Lawrence W. Bassett

Bio: Lawrence W. Bassett is an academic researcher from University of California, Los Angeles. The author has contributed to research in topics: Mammography & Breast cancer. The author has an hindex of 49, co-authored 180 publications receiving 9133 citations. Previous affiliations of Lawrence W. Bassett include UCLA Medical Center & University of California, San Diego.

Diagnostic Performance of Digital versus Film Mammography for Breast-Cancer Screening

Abstract: background Film mammography has limited sensitivity for the detection of breast cancer in women with radiographically dense breasts. We assessed whether the use of digital mammography would avoid some of these limitations. methods A total of 49,528 asymptomatic women presenting for screening mammography at 33 sites in the United States and Canada underwent both digital and film mammography. All relevant information was available for 42,760 of these women (86.3 percent). Mammograms were interpreted independently by two radiologists. Breast-cancer status was ascertained on the basis of a breast biopsy done within 15 months after study entry or a follow-up mammogram obtained at least 10 months after study entry. Receiver-operating-characteristic (ROC) analysis was used to evaluate the results. results In the entire population, the diagnostic accuracy of digital and film mammography was similar (difference between methods in the area under the ROC curve, 0.03; 95 percent confidence interval, i0.02 to 0.08; P=0.18). However, the accuracy of digital mammography was significantly higher than that of film mammography among women under the age of 50 years (difference in the area under the curve, 0.15; 95 percent confidence interval, 0.05 to 0.25; P=0.002), women with heterogeneously dense or extremely dense breasts on mammography (difference, 0.11; 95 percent confidence interval, 0.04 to 0.18; P=0.003), and premenopausal or perimenopausal women (difference, 0.15; 95 percent confidence interval, 0.05 to 0.24; P=0.002). conclusions The overall diagnostic accuracy of digital and film mammography as a means of screening for breast cancer is similar, but digital mammography is more accurate in women under the age of 50 years, women with radiographically dense breasts, and premenopausal or perimenopausal women. (clinicaltrials.gov number, NCT00008346.)

Diagnostic Performance of Digital versus Film Mammography for Breast-Cancer Screening

Abstract: Previous trials, limited in many respects, have not found digital mammography to be significantly more accurate than the standard film method. A total of 42,760 asymptomatic women seen at 33 sites in the United States and Canada requested screening mammography and underwent both film and digital examinations. Two radiologists independently interpreted the film and digital mammograms. All participants either had breast biopsy within 15 months after evaluation or had a follow-up mammogram 10 months or longer after entry to the study. The results were assessed by receiver operating characteristic analysis. Both digital and film mammograms were positive in 0.5% of women. Another 2.2% had only a positive digital study, whereas 1.9% had only a positive film study. In the remaining women, approximately 95% of the total, both imaging studies were negative. Of 335 breast cancers diagnosed within 455 days after entry to the study, approximately three fourths were found within a year after evaluation. There were no substantial differences between the digital and film findings with respect to histology or stage of disease. The area under the curve was similar for the 2 studies and was not influenced by race or the risk of breast cancer. Digital mammography did, however, perform significantly better than the film method in women less than 50 years of age, in those having heterogeneously dense or very dense breasts, and premenopausal or perimenopausal women. The digital and film methods performed equally well in women age 50 years and older, those with fatty breasts or scattered fibroglandular densities, and those who were postmenopausal.

Diagnostic accuracy of digital versus film mammography: exploratory analysis of selected population subgroups in DMIST.

Abstract: Purpose: To retrospectively compare the accuracy of digital versus film mammography in population subgroups of the Digital Mammographic Imaging Screening Trial (DMIST) defined by combinations of age, menopausal status, and breast density, by using either biopsy results or follow-up information as the reference standard. Materials and Methods: DMIST included women who underwent both digital and film screening mammography. Institutional review board approval at all participating sites and informed consent from all participating women in compliance with HIPAA was obtained for DMIST and this retrospective analysis. Areas under the receiver operating characteristic curve (AUCs) for each modality were compared within each subgroup evaluated (age < 50 vs 50–64 vs ≥ 65 years, dense vs nondense breasts at mammography, and pre- or perimenopausal vs postmenopausal status for the two younger age cohorts [10 new subgroups in toto]) while controlling for multiple comparisons (P < .002 indicated a significant difference...

Standard for Breast Conservation Therapy in the Management of Invasive Breast Carcinoma

Abstract: Multidisciplinary guidelines for management of invasive breast carcinoma from the American College of Radiology, the American College of Surgeons, the College of American Pathology, and the Society of Surgical Oncology have been updated to reflect the continuing advances in the diagnosis and treatment of invasive breast cancer. The guidelines provide a framework for clinical decision-making for patients with invasive breast carcinoma based on review of relevant literature and include information on patient selection and evaluation, technical aspects of surgical treatment, techniques of irradiation, and follow-up care.

Radiomics: Images Are More than Pictures, They Are Data.

Abstract: In the past decade, the field of medical image analysis has grown exponentially, with an increased number of pattern recognition tools and an increase in data set sizes. These advances have facilitated the development of processes for high-throughput extraction of quantitative features that result in the conversion of images into mineable data and the subsequent analysis of these data for decision support; this practice is termed radiomics. This is in contrast to the traditional practice of treating medical images as pictures intended solely for visual interpretation. Radiomic data contain first-, second-, and higher-order statistics. These data are combined with other patient data and are mined with sophisticated bioinformatics tools to develop models that may potentially improve diagnostic, prognostic, and predictive accuracy. Because radiomics analyses are intended to be conducted with standard of care images, it is conceivable that conversion of digital images to mineable data will eventually become routine practice. This report describes the process of radiomics, its challenges, and its potential power to facilitate better clinical decision making, particularly in the care of patients with cancer.

Circulating Tumor Cells, Disease Progression, and Survival in Metastatic Breast Cancer

Abstract: Metastatic breast cancer (MBC) is considered incurable; therefore, palliative treatment is the only option. The biologic heterogeneity of the disease is reflected in its somewhat unpredictable clinical behavior. The presence of circulating tumor cells (CTCs) in patients with MBC about to start a new line of treatment has been shown to predict progression-free and overall survival. This prognostic value is independent of the line of therapy (eg, first or second line). Moreover, a multivariate analysis has shown the prognostic value of CTCs to be superior to that of site of metastasis, type of therapy, and length of time to recurrence after definitive primary surgery. These data suggest that the presence of CTCs may be used to modify the staging system for advanced disease. Larger studies are needed to confirm these data and evaluate the use of CTC detection in monitoring treatment and furthering our understanding of breast cancer biology when combined with other diagnostic technologies.

Resource Manual for Nursing Research: Generating and Assessing Evidence for Nursing Practice

Abstract: The perfect complement to Nursing Research: Generating and Assessing Evidence for Nursing Practice, Ninth Edition, this knowledge builder helps you develop and reinforce basic skills essential to nursing research.

Mammographic Density and the Risk and Detection of Breast Cancer

Abstract: Methods We carried out three nested case–control studies in screened populations with 1112 matched case–control pairs. We examined the association of the measured percentage of density in the baseline mammogram with risk of breast cancer, according to method of cancer detection, time since the initiation of screening, and age. Results As compared with women with density in less than 10% of the mammogram, women with density in 75% or more had an increased risk of breast cancer (odds ratio, 4.7; 95% confidence interval [CI], 3.0 to 7.4), whether detected by screening (odds ratio, 3.5; 95% CI, 2.0 to 6.2) or less than 12 months after a negative screening examination (odds ratio, 17.8; 95% CI, 4.8 to 65.9). Increased risk of breast cancer, whether detected by screening or other means, persisted for at least 8 years after study entry and was greater in younger than in older women. For women younger than the median age of 56 years, 26% of all breast cancers and 50% of cancers detected less than 12 months after a negative screening test were attributable to density in 50% or more of the mammogram. Conclusions Extensive mammographic density is strongly associated with the risk of breast cancer detected by screening or between screening tests. A substantial fraction of breast cancers can be attributed to this risk factor.