Noah Kauff

Positions:

Instructor, Temporary in the Obstetrics and Gynecology

Obstetrics and Gynecology, Gynecologic Oncology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1993

University of Pennsylvania

Grants:

Publications:

RE: Breast Cancer Risk After Salpingo-Oophorectomy in Healthy BRCA1/2 Mutation Carriers: Revisiting the Evidence for Risk Reduction.

Authors
Chai, X; Domchek, S; Kauff, N; Rebbeck, T; Chen, J
MLA Citation
Chai, Xinglei, et al. “RE: Breast Cancer Risk After Salpingo-Oophorectomy in Healthy BRCA1/2 Mutation Carriers: Revisiting the Evidence for Risk Reduction..” J Natl Cancer Inst, vol. 107, no. 9, Sept. 2015. Pubmed, doi:10.1093/jnci/djv217.
URI
https://scholars.duke.edu/individual/pub1327345
PMID
26264690
Source
pubmed
Published In
J Natl Cancer Inst
Volume
107
Published Date
DOI
10.1093/jnci/djv217

Risk of metachronous breast cancer after BRCA mutation-associated ovarian cancer.

BACKGROUND: This study sought to estimate the risk of breast cancer (BC) after a diagnosis of ovarian cancer (OC) associated with mutation of the BRCA1/2 (breast cancer, early onset) genes (BRCA-OC). METHODS: The Memorial Sloan-Kettering Cancer Center and the University of Pennsylvania, clinical genetics databases were searched to identify women with BRCA-OC who participated in genetic testing and follow-up studies from 1995 to 2009. The primary objective was to determine the risk of developing BC after BRCA-OC. Overall survival (OS) and BC-free survival (BCFS) were determined by the Kaplan-Meier method; patients were censored at the time of last follow-up. RESULTS: A total of 164 patients had BRCA-OC (115 with BRCA1; 49 with BRCA2). Of these 164 patients, 152 developed OC prior to BRCA testing (median time to testing, 2.4 years [0.01-55 years]). Median follow-up from OC for those not developing BC was 5.8 years (0.25-55.6 years). There were 46 deaths, but none were due to BC. The 5- and 10-year OS were 85% (95% confidence interval [CI] = 0.78, 0.90) and 68% (95% CI = 0.59, 0.76), respectively. There were 18 metachronous BC diagnoses. The 5- and 10-year BCFS were 97% (95% CI = 0.92, 0.99) and 91% (95% CI = 0.82, 0.95), respectively. A subset of 64 women were tested either before or within 12 months of BRCA-OC. In this pseudo-incident subset, 5- and 10- year OS was 71% (95% CI = 0.53, 0.83) and 62% (95% CI = 0.44, 0.75), respectively, and 5- and 10-year BCFS were 100% and 87% (95% CI = 0.56, 0.96), respectively. CONCLUSIONS: OS was dominated by OC deaths. Metachronous BC risk was lower than reported for unaffected BRCA mutation carriers. These results support nonsurgical management of BC risk in women with BRCA-OC.
Authors
Domchek, SM; Jhaveri, K; Patil, S; Stopfer, JE; Hudis, C; Powers, J; Stadler, Z; Goldstein, L; Kauff, N; Khasraw, M; Offit, K; Nathanson, KL; Robson, M
MLA Citation
Domchek, Susan M., et al. “Risk of metachronous breast cancer after BRCA mutation-associated ovarian cancer.Cancer, vol. 119, no. 7, Apr. 2013, pp. 1344–48. Pubmed, doi:10.1002/cncr.27842.
URI
https://scholars.duke.edu/individual/pub1327359
PMID
23165893
Source
pubmed
Published In
Cancer
Volume
119
Published Date
Start Page
1344
End Page
1348
DOI
10.1002/cncr.27842

Discriminatory accuracy and potential clinical utility of genomic profiling for breast cancer risk in BRCA-negative women.

Several single nucleotide polymorphisms (SNPs) are associated with an increased risk of breast cancer. The clinical utility of genotyping individuals at these loci is not known. Subjects were 519 unaffected women without BRCA mutations. Gail, Claus, and IBIS models were used to estimate absolute breast cancer risks. Subjects were then genotyped at 15 independent risk loci. Published per-allele and genotype-specific odds ratios were used to calculate the composite cumulative genomic risk (CGR) for each subject. Affected age- and ethnicity-matched BRCA mutation-negative women were also genotyped as a comparison group for the calculation of discriminatory accuracy. The CGR was used to adjust absolute breast cancer risks calculated by Gail, Claus and IBIS models to determine the proportion of subjects whose recommendations for chemoprevention or MRI screening might be altered (reclassified) by such adjustment. Mean lifetime breast cancer risks calculated using the Gail, Claus, and IBIS models were 19.4, 13.0, and 17.7%, respectively. CGR did not correlate with breast cancer risk as calculated using any model. CGR was significantly higher in affected women (mean 3.35 vs. 3.12, P = 0.009). The discriminatory accuracy of the CGR alone was 0.55 (SE 0.019; P = 0.006). CGR adjustment of model-derived absolute risk estimates would have altered clinical recommendations for chemoprevention in 11-19% of subjects and for MRI screening in 8-32%. CGR has limited discriminatory accuracy. However, the use of a genomic risk term to adjust model-derived estimates has the potential to alter individual recommendations. These observations warrant investigation to evaluate the calibration of adjusted risk estimates.
Authors
Comen, E; Balistreri, L; Gönen, M; Dutra-Clarke, A; Fazio, M; Vijai, J; Stadler, Z; Kauff, N; Kirchhoff, T; Hudis, C; Offit, K; Robson, M
MLA Citation
Comen, E., et al. “Discriminatory accuracy and potential clinical utility of genomic profiling for breast cancer risk in BRCA-negative women..” Breast Cancer Res Treat, vol. 127, no. 2, June 2011, pp. 479–87. Pubmed, doi:10.1007/s10549-010-1215-2.
URI
https://scholars.duke.edu/individual/pub1327403
PMID
20957429
Source
pubmed
Published In
Breast Cancer Res Treat
Volume
127
Published Date
Start Page
479
End Page
487
DOI
10.1007/s10549-010-1215-2

Is It time to stratify for BRCA mutation status in therapeutic trials in ovarian cancer?

Authors
MLA Citation
Kauff, Noah D. “Is It time to stratify for BRCA mutation status in therapeutic trials in ovarian cancer?.” J Clin Oncol, vol. 26, no. 1, Jan. 2008, pp. 9–10. Pubmed, doi:10.1200/JCO.2007.14.0244.
URI
https://scholars.duke.edu/individual/pub1327388
PMID
18165631
Source
pubmed
Published In
Journal of Clinical Oncology
Volume
26
Published Date
Start Page
9
End Page
10
DOI
10.1200/JCO.2007.14.0244

Laparoscopic bilateral salpingo-oophorectomy in breast cancer patients after transverse rectus abdominus myocutaneous flap reconstructive surgery.

OBJECTIVE: The aim of this study was to describe the feasibility and outcome of laparoscopic risk-reducing salpingo-oophorectomy (RRSO) in patients with a history of breast cancer who previously had undergone a transverse rectus abdominus myocutaneous (TRAM) flap reconstruction. METHODS: We performed a retrospective review of patients with a history of breast cancer who had undergone laparoscopic RRSO between February 1995 and April 2002. Patients who had undergone TRAM flap reconstructive surgery were compared with patients who had undergone laparoscopic RRSO without prior reconstructive surgery. RESULTS: We identified 102 patients with a history of breast cancer who were candidates for a laparoscopic RRSO during the study period. One hundred one of these patients underwent the procedure, including 10 patients with a history of TRAM flap breast reconstructive surgery. One patient did not undergo the procedure because she was noted to be hypotensive prior to the procedure from her bowel preparation. There were no differences between the groups with or without prior history of TRAM flap reconstruction with respect to body mass index, prior abdominal surgery, menopausal status, or preoperative ultrasound characteristics. Operatively, there was no difference between the groups with respect to estimated blood loss, hospital stay, and intraoperative and postoperative complication rates. The only noted difference between the two groups was the estimated operating time (TRAM group, 91 min; non-TRAM group, 70 min [P<0.01]). CONCLUSIONS: Laparoscopic RRSO is safe and feasible in patients who have undergone a prior TRAM flap reconstruction.
Authors
Awtrey, CS; Abu-Rustum, NR; Disa, JJ; Ivy, JJ; Kauff, ND; Hummer, AJ; Barakat, RR
MLA Citation
Awtrey, Christopher S., et al. “Laparoscopic bilateral salpingo-oophorectomy in breast cancer patients after transverse rectus abdominus myocutaneous flap reconstructive surgery..” Gynecol Oncol, vol. 99, no. 3, Dec. 2005, pp. 720–25. Pubmed, doi:10.1016/j.ygyno.2005.07.120.
URI
https://scholars.duke.edu/individual/pub1327372
PMID
16169063
Source
pubmed
Published In
Gynecologic Oncology
Volume
99
Published Date
Start Page
720
End Page
725
DOI
10.1016/j.ygyno.2005.07.120