JOSE ROBERTO FILASSI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina
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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bookPart Carcinoma de mama: diagnóstico(2016) MENDES, Daniele Carvalho Calvano; CHALA, Luciano Fernandes; BARROS, Nestor de; FILASSI, Jose Roberto- The circulating 70 kDa heat shock protein (HSPA1A) level is a potential biomarker for breast carcinoma and its progression(2022) FREITAS, Gabriela Boufelli de; PENTEADO, Laura; MIRANDA, Mila Meneguelli; FILASSI, Jose Roberto; BARACAT, Edmund Chada; LINHARES, Iara MorenoThe early diagnosis of breast cancer can improve treatment and prognosis. We sought to evaluate whether the serum concentration of the 70 kDa heat shock protein (HSPA1A) was elevated in Brazilian women with breast cancer, and if levels correlated with tumor characteristics. This was a cross-sectional, analytical, case-control exploratory study performed at The University of Sao Paulo School of Medicine. From September 2017 to December 2018, 68 women with breast cancer and 59 controls were recruited. The HSPA1A concentration in serum samples was determined by ELISA by individuals blinded to the clinical data. The mean ages in the study and control groups were 54.9 and 52.0 years, respectively. The median serum levels of HSPA1A were elevated in women with breast cancer (1037 pg/ml) compared with controls (300 pg/ml) (p < 0.001). Elevated HSPA1A levels were associated with advanced histological tumor grade (p < 0.001) and with the cell proliferation index (KI67) (p = 0.0418). The HSPA1A concentration was similar in women with different histological subtypes, nuclear grade, hormone receptor expression, HER2 status and the presence or absence of angiolymphatic invasion. Elevated serum HSPA1A in Brazilian women with advanced histological grade and proliferation index breast cancer supports the potential value of additional investigation on larger and more varied populations to verify the value of HSPA1A detection as a component of breast cancer diagnosis and progression.
- Outcome Analysis of Immediate and Delayed Conservative Breast Surgery Reconstruction With Mastopexy and Reduction Mammaplasty Techniques(2011) MUNHOZ, Alexandre Mendonca; ALDRIGHI, Claudia Maria; MONTAG, Eduardo; ARRUDA, Eduardo; BRASIL, Jose Augusto; FILASSI, Jose Roberto; ALDRIGHI, Jose Mendes; GEMPERLI, Rolf; FERREIRA, Marcus CastroBackground: Bilateral mammaplasty or mastopexy is frequently used for oncoplastic objectives. However, little information has been available regarding outcome following immediate and delayed reconstruction. Method: Patients were divided into Group I (immediate reconstruction) and Group II (delayed reconstruction). Retrospective review was performed to compare complications, length of hospital stay, revision surgeries, and satisfaction. The associations between the complications with potential risk factors (timing, age, body mass index, smoking, and comorbid medical conditions) were analyzed. Results: There were a total of 144 patients with a mean follow-up of 47 months. Of the 106 patients in Group I, complications occurred in 24 (22.6%), skin necrosis was observed in 7.5%, fat necrosis in 5.6%, and 6.6% patients developed local recurrence. Mean period of hospitalization was 1.89 days. Of the 38 patients of the Group II, complications occurred in 12 (31.5%), skin necrosis was observed in 7 (18.4%), fat necrosis in 4 (10.5%), and 5.2% patients developed local recurrence. Mean period of hospitalization was 1.35 days. Increased length of hospital stay greater than 1 day (P < 0.001) and the number of revision surgeries (P = 0.043) were associated with the timing of the reconstruction. In univariate analysis, no difference between groups was found with respect to complication incidence (P = 0.275); however, after adjusting for other risk factors, the probability of complications tend to be higher for Group II (OR = 2.65; 95% confidence interval - 1.01-7.00; P = 0.049). Conclusions: On the basis of the results of our study, the probability of complications tends to be higher for delayed reconstructions, and it is demonstrated that obesity and smoking are risk factors for complications. Ultimately, these data may facilitate the provision of individualized risk information for shared medical decision-making.
article 13 Citação(ões) na Scopus Current Approaches to Managing Partial Breast Defects: The Role of Conservative Breast Surgery Reconstruction(2014) MUNHOZ, Alexandre Mendoca; MONTAG, Eduardo; FILASSI, Jose Roberto; GEMPERLI, RolfRecently breast surgeons can offer patients a variety of treatment and reconstructive alternatives when early breast cancer is diagnosed. In fact, advances in reconstructive techniques have reduced surgical trauma and thus are capable of preserving the breast form as well as quality of life. Depending on a variety of different factors, including stage, tumor size, location, hystological type, but also breast volume, a reconstructive schedule is established. The main techniques are related to volume displacement or replacement procedures including local flaps, latissimus dorsi myocutaneous flap and reduction mammaplasty/ masthopexy. Regardless of the fact that there are is no consensus over the best approach, the criteria are determined by the surgeon's experience and the size of the defect in relation to the size of the remaining breast. Aim of every reconstructive procedure decision should be breast preservation and an adequate aesthetic outcome. Additionally, reconstruction permits wider excision of the tumor, with a superior mean volume of the specimen and potentially reducing the incidence of margin involvement. The objective of this review is to give an overview of reconstructive modalities for conservative breast surgery, based not only on traditional but also on the latest studies regarding the outcome of the main techniques employed. Surgical approaches, as well as conservative treatment options, such as lumpectomy and quadrantectomy, are further discussed. Surgical planning should include the patients' preferences, while chiefly addressing individual reconstructive requirements, and enabling each patient to receive an individual ""custom-made"" reconstruction.- Underestimation Rate in the Percutaneous Diagnosis of Radial Scar/Complex Sclerosing Lesion of the Breast: Systematic Review(2022) ZANON, Ana Beatrice Bonganha; MAESAKA, Jonathan Yugo; CHEQUIN, Bruna Bello; SANTOS, Ana Gabriela de Siqueira; BARACAT, Edmund Chada; FILASSI, Jose RobertoObjective To evaluate the underestimation rate in breast surgical biopsy after the diagnosis of radial scar/complex sclerosing lesion through percutaneous biopsy. Data Sources A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The Pub M ed, SciELO, Cochrane, and Embase databases were consulted, with searches conducted through November 2020, using specific keywords ( radial scar OR complex sclerosing lesion , breast cancer , anatomopathological percutaneous biopsy AND/OR surgical biopsy ). Data collection Study selection was conducted by two researchers experienced in preparing systematic reviews. The eight selected articles were fully read, and a comparative analysis was performed. Study selection A total of 584 studies was extracted, 8 of which were selected. One of them included women who had undergone a percutaneous biopsy with a histological diagnosis of radial scar/complex sclerosing lesion and subsequently underwent surgical excision; the results were used to assess the underestimation rate of atypical and malignant lesions. Data synthesis The overall underestimation rate in the 8 studies ranged from 1.3 to 40% and the invasive lesion underestimation rate varied from 0 to 10.5%. Conclusion The histopathological diagnosis of a radial scar/complex sclerosing lesion on the breast is not definitive, and it may underestimate atypical and malignant lesions, which require a different treatment, making surgical excision an important step in diagnostic evaluation.
- Core needle biopsy in fibroepithelial tumors: predicting factors for phyllodes tumors(2021) REIS, Yedda Nunes; MAESAKA, Jonathan Yugo; SHIMIZU, Carlos; SOARES-JUNIOR, Jose Maria; BARACAT, Edmund Chada; FILASSI, Jose RobertoOBJECTIVES: This study aimed to evaluate the clinical and imaging predictive factors for the diagnosis of phyllodes tumors in patients with inconclusive results from core needle biopsy (fibroepithelial lesions). METHODS: We retrospectively analyzed data of patients who underwent surgical excision of breast lesions previously diagnosed as fibroepithelial lesions. Numeric variables were analyzed using the Shapiro-Wilk and t-tests, and categorical variables were analyzed using the chi-square and Fisher's exact tests. Multivariate logistic regression was performed to calculate odds ratios and detect predictive factors for the diagnosis of PT. RESULTS: A total of 89 biopsy samples were obtained from 77 patients, of which 43 were confirmed as fibroadenomas, 43 as phyllodes tumors, and 3 as other benign, non-fibroepithelial breast lesions. The mean tumor size was 3.61 cm (range, 0.8-10 cm) for phyllodes tumors and 2.4 cm (range, 0.8-7.9 cm) for fibroadenomas. The predictive factor for phyllodes tumor diagnosis was lesion size >3 cm (p< 0.001). CONCLUSION: Our data indicate that fibroepithelial lesions of the breast larger than 3 cm are more likely to be phyllodes tumors.
- Reply to: Mastectomy skin flap thickness(2018) MARTA, Gustavo Nader; POORTMANS, Philip; BARROS, Alfredo C. de; FILASSI, Jose Roberto; FREITAS-JUNIOR, Ruffo; AUDISIO, Riccardo A.; MANO, Max Senna; METERISSIAN, Sarkis; DESNYDER, Sarah M.; BUCHHOLZ, Thomas A.; HIJAL, Tarek
- Occult Carcinoma in 866 Reduction Mammaplasties: Preserving the Choice of Lumpectomy(2011) MUNHOZ, Alexandre Mendonca; GEMPERLI, Rolf; FILASSI, Jose Roberto
- Lymphocyte-predominant triple-negative breast carcinomas in premenopausal patients: Lower expression of basal immunohistochemical markers(2017) MASILI-OKU, Sergio Mitsuo; ALMEIDA, Bernardo Gomes Lacerda de; BACCHI, Carlos Eduardo; FILASSI, Jose Roberto; BARACAT, Edmund Chada; CARVALHO, Filomena MarinoObjectives: Triple-negative breast carcinomas (TNBCs) correspond to a molecular heterogeneous disease defined by lack of estrogen and progesterone receptor expression, and the absence of overexpression and/or amplification of HER2. Recent data indicate that clinical outcome in TNBC is affected by tumorinfiltrating lymphocytes, suggesting that they can benefit from immunotherapies. We selected 116 consecutive premenopausal patients with TNBC to compare the immunohistochemical profile of the group rich in tumor-infiltrating lymphocytes with those without this characteristic. Materials and methods: We reviewed all the original histological sections to assess pathological features, and to select a representative area for tissue microarrays and immunohistochemical study. Estrogen and progesterone receptors, HER2 and Ki-67 were evaluated in whole histological sections. The following markers were analyzed in tissue microarrays sections: androgen receptor, cytokeratin 5/6, cytokeratin 14, epidermal growth factor receptor (EGFR), vimentin, p16, claudin-3, -4, and -7, p63, and aldehyde dehydrogenase isoform 1 (ALDH1). Lymphocyte-predominant breast cancer (LPBC) was defined by the presence of more than 50% of lymphocytes in the intratumoral stroma. Results: Twenty-six (22.4%) patients present tumors classified as LPBC and 90 (77.6%) as non-LPBC. The two groups were similar regarding age of patients, tumor grade and Ki-67 positive cells. LPBC cases presented lower frequency of expression of the basal cytokeratins, EGFR, and basal-like immunoprofile. There was a trend to higher expression of ALDH1 by stromal intratumoral cells. The expression of all other markers were similar in the two groups. Conclusions: Lymphocyte-predominant TNBC in premenopausal patients are mostly of non-basal phenotype.
- 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