MARCOS DESIDERIO RICCI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Brazilian randomized study: Impact of preoperative magnetic resonance in the evaluation for breast cancer conservative surgery (BREAST-MRI Trial)(2019) MOTA, B. S.; REIS, Y. N.; DORIA, M. T.; RICCI, M. D.; SHIMIZU, C.; FERREIRA, V.; TUCUNDUVA, T.; BARROS, N. de; BARACAT, E. C.; FILASSI, J. R.- Brazilian Randomized Study - BREAST-MRI Trial - Impact of Preoperative Magnetic Resonance in the Evaluation for Breast Cancer Conservative Surgery: Local recurrence and surgical outcomes(2023) MOTA, Bruna S.; REIS, Yedda N.; BARROS, Nestor; CARDOSO, Natalia; MOTA, Rosa S.; SHIMIZU, Carlos; TUCUNDUVA, Tatiana; GONCALVES, Rodrigo; DORIA, Maira T.; FERREIRA, Vera; RICCI, Marcos; TRINCONI, Angela; RIERA, Rachel; BARACAT, Edmund C.; SOARES JR., Jose Maria; FILASSI, Jose Roberto
conferenceObject Brazilian randomized study - Impact of preoperative magnetic resonance in the evaluation for breast cancer conservative surgery (BREAST-MRI trial)(2018) DORIA, Maira T.; MOTA, Bruna S.; REIS, Yedda N.; RICCI, Marcos D.; PIATO, Jose R. M.; FERREIRA, Vera C. C. S.; SHIMIZU, Carlos; BARROS, Nestor; FILASSI, Jose R.; BARACAT, Edmund C.article 2 Citação(ões) na Scopus Evaluation of frozen-section analysis of surgical margins in the treatment of breast cancer(2012) NOVITA, G.; FILASSI, J. R.; RUIZ, C. A.; RICCI, M. D.; PINCERATO, K. M.; OLIVEIRA FILHO, H. R. de; SOARES JR., J. M.; BARACAT, E. C.Objective: To evaluate surgical margins in cases of ductal carcinoma through a histopathological exam using frozen sections. Materials and Methods: Retrospective study encompassing 242 conservative surgeries, 179 of which included intraoperative frozensection histopathology and 63 intraoperative nonfreezing techniques (macroscopy/gross examination and cytology). The results of such analyses were compared with those of the histology processing following paraffin embedment and hematoxylin and eosin (H & E) staining. A margin was deemed free when the distance between the tumor and the surgical border was equal to or greater than two millimeters. The factors given consideration for possibly affecting the results were: age, surgical aspects (skin removal and widening of surgical margins), histopathological findings (size, affected lymph nodes, and angiolymphatic invasion), and extensive intraductal and immunohistochemical components (estrogen, progesterone, Ki-67, and HER-2 receptors). In the statistical analyses, the chi-square test was used and negative predictive values were calculated. Results: The negative predictive values were 87.1% and 79.3% for frozen and nonfrozen sections, respectively. There was no significant difference between the two groups (p = 0.14). The factors under consideration had no influence on the results of the intraoperative exam of the margins. Conclusion: The present study allowed to conclude that the intraoperative exam of the surgical margins by frozen section is not superior to a macroscopy and / or cytology exam.- Predictive factors for positive surgical margins in the treatment of breast ductal carcinoma in situ(2016) HASSAN, Rafael A. M.; MAESAKA, Jonathan Y.; RICCI, Marcos D.; SOARES JR., Jose M.; DORIA, Maira Teixeira; BARACAT, Edmund C.; FILASSI, Jose R.Context: Surgery is the main form of treatment for ductal carcinoma in situ (DCIS) of the breast. Among other factors, treatment success requires that the surgical margins are free of disease, to reduce the risk of recurrence. Aims: The purpose of this study was to analyze factors that might be associated with positive margins in patients diagnosed with DCIS. Settings and Design: A retrospective analysis was performed of hospital databases from the year 2006 to 2014, to identify patients with an initial diagnosis of DCIS made by percutaneous biopsy. Subjects and Methods: Age, the presence of disease symptoms, lesion size on mammogram, and the presence of estrogen receptors, and their relationship to the surgical margins were evaluated in 249 patients. Statistical Analysis Used: Shapiro and WilcoxonuMannuWhitney tests were used to verify that the data were normally distributed. Chi-squared test was used to verify the independence of the variables. Results: Lesions measuring 1.55 cm or greater had a relative risk of positive margins after conservative surgery of 1.39 (95% confidence interval [95% CI]: 1.02u1.90). The presence of symptoms had a relative risk of positive margins after conservative surgery of 1.54 (95% CI: 1.17u2.02). Conclusion: Lesions measuring 1.55 cm or greater and the presence of symptoms are risk factors for positive margins in the treatment of ductal carcinoma in situ. Therefore, these patients need a better surgical planning in order to reduce the risk of positive margins. There is a clear need for large prospective studies to validate our findings and define other factors that might contribute to the success of surgical resection for ductal carcinoma in situ.
- Effects of preoperative magnetic resonance image on survival rates and surgical planning in breast cancer conservative surgery: randomized controlled trial (BREAST-MRI trial)(2023) MOTA, Bruna Salani; REIS, Yedda Nunes; BARROS, Nestor de; CARDOSO, Natalia Pereira; MOTA, Rosa Maria Salani; SHIMIZU, Carlos; TUCUNDUVA, Tatiana Cardoso de Mello; FERREIRA, Vera Christina Camargo de Siqueira; GONCALVES, Rodrigo; DORIA, Maira Teixeira; RICCI, Marcos Desiderio; TRINCONI, Angela Francisca; CAMARGO, Cristina Pires; RIERA, Rachel; BARACAT, Edmund Chada; JR, Jose Maria Soares; FILASSI, Jose RobertoBackgroundBreast magnetic resonance imaging (MRI) has high sensitivity in detecting invasive neoplasms. Controversy remains about its impact on the preoperative staging of breast cancer surgery. This study evaluated survival and surgical outcomes of preoperative MRI in conservative breast cancer surgery.MethodsA phase III, randomized, open-label, single-center trial including female breast cancer participants, stage 0-III disease, and eligible for breast-conserving surgery. We compared the role of including MRI in preoperative evaluation versus radiologic exam routine with mammography and ultrasound in breast cancer conservative candidates. The primary outcome was local relapse-free survival (LRFS), and secondary outcomes were overall survival (OS), mastectomy rate, and reoperation rate.Results524 were randomized to preoperative MRI group (n = 257) or control group (n = 267). The survival analysis showed a 5.9-years LRFS of 99.2% in MRI group versus 98.9% in control group (HR = 0.72; 95% CI 0.12-4.28; p = 0.7) and an OS of 95.3% in the MRI group versus 96.3% in the control group (HR = 1.37 95% CI 0.59-3.19; p = 0.8). Surgical management changed in 21 ipsilateral breasts in the MRI group; 21 (8.3%) had mastectomies versus one in the control group. No difference was found in reoperation rates, 22 (8.7%) in the MRI group versus 23 (8.7%) in the control group (RR = 1.002; 95% CI 0.57-1.75; p = 0.85).ConclusionPreoperative MRI increased the mastectomy rates by 8%. The use of preoperative MRI did not influence local relapse-free survival, overall survival, or reoperation rates.
- Improved frozen section examination of the retroareolar margin for prediction of nipple involvement in breast cancer(2016) PIATO, J. R.; AGUIAR, F. N.; MOTA, B. S.; DORIA, M. T.; ALVES-JALES, R. D.; MESSIAS, A. P.; GONCALVES, R.; MANO, M. S.; SOARES, J. M.; RICCI, M. D.; FILASSI, J. R.; BARACAT, E. C.
conferenceObject Skin-sparing mastectomy for the treatment of breast cancer(2016) MOTA, B.; BEVILACQUA, J. L.; RICCI, M.; ATALLAH, A.; RIERA, R.conferenceObject Does conservative surgery treatment for locally advanced breast cancer safe after neoadjuvant treatment?(2018) BOUFELLI, Gabriela; MOTA, Bruna Salani; FRANCA, Flavia Cardoso; DORIA, Maira Teixeira; MAESAKA, Jonathan Yugo; RICCI, Marcos Desiderio; PIATO, Jose Roberto Morales; ROCHA, Fernanda Barbosa Coelho; GIRIBELA, Aricia Helena Galvao; GONCALVES, Rodrigo; MASILI-OKU, Sergio; MANO, Max Senna; CHALA, Luciano Fernandes; THOMPSON, Bruna Maria; BARACAT, Edmund Chada; FILASSI, Jose Roberto- Improved frozen section examination of the retroareolar margin for prediction of nipple involvement in breast cancer(2015) PIATO, J. R. Morales; AGUIAR, F. N.; MOTA, B. S.; RICCI, M. D.; DORIA, M. T.; ALVES-JALES, R. D.; MESSIAS, A. P.; FILASSI, J. R.; BARACAT, E. C.Introduction: In this prospective ex vivo study, we propose a new technique for the intraoperative examination of retroareolar tissue and describe both surgical excision and pathological methods. We performed a nipple-sparing mastectomy simulation in patients selected to total mastectomy, in order to evaluate the accuracy of these new technique. Materials and methods: A total of 158 total mastectomy specimens from patients affected by ductal carcinoma in situ (n = 15) or invasive ductal carcinoma (stages I, II, or IIIA) (n = 143) were examined. To obtain the entire sample area, the terminal retroareolar milk duct bunch was isolated. Fragments approximately 1.5 cm in length were excised and sectioned in parallel at the base of the nipple using a cold bistoury. Three transverse histological sections (4 gm each) at 200 gm intervals that included the entire isolated fragments were subjected to frozen section examination. The sections were stained with hematoxylin-eosin and were evaluated. The remainder of each fragment was embedded in paraffin and 4 gm sections were subsequently stained with hematoxylin-eosin and examined. Results: There were two false-negative (1.3%) and five false-positive (3.1%) findings among the frozen and paraffin sections analyzed. A statistical analysis of the frozen section examinations showed a sensitivity of 92.0%, a specificity of 96.2%, a positive predictive value of 82.1%, a negative predictive value of 98.4%, and an accuracy of 95.4%. Conclusion: The frozen section examination technique described here detected nipple involvement in breast cancer with greater accuracy than the frozen section usually performed by most surgeons.