Stephen L. Rose

Bio: Stephen L. Rose is an academic researcher from University of Wisconsin-Madison. The author has contributed to research in topics: Ovarian cancer & Endometrial cancer. The author has an hindex of 27, co-authored 67 publications receiving 2474 citations. Previous affiliations of Stephen L. Rose include University of Iowa Hospitals and Clinics & University of Wisconsin Hospital and Clinics.

Breast Cancer Screening Using Tomosynthesis in Combination With Digital Mammography

Abstract: mammography + tomosynthesis; difference, 1.3 (95% CI, 0.4-2.1; P = .004); for cancer detection, 4.2 (95% CI, 3.8-4.7) with digital mammography vs 5.4 (95% CI, 4.9-6.0) with digital mammography + tomosynthesis; difference, 1.2 (95% CI, 0.8-1.6; P < .001); and for invasive cancer detection, 2.9 (95% CI, 2.5-3.2) with digital mammography vs 4.1 (95% CI, 3.7-4.5) with digital mammography + tomosynthesis; difference, 1.2 (95% CI, 0.8-1.6; P < .001). The in situ cancer detection rate was 1.4 (95% CI, 1.2-1.6) per 1000 screens with both methods. Adding tomosynthesis was associated with an increase in the positive predictive value for recall from 4.3% to 6.4% (difference, 2.1%; 95% CI, 1.7%-2.5%; P < .001) and for biopsy from 24.2% to 29.2% (difference, 5.0%; 95% CI, 3.0%-7.0%; P < .001). CONCLUSIONS AND RELEVANCE Addition of tomosynthesis to digital mammography was associated with a decrease in recall rate and an increase in cancer detection rate. Further studies are needed to assess the relationship to clinical outcomes.

O-RADS US Risk Stratification and Management System: A Consensus Guideline from the ACR Ovarian-Adnexal Reporting and Data System Committee

Abstract: The Ovarian-Adnexal Reporting and Data System (O-RADS) US risk stratification and management system is designed to provide consistent interpretations, to decrease or eliminate ambiguity in US reports resulting in a higher probability of accuracy in assigning risk of malignancy to ovarian and other adnexal masses, and to provide a management recommendation for each risk category. It was developed by an international multidisciplinary committee sponsored by the American College of Radiology and applies the standardized reporting tool for US based on the 2018 published lexicon of the O-RADS US working group. For risk stratification, the O-RADS US system recommends six categories (O-RADS 0-5), incorporating the range of normal to high risk of malignancy. This unique system represents a collaboration between the pattern-based approach commonly used in North America and the widely used, European-based, algorithmic-style International Ovarian Tumor Analysis (IOTA) Assessment of Different Neoplasias in the Adnexa model system, a risk prediction model that has undergone successful prospective and external validation. The pattern approach relies on a subgroup of the most predictive descriptors in the lexicon based on a retrospective review of evidence prospectively obtained in the IOTA phase 1-3 prospective studies and other supporting studies that assist in differentiating management schemes in a variety of almost certainly benign lesions. With O-RADS US working group consensus, guidelines for management in the different risk categories are proposed. Both systems have been stratified to reach the same risk categories and management strategies regardless of which is initially used. At this time, O-RADS US is the only lexicon and classification system that encompasses all risk categories with their associated management schemes.

Recurrence Rates in Patients With Cervical Cancer Treated With Abdominal Versus Minimally Invasive Radical Hysterectomy: A Multi-Institutional Retrospective Review Study.

Abstract: PURPOSETo compare the disease-free survival (DFS) between open and minimally invasive radical hysterectomies (RH) performed in academic medical institutionsMETHODSRetrospective multi-institutional ...

Incorporation of Bevacizumab in the Primary Treatment of Ovarian Cancer

Abstract: METHODS In our double-blind, placebo-controlled, phase 3 trial, we randomly assigned eligible patients with newly diagnosed stage III (incompletely resectable) or stage IV epithelial ovarian cancer who had undergone debulking surgery to receive one of three treatments All three included chemotherapy consisting of intravenous paclitaxel at a dose of 175 mg per square meter of body-surface area, plus carboplatin at an area under the curve of 6, for cycles 1 through 6, plus a study treatment for cycles 2 through 22, each cycle of 3 weeks’ duration The control treatment was chemotherapy with placebo added in cycles 2 through 22; bevacizumab-initiation treatment was che motherapy with bevacizumab (15 mg per kilogram of body weight) added in cycles 2 through 6 and placebo added in cycles 7 through 22 Bevacizumab-throughout treatment was chemotherapy with bevacizumab added in cycles 2 through 22 The primary end point was progression-free survival RESULTS Overall, 1873 women were enrolled The median progression-free survival was 103 months in the control group, 112 in the bevacizumab-initiation group, and 141 in the bevacizumab-throughout group Relative to control treatment, the hazard ratio for progression or death was 0908 (95% confidence interval [CI], 0795 to 1040; P = 016) with bevacizumab initiation and 0717 (95% CI, 0625 to 0824; P<0001) with bevacizumab throughout At the time of analysis, 763% of patients were alive, with no significant differences in overall survival among the three groups The rate of hypertension requiring medical therapy was higher in the bevacizumab-initiation group (165%) and the bevacizumab-throughout group (229%) than in the control group (72%) Gastrointestinal-wall disruption requiring medical intervention occurred in 12%, 28%, and 26% of patients in the control group, the bevacizumab-initiation group, and the bevacizumab-throughout group, respectively CONCLUSIONS The use of bevacizumab during and up to 10 months after carboplatin and pacli taxel chemotherapy prolongs the median progression-free survival by about 4 months in patients with advanced epithelial ovarian cancer (Funded by the National Cancer Institute and Genentech; ClinicalTrialsgov number, NCT00262847)

Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement

Abstract: This guideline from the USPSTF is based on current evidence on mammography, digital breast tomography, and supplemental screening for breast cancer. The recommendations apply to asymptomatic women ...

Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society

Abstract: Importance Breast cancer is a leading cause of premature mortality among US women. Early detection has been shown to be associated with reduced breast cancer morbidity and mortality. Objective To update the American Cancer Society (ACS) 2003 breast cancer screening guideline for women at average risk for breast cancer. Process The ACS commissioned a systematic evidence review of the breast cancer screening literature to inform the update and a supplemental analysis of mammography registry data to address questions related to the screening interval. Formulation of recommendations was based on the quality of the evidence and judgment (incorporating values and preferences) about the balance of benefits and harms. Evidence Synthesis Screening mammography in women aged 40 to 69 years is associated with a reduction in breast cancer deaths across a range of study designs, and inferential evidence supports breast cancer screening for women 70 years and older who are in good health. Estimates of the cumulative lifetime risk of false-positive examination results are greater if screening begins at younger ages because of the greater number of mammograms, as well as the higher recall rate in younger women. The quality of the evidence for overdiagnosis is not sufficient to estimate a lifetime risk with confidence. Analysis examining the screening interval demonstrates more favorable tumor characteristics when premenopausal women are screened annually vs biennially. Evidence does not support routine clinical breast examination as a screening method for women at average risk. Recommendations The ACS recommends that women with an average risk of breast cancer should undergo regular screening mammography starting at age 45 years (strong recommendation). Women aged 45 to 54 years should be screened annually (qualified recommendation). Women 55 years and older should transition to biennial screening or have the opportunity to continue screening annually (qualified recommendation). Women should have the opportunity to begin annual screening between the ages of 40 and 44 years (qualified recommendation). Women should continue screening mammography as long as their overall health is good and they have a life expectancy of 10 years or longer (qualified recommendation). The ACS does not recommend clinical breast examination for breast cancer screening among average-risk women at any age (qualified recommendation). Conclusions and Relevance These updated ACS guidelines provide evidence-based recommendations for breast cancer screening for women at average risk of breast cancer. These recommendations should be considered by physicians and women in discussions about breast cancer screening.