cooperative Oncology Group performance status of 1 or greater, and 27% had 1 or more comorbidities. Reductions in RDI to less than 85% of standard in the first cycle were planned in 23.6% of patients, whereas primary colony-stimulating factor prophylaxis was used in 18.2%. In the first 3 cycles of treatment, 10.7% of patients experienced FN, with most of these events (58.9%) occurring in the first cycle. This first-cycle pattern was consistently observed despite wide variations in event rates by tumor type, disease stage, chemotherapy regimen and dose, and patient characteristics. Despite frequent planned reductions from standard RDI, the incidence of FN remains high in community oncology practice in the United States. Improved methods of pretreatment assessment of patient risk factors for neutropenia are needed.

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Robert J. Morgan Jr

Epithelial ovarian cancer remains one of the most feared and lethal malignancies in women. It is the eighth most common cancer in women, but the fifth leading cause of cancer deaths. 1 In light of these statistics, it is important to implement

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Telehealth Program on Reducing Geographic Barriers to Treatment and Improving Symptom Management in Rural Patients With Advanced Ovarian Cancer Principal Investigator: Haller J. Smith, MD Condition: Ovarian – quality Institution: University of

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Navigation Program for Social Determinants of Health in Advanced Ovarian Cancer Principal Investigator: Cary Gross, MD Condition: Advanced ovarian cancer – quality Institution: Yale Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER

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Cancer Principal Investigator: Julian C. Schink, MD Condition: Recurrent epithelial ovarian cancer, recurrent fallopian tube cancer, and recurrent primary peritoneal cancer Institution: Robert H. Lurie Comprehensive Cancer Center of Northwestern