RODRIGO GONCALVES
Projetos de Pesquisa
Unidades Organizacionais
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
9 resultados
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Agora exibindo 1 - 9 de 9
- Copy number alterations associated with clinical features in an underrepresented population with breast cancer(2019) RODRIGUES-PERES, Raquel M.; CARVALHO, Benilton S.; ANURAG, Meenakshi; LEI, Jonathan T.; CONZ, Livia; GONCALVES, Rodrigo; CARDOSO FILHO, Cassio; RAMALHO, Susana O. B.; PAIVA, Geisilene R. de; DERCHAIN, Sophie F. M.; LOPES-CENDES, Iscia; ELLIS, Matthew J.; SARIAN, Luis O. Z.Background As the most incident tumor among women worldwide, breast cancer is a heterogeneous disease. Tremendous efforts have been made to understand how tumor characteristics as histological type, molecular subtype, and tumor microenvironment collectively influence disease diagnosis to treatment, which impact outcomes. Differences between populations and environmental and cultural factors have impacts on the origin and evolution of the disease, as well as the therapeutic challenges that arise due to these factors. We, then, compared copy number variations (CNVs) in mucinous and nonmucinous luminal breast tumors from a Brazilian cohort to investigate major CNV imbalances in mucinous tumors versus non-mucinous luminal tumors, taking into account their clinical and pathological features. Methods 48 breast tumor samples and 48 matched control blood samples from Brazilian women were assessed for CNVs by chromosome microarray. Logistic regression and random forest models were used in order to assess CNVs in chromosomal regions from tumors. Results CNVs that were identified in chromosomes 1, 5, 8, 17, 19, and 21 classify tumors according to their histological type, ethnicity, disease stage, and familial history. Conclusion Copy number alterations described in this study provide a better understanding of the landscape of genomic aberrations in mucinous breast cancers that are associated with clinical features.
- Ethical issues surrounding breast cancer screening in Brazil(2019) GONCALVES, Rodrigo; SOARES- JR., Jose Maria; BARACAT, Edmund Chada; FILASSI, Jose Roberto
- Papillomas of the breast: factors associated with underestimation(2018) BOUFELLI, Gabriela; GIANNOTTI, Marcelo A.; RUIZ, Carlos A.; BARROS, Nestor de; CHALA, Luciano E.; MAESAKA, Jonathan Y.; GONCALVES, Rodrigo; BRESCIANI, Barbara H.; VIANNA, Paula; SOARES JR., Jose. M.; BARACAT, Edmund C.; FILASSI, Jose. R.The distinction between benign and malignant papilloma of the breast through percutaneous needle biopsy can be difficult because of limited samples; the underestimation rate can be up to 25%. The aim of this study is to identify clinical and histological factors associated with underestimation, invasive ductal carcinoma, or ductal in-situ carcinoma (DCIS) of the breast found in surgical specimens from papillary lesions. This may contribute toward selection of patients for a follow-up strategy without the need for surgical excision. From a database of 3563 patients, we identified 85 with intraductal papilloma between 2007 and 2013 who had undergone breast-imaging studies, percutaneous needle biopsy, and surgical resection of the lesion. Central papillomas normally present with a palpable mass, whereas peripheral papillomas generally do not have clinical manifestations (microcalcifications); both central and peripheral papillomas were related to atypical lesions, 13.5 and 15.4%, respectively. Among the 59 cases of central papillomas, there were four cases of underestimation, three DCIS and one invasive ductal carcinoma (6.8%). Among the 26 cases of peripheral papillomas, there was one case of DCIS (3.8%), with a total underestimation rate of 5.8%; all underestimated lesions measured more than 1cm. The median size was 11mm at mammography and 19mm at ultrasound. Our data suggest that lesions less than 1cm in size, without atypia and concordant imaging and clinical findings, may not require surgical resection.
- The oncological safety of autologous fat grafting: a systematic review and meta-analysis(2022) GONCALVES, Rodrigo; MOTA, Bruna Salani; SOBREIRA-LIMA, Bruno; RICCI, Marcos Desiderio; JR, Jose Maria Soares; MUNHOZ, Alexandre Mendonca; BARACAT, Edmund Chada; FILASSI, Jose RobertoObjective To present a systematic review of the literature and a meta-analysis evaluating the oncological safety of autologous fat grafting (AFG). Summary background data: AFG for breast reconstruction presents difficulties during follow-up radiological exams, and the oncological potential of grafted fat is uncertain. Previous studies confirmed that the fatty tissue could be transferred under a good condition suitable would not interfere with mammographic follow-up, although the issue of oncological safety remains. Methods We reviewed the literature published until 01/18/2021. The outcomes were overall survival (OS), disease-free survival (DFS), and local recurrence (LR). We included studies that evaluated women with breast cancer who undergone surgery followed by reconstruction with AFG. We synthesized data using the inverse variance method on the log-HR (log of the hazard ratio) scale for time-to-event outcomes using RevMan. We assessed heterogeneity using the Chi(2) and I-2 statistics. Results Fifteen studies evaluating 8541 participants were included. The hazard ratios (HR) could be extracted from four studies, and there was no difference in OS between the AFG group and control (HR 0.9, 95% CI 0.53 to 1.54, p = 0.71, I-2 = 58%, moderate certainty evidence), and publication bias was not detected. The HR for DFS could be extracted from six studies, and there was no difference between the AFG group and control (HR 1.01, 95% CI 0.73 to 1.38, p = 0.96, I-2 = 0%, moderate certainty evidence). The HR for LR could be extracted from ten studies, and there was no difference between the AFG group and control (HR 0.86, 95% CI 0.66 to 1.12, p = 0.43, I-2 = 1%, moderate certainty evidence). Conclusion According to the current evidence, AFG is a safe technique of breast reconstruction for patients that have undergone BC surgery and did not affect OS, DFS, or LR.
- Multidisciplinary Approach to Neoadjuvant Endocrine Therapy in Breast Cancer: A Comprehensive Review(2016) REINERT, Tomás; RAMALHO, Susana; GONÇALVES, Rodrigo; BARRIOS, Carlos Henrique; GRAUDENZ, Marcia Silveira; BINES, JoséABSTRACT Breast cancer is the most common type of cancer and the leading cause of cancer-related death among women worldwide. Hormone receptor-positive (HRþ) tumors represent the most common form of this disease, with more than 70% of breast cancers expressing these receptors. Response and benefit to neoadjuvant chemo-therapy (NCT) varies according to HR expression, with lower responses in luminal tumors as compared with hormone receptor-negative (HR-) and human epidermal growth factor receptor 2-positive (HER2þ) tumors. Neoadjuvant endocrine therapy (NET) is an option for selected patients with HRþ locally advanced breast cancer. Neoadjuvant endocrine therapy has a favorable toxicity profile, and is associated with benefits such as having low cost and being more easily available even for cancer care professionals outside major urban areas or tertiary centers. These factors are particularly relevant, as 70% of breast cancer deaths occur in women from low-income and middle-income countries. Additionally, NET is being increasingly explored, not simply to allow for less extensive surgery, but also as a scientific tool, with the use of biomarkers to predict outcomes in adjuvant trials and for the individual patient. This review details the current and most relevant evidence about NET for breast cancer as well as the future directions of this field.
- Health Services, Socioeconomic Indicators, and Primary Care Coverage in Mortality by Lower Genital Tract and Breast Neoplasias in Brazilian Women during Reproductive and Non-Reproductive Periods(2020) RAMOS, Jose Lucas Souza; FIGUEIREDO, Francisco Winter dos Santos; ZUCHELO, Lea Tami Suzuki; PURCINO, Flavia Abranches Corsetti; ADAMI, Fernando; GONCALVES, Rodrigo; RUIZ, Carlos Alberto; BARACAT, Edmund Chada; SOARES JUNIOR, Jose Maria; SORPRESO, Isabel Cristina EspositoWomen's health assistance at the low-complexity level is focused on the most common diseases and can be affected by primary health care coverage, particularly in areas far away from large urban centers. Thus, in this work, we aim to analyze the relationship between socioeconomic status, health care indicators, and primary care coverage in mortality from neoplasms of the lower genital tract and breast in Brazilian women during reproductive and non-reproductive periods. We conducted an ecological study at the Gynecology Discipline, Medicine School, University of Sao Paulo. Secondary data were collected from women according to reproductive periods and mortality data from the Mortality Information System based on International Classification of Disease-10th edition regarding breast and lower genital tract neoplasms in 2017. The health service and socioeconomic indicators were obtained from the Informatics Department of the Unified Health System and Brazilian Institute of Geography and Statistics. Our results showed that primary care coverage and health service indicators were not associated with mortality from breast cancer and the female lower genital tract, both in reproductive and non-reproductive periods. Sociodemographic indicators were found to be associated with mortality from breast cancer and the female lower genital tract, with income being associated with reproductive period (beta= -0.4; 95% CI, -0.8 to -0.03) and educational level in the non-reproductive period (beta= 9.7; 95% CI, 1.5 to 18.0).
- Functional Annotation of ESR1 Gene Fusions in Estrogen Receptor-Positive Breast Cancer(2018) LEI, Jonathan T.; SHAO, Jieya; ZHANG, Jin; IGLESIA, Michael; CHAN, Doug W.; CAO, Jin; ANURAG, Meenakshi; SINGH, Purba; HE, Xiaping; KOSAKA, Yoshimasa; MATSUNUMA, Ryoichi; CROWDER, Robert; HOOG, Jeremy; PHOMMALY, Chanpheng; GONCALVES, Rodrigo; RAMALHO, Susana; PERES, Raquel Mary Rodrigues; PUNTURI, Nindo; SCHMIDT, Cheryl; BARTRAM, Alex; JOU, Eric; DEVARAKONDA, Vaishnavi; HOLLOWAY, Kimberly R.; LAI, W. Victoria; HAMPTON, Oliver; ROGERS, Anna; TOBIAS, Ethan; PARIKH, Poojan A.; DAVIES, Sherri R.; LI, Shunqiang; MA, Cynthia X.; SUMAN, Vera J.; HUNT, Kelly K.; WATSON, Mark A.; HOADLEY, Katherine A.; THOMPSON, E. Aubrey; CHEN, Xi; KAVURI, Shyam M.; CREIGHTON, Chad J.; MAHER, Christopher A.; PEROU, Charles M.; HARICHARAN, Svasti; ELLIS, Matthew J.RNA sequencing (RNA-seq) detects estrogen receptor alpha gene (ESR1) fusion transcripts in estrogen receptor-positive (ER+) breast cancer, but their role in disease pathogenesis remains unclear. We examined multiple ESR1 fusions and found that two, both identified in advanced endocrine treatment-resistant disease, encoded stable and functional fusion proteins. In both examples, ESR1-e6>YAP1 and ESR1-e6>PCDH11X, ESR1 exons 1-6 were fused in frame to C-terminal sequences from the partner gene. Functional properties include estrogen-independent growth, constitutive expression of ER target genes, and anti-estrogen resistance. Both fusions activate a metastasis-associated transcriptional program, induce cellular motility, and promote the development of lung metastasis. ESR1-e6>YAP1- and ESR1-e6>PCDH11X-induced growth remained sensitive to a CDK4/6 inhibitor, and a patient-derived xenograft (PDX) naturally expressing the ESR1-e6>YAP1 fusion was also responsive. Transcriptionally active ESR1 fusions therefore trigger both endocrine therapy resistance and metastatic progression, explaining the association with fatal disease progression, although CDK4/6 inhibitor treatment is predicted to be effective.
- Accuracy of frozen section in intraoperative margin assessment for breast-conserving surgery: A systematic review and meta-analysis(2021) GARCIA, Mila Trementosa; MOTA, Bruna Salani; CARDOSO, Natalia; MARTIMBIANCO, Ana Luiza Cabrera; RICCI, Marcos Desiderio; CARVALHO, Filomena Marino; GONCALVES, Rodrigo; SOARES JUNIOR, Jose Maria; FILASSI, Jose RobertoBackground and objectives It is well established that tumor-free margin is an important factor for reducing local recurrence and reoperation rates. This systematic review with meta-analysis of frozen section intraoperative margin assessment aims to evaluate the accuracy, and reoperation and survival rates, and to establish its importance in breast-conserving surgery. Methods A thorough review was conducted in all online publication-databases for the related literature up to March 2020. MeSH terms used: ""Breast Cancer"", ""Segmental Mastectomy"" and ""Frozen Section"". We included the studies that evaluated accuracy of frozen section, reoperation and survival rates. To ensure quality of the included articles, the QUADAS-2 tool (adapted) was employed. The assessment of publication bias by graphical and statistical methods was performed using the funnel plot and the Egger's test. The review protocol was registered in PROSPERO (CRD42019125682). Results Nineteen studies were deemed suitable, with a total of 6,769 cases. The reoperation rate on average was 5.9%. Sensitivity was 0.81, with a Confidence Interval of 0.79-0.83, p = 0.0000, I2 = 95.1%, and specificity was 0.97, with a Confidence Interval of 0.97-0.98, p = 0.0000, I-2 = 90.8%, for 17 studies and 5,615 cases. Accuracy was 0.98. Twelve studies described local recurrence and the highest cumulative recurrence rate in 3 years was 7.5%. The quality of the included studies based on the QUADAS-2 tool showed a low risk of bias. There is no publication bias (p = 0.32) and the funnel plot showed symmetry. Conclusion Frozen section is a reliable procedure with high accuracy, sensitivity and specificity in intraoperative margin assessment of breast-conserving surgery. Therefore, this modality of margin assessment could be useful in reducing reoperation rates.
- Locally advanced breast cancer: breast-conserving surgery and other factors linked to overall survival after neoadjuvant treatment(2023) NOBREGA, Gabriela Bezerra; MOTA, Bruna Salani; FREITAS, Gabriela Boufelli de; MAESAKA, Jonathan Yugo; MOTA, Rosa Maria Salani; GONCALVES, Rodrigo; TRINCONI, Angela Francisca; RICCI, Marcos Desiderio; PIATO, Jose Roberto; SOARES-JR, Jose Maria; BARACAT, Edmund Chada; FILASSI, Jose RobertoBackground Recent data suggest that breast-conserving surgery (BCS) may positively impact overall survival (OS) in early breast cancer. However, the role of BCS in locally advanced breast cancer (LABC) following neoadjuvant therapy (NAT) remains uncertain.Methods We conducted a retrospective cohort study involving 530 LABC patients who underwent surgery after NAT between 2010 and 2015. Outcomes examined included OS, distant recurrence rates (DRR), and loco-regional recurrence rates (LRRs).Results Among the 927 breast cancer patients who received NAT, 530 were eligible for our study. Of these, 24.6% underwent BCS, while 75.4% underwent mastectomy (MS). The median follow-up duration was 79 months. BCS patients exhibited a higher pathological complete response (PCR) rate compared to those who underwent MS (22.3% vs. 10%, p < 0.001). The 6-year OS rates for BCS and MS were 81.5% and 62%, respectively (p < 0.000). In multivariate OS analysis, MS was associated with worse outcomes (OR 1.678; 95% CI 1.069-2.635; p = 0.024), as was body mass index (BMI) (OR 1.031; 95% CI 1.006-1.058; p = 0.017), and stage IIIB or IIIC (OR 2.450; 95% CI 1.561-3.846; p < 0.000). Conversely, PCR (OR 0.42; 95% CI 0.220-0.801; p = 0.008) was associated with improved survival. DRR was significantly lower in BCS (15.4%) compared to MS (36.8%) (OR 0.298; 95% CI 0.177-0.504). LRRs were comparable between BCS (9.2%) and MS (9.5%) (OR 0.693; 95% CI 0.347-1.383).Conclusion Our findings suggest that BCS is oncologically safe, even for patients with large lesions, and is associated with superior OS rates compared to MS. Additionally, lower BMI, lower pretreatment stage, and achieving PCR were associated with improved survival outcomes.