Live-tweeting tonight from #UW @fredhutch with Olufunmilayo (Fumni) Olopade, Director Center for Clinical Cancer Genetics @ U of Chicago #breastcancer
Her bio >…
"Cancer is a Genetic Disease/Disorder" (tonight's topic)
In the 1960s, no one believed that genetics were involved in cancer. While she was a student, they discovered BCR-ABL1 leukemia…
Approximately 1.5 percent of men and women will be diagnosed with leukemia in US >…
Fraction of leukemia patients have this genetic abnormalit.
Chronic myeloid leukemia accounts for 0.5% of all cancer cases and 0.2% of all cancer deaths.…
Genome project - $5 billion
With cancer - genomic data used to help with treatment
[#breastcancer >… ]
Now talking about genes (nature) versus environment (nurture)
Then ...
Germline mutations and Somatic mutations
How does cancer metastasize? (No answer)

Now a segue into BRCA1 and BRCA2 mutations.

These mutations are "relatively rare in the general population" but convey a high risk of cancer…
Important to ask about father's family history -- too often the focus has been mother's family history. These mutations may be associated with more than reproductive organ cancer.

She's said pancreatic cancer several times.
The cost of doing genetic screening is dropping, making it possible to test more people. SCOTUS overturned attempt to patent genes -- which jumpstarted research (she said)…
"Why would you do genetic testing? Your insurance company would drop you."
This was a REAL barrier. Now we have HIPPA (privacy protected).
You did not choose your genes - so genetic discrimination should not be how we manage medicine.
Who wants to know that she has triple negative breast cancer if there is nothing you can do about it?
We know that Ashkenazi Jewish heritage increases risk of breast cancer. She is focused on African American women.
High risk women (BRC1 and BRC2) - MRI imaging every six months; started in 2004. It was a successful trial (4 DCIS and 13 early stage cancer, no lymph node environment). The average tumor size was 6.1mm.
Reminder of lifestyle factors (smoking, excessive drinking) that predispose you to cancer.
Reminder that mammography doesn't show #breastcancer well for young women or women with dense breasts.
Now discussion of over-diagnosis of DCIS.
How to identify cancers that will kill you.
Population risk stratification.
Chart shows that MRI is more successful than mammogram for BRCA-high-risk women.
Yes, genetic mutations provide path for target therapies.
BUT (I am arguing here) ... most cancers still do not have distinct genetic mutation.
Where you live determines whether you live -- chart of age-adjusted African American mortality (State cancer profiles)
Q: Are you recommending early genetic testing?
A: There are times when it's not useful to know (example babies with holes in heart). The question is - when should a woman know? Risk goes up in 30s and 40s. Maybe wait until you have children.
Will doctors be ready to see so many people?
Does a genetic mutation "make you sick"?
How will individuals use that information?
Have a discussion because it runs in the family. The children know what's going on - let them choose but the doctors need to ask. So many say that they had not gotten tests or joined trial because no one asked.
Full thread >…

Dr. Olopade in 2011 (photo looks like it was taken yesterday)…
I asked question about these data on risk of dying from #breastcancer (no real change in 40 years - data are not age adjusted)…

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More from @kegill

Oct 8, 2018
Brand new Texas group sues Harvard and NYU Law Reviews this weekend claiming reverse discrimination. Lawyer on case: Trump nominee

Harvard filed Sat. NYU on Sun.

Timing a coincidence? I think not.…

Story also @ (paywall)
Complainant : Texas-based ‘Faculty, Alumni and Students Opposed to Racial Preferences’

From @Bloomberg- goal to “restore meritocracy at American universities by eliminating the use of race and sex preferences.”

Frivolous suit: no individuals named as having been harmed
Brand new group: web site created Saturday. Coincidence? Doubtful.
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Oct 3, 2018
Dear @resistbot developers

STOP asking for DOB which you are linking to first and last names and phone over insecure SMS.

I’m stunned. This is the sort of info we opposed Trump’s gathering en masse last year.

#justSayNo to today’s ask about being registered to vote.
Reminder that @resistbot org fails basic transparency test on “about” page.

Nothing about how they manage your data, protect your #privacy , who is advisory board, who makes decisions, etc. #Opaque.
You can find two names buried near the bottom of long, densely-packed about page. No details/links.
Via Google search:
ED is Jason @Putorti
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Sep 29, 2018
“In a 2014 address to Yale Law students, [Kavanaugh] recalled a night of ‘group chugs’ in Boston that ended with his group “falling out of the bus onto the front steps of Yale Law School at about 4:45 a.m.”…
Drinking to excess is not synonymous with blacking out (having memory gaps). Kavanaugh implied the former by denying the latter.
Kavanaugh claimed it was “legal to drink” in his senior year. Not true. The legal drinking age in Maryland had been raised to 21 before he turned 18. And 1982, the summer in question, was the summer BEFORE his senior year. He turned 18 in 1983.
Read 12 tweets
Sep 20, 2018
Plan in place in S Africa and UK by a CANADIAN company. John Hancock is not US-owned.

Welcome to global rule by capitalists.

Example of news-release-“reporting” or zero curiosity on the part of the writer.
#privacy #elitism #dataBreachRisk…
Do you want ANY corporation monitoring your whereabouts and behavior 24x7? Hell no.

And a reminder that “insurance” wasn’t created to help the most secure/fit. Franklin’s vision: to spread risk throughout a community.

h/t @MrAlanCooper
Insurance as envisioned by Benjamin Franklin was the opposite of individualism (an American myth with long legs).
Read 6 tweets
Sep 20, 2018
Lost in the fevered GOP rhetoric that there is a proverbial time-bomb counting down on the Kavanaugh nomination:

In 2016, some in the GOP said they’d not let Clinton appoint a SCOTUS justice.
h/t @KevinMKruse…
These “omg we have to vote now else democracy is lost” hypocrites held open a SCOTUS justice seat for ONE YEAR AND 53 DAYS because they did not want the country’s first black president to make that appointment.…
The GOP rhetoric is classic 1984-doublespeak (AKA bullsh*t).

CLAIM: The FBI does not investigate charges like those made by Dr. Blasey.

FACT: the FBI investigated Anita Hill’s allegation.…
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Sep 18, 2018
"In the face of warnings that climate change was making" storms like Florence "more common" NC created an 'insurer of last resort' and "has written policies for thousands of coastal properties worth tens of billions of dollars." #NoFederalBailOutForNC…
Why did the NC politicians do this?
Because "nationally known insurance companies pulled out of the state’s coastal communities". You know, they assessed the risk and said 'hell no.'
State Farm stopped writing new homeowner policies for houses within a mile of the ocean in 2006. By the end of 2008, Farmers Insurance and Encompass Insurance joined SF.
Read 8 tweets

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