NESTOR DE BARROS
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Radiologia, Faculdade de Medicina - Docente
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/44 - Laboratório de Ressonância Magnética em Neurorradiologia, Hospital das Clínicas, Faculdade de Medicina
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/44 - Laboratório de Ressonância Magnética em Neurorradiologia, Hospital das Clínicas, Faculdade de Medicina
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article 12 Citação(ões) na Scopus The Impact of Breast Cancer Screening Among Younger Women in the Barretos Region, Brazil(2013) MATTOS, Jaco Saraiva De Castro; MAUAD, Edmundo Carvalho; SYRJANEN, Kari; LONGATTO-FILHO, Adhemar; HAIKEL, Raphael Luiz; VIEIRA, Rene Aloisio Da Costa; SILVA, Thiago Buosi; BARROS, Nestor DeAim: To verify the impact of breast cancer screening in women aged 40-49 years in one region of Brazil. Patients and Methods: This is a cross-sectional study, targeted to asymptomatic women aged 40-69 years who had breast cancer screening mammography performed between January 2003 and December 2007. Logistic regression was used to estimate the risk of breast cancer by age groups (40-49, 5059, 60-69 years). Results: Of the 27,133 screened women, 51.9% (14,082) were aged between 40-49 years. The odds ratio (OR) of breast cancer among the 45-49 year age cohort was not significantly different from that of 60 to 69-year-old women (OR=0.64; 95% Confidence Interval 0.39 to 1.03). Conclusion: The risk of breast cancer among women aged 45 to 49 years is equivalent to that of women aged 60 to 69 years, indicating that breast cancer screening in this region of Brazil should start at the age of 45 years or immediately thereafter.- Suspicious amorphous microcalcifications detected on full-field digital mammography: correlation with histopathology(2018) FERREIRA, Vera Christina Camargo de Siqueira; ETCHEBEHERE, Elba Cristina Sá de Camargo; BEVILACQUA, José Luiz Barbosa; BARROS, Nestor deAbstract Objective: To evaluate suspicious amorphous calcifications diagnosed on full-field digital mammography (FFDM) and establish correlations with histopathology findings. Materials and Methods: This was a retrospective study of 78 suspicious amorphous calcifications (all classified as BI-RADS® 4) detected on FFDM. Vacuum-assisted breast biopsy (VABB) was performed. The histopathological classification of VABB core samples was as follows: pB2 (benign); pB3 (uncertain malignant potential); pB4 (suspicion of malignancy); and pB5 (malignant). Treatment was recommended for pB5 lesions. To rule out malignancy, surgical excision was recommended for pB3 and pB4 lesions. Patients not submitted to surgery were followed for at least 6 months. Results: Among the 78 amorphous calcifications evaluated, the histopathological analysis indicated that 8 (10.3%) were malignant/suspicious (6 classified as pB5 and 2 classified as pB4) and 36 (46.2%) were benign (classified as pB2). The remaining 34 lesions (43.6%) were classified as pB3: 33.3% were precursor lesions (atypical ductal hyperplasia, lobular neoplasia, or flat epithelial atypia) and 10.3% were high-risk lesions. For the pB3 lesions, the underestimation rate was zero. Conclusion: The diagnosis of precursor lesions (excluding atypical ductal hyperplasia, which can be pB4 depending on the severity and extent of the lesion) should not necessarily be considered indicative of underestimation of malignancy. Suspicious amorphous calcifications correlated more often with precursor lesions than with malignant lesions, at a ratio of 3:1.
- Detection of Architectural Distortion with Deep Convolutional Neural Network and Data Augmentation of Limited Dataset(2019) COSTA, Arthur C.; OLIVEIRA, Helder C. R.; CATANI, Juliana H.; BARROS, Nestor de; MELO, Carlos F. E.; VIEIRA, Marcelo A. C.Early detection of breast cancer can increase treatment efficiency. One of the earliest signs of breast cancer is the Architectural Distortion (AD), which is a subtle contraction of the breast tissue, most of the time unnoticeable. A lot of techniques have been proposed over the years to aid the detection of AD in digital mammography but only a few using a deep learning approach. One of the most successful algorithms of deep neural architecture are the Convolutional Neural Networks (CNNs). However, to assure better CNN performance, the training step requires a large volume of data. This paper presents a deep CNN architecture designed for the automatic detection of AD in digital mammography images. For the training step, we considered the data augmentation approach, to overcome the limitation of clinical dataset. CNN performance was evaluated in terms of Receiver Operating Characteristic (ROC). The measured area under the ROC curve (AUC) was 0:87 for the proposed CNN in the task of AD detection in digital mammography.
- AXILLARY LYMPH NODE SONOGRAPHIC FEATURES AND BREAST TUMOR CHARACTERISTICS AS PREDICTORS OF MALIGNANCY: A NOMOGRAM TO PREDICT RISK(2017) TEIXEIRA, Patricia Akissue de Camargo; CHALA, Luciano F.; SHIMIZU, Carlos; FILASSI, Jose R.; MAESAKA, Jonathan Y.; BARROS, Nestor deThe purpose of this study was to build a mathematical model to predict the probability of axillary lymph node metastasis based on the ultrasonographic features of axillary lymph nodes and the tumor characteristics. We included 74 patients (75 axillae) with invasive breast cancer who underwent axillary ultrasonography ipsilateral to the tumor and fine-needle aspiration of one selected lymph node. Lymph node pathology results from sentinel lymph node biopsy or surgical dissection were correlated with lymph node ultrasonographic data and with the cytologic findings of fine-needle aspiration. Our mathematical model of prediction risk of lymph node metastasis included only pre-surgical data from logistic regression analysis: lymph node cortical thickness (p = 0.005), presurgical tumor size (p = 0.030), menopausal status (p = 0.017), histologic type (p = 0.034) and tumor location (p = 0.011). The area under the receiver operating characteristic curve of the model was 0.848, reflecting an excellent discrimination of the model. This nomogram may assist in the choice of the optimal axillary approach. (E-mail: pakissue@gmail.com) (C) 2017 World Federation for Ultrasound in Medicine & Biology.
- The expression of the estrogen receptor in obese patients with high breast density (HBD)(2014) SOUZA, Marilene Alicia; FONSECA, Angela de Maggio da; BAGNOLI, Vicente Renato; BARROS, Nestor de; NEVES, Erica Mendonca das; MORAES, Sandra Dircinha Teixeira de Araujo; HORTENSE, Victor Hugo Souza; SOARES, Jose Maria; BARACAT, Edmund ChadaObjective: Obesity has been associated with increased risk for breast cancer (BC) mortality. Verifying in women with high breast density (HBD) post-menopausal, the frequency of polymorphisnns of estrogen receptor (ER)alpha-Pvull, ER alpha-Xbal and if they influence the body mass index (BMI). Methods: Study with 308 women with HBD post-menopause divided into two groups according to BMI: 1st group = BMI <25 kg/m(2), 2nd group = BMI >= 25 kg/m(2). It was characterized in the clinical history: menarche, menopause, parity, family history of BC, smoking and alcohol intake. Results: Allele and genotype frequencies for the ER alpha-397-Pvull and ER alpha-351-Xbal: P =43.99%, p =56.01%, pp =32.14%, Pp =47.73%, PP =X =20.13% and X=41.56%, x=58.44%; xx = 33.44%; Xx =50.00%; XX =16.56%, respectively. Both Pvull and Xbal influenced BMI. When Xbal is mutated the tendency is toward higher BMI (0.039), and women with lower BMI were more frequent in Pvull genotype (p = 0.002). More frequent risk factors for BC: menarche before the age of 12 years (35.38%), nulliparity or 1st child after 28 years old (41.66%), family history of BC (19.16%) and overweight/obesity (62.01%). Conclusion: Variations in the ER alpha gene affected the BMI in women with HBD, who already are at increased risk for BC.
- Sarcomas of the breast: findings on mammography, ultrasound, and magnetic resonance imaging(2018) MATSUMOTO, Renato Augusto Eidy Kiota; HSIEH, Su Jin Kim; CHALA, Luciano Fernandes; MELLO, Giselle Guedes Netto de; BARROS, Nestor deAbstract Sarcomas of the breast belong to a heterogeneous group of breast tumors of mesenchymal origin, without epithelial components. These tumors can be primary or secondary (after previous treatment for breast cancer), are rare, present aggressive behavior, and have a poor prognosis. They occur mainly in women between 45 and 50 years of age, with the exception of angiosarcomas, which can occur in younger patients. Clinically, breast sarcomas manifest as palpable, mobile, rapidly growing masses, without skin thickening, axillary lymphadenopathy, or nipple discharge. Although the imaging findings are non specific, they can be suggestive of sarcoma. For instance, a solitary mass showing rapid growth, with circumscribed or indistinct margins and, a complex (solid-cystic) or heterogeneous echotexture, without axillary lymph node involvement, can raise the suspicion of sarcoma. The treatment is not well established, because of the rarity and heterogeneity of this type of neoplasm. The principles of treatment for sarcoma of the breast have been addressed only in small cohort studies. In most cases, the treatment of choice is surgery without axillary lymphadenectomy.
- A cross-cutting approach for tracking architectural distortion locii on digital breast tomosynthesis slices(2019) OLIVEIRA, Helder C. R. de; MENCATTINI, Arianna; CASTI, Paola; CATANI, Juliana H.; BARROS, Nestor de; GONZAGA, Adilson; MARTINELLI, Eugenio; VIEIRA, Marcelo A. da CostaBackground and objective: Full-field digital mammography (FFDM) is the predominant breast cancer screening exam used. However, with the emergence of digital breast tomosynthesis (DBT) the radiologists could improve early recognition of breast cancer signs. In this scenario, the detection of architectural distortion (AD) is still a challenging task. ADs are very subtle contraction of the breast parenchyma that could represent the earliest manifestation of cancer, assessing at present 50% of missed cases. Methods: This paper proposes a new paradigm to detect AD in DBT exams by a cross-cutting approach exploiting the 3-dimensionality of the imaging modality. After locating AD candidates in each DBT slice, the suspicious spots are tracked in cross-slice direction and then characterized in terms of neighboring texture. In this approach, which mimics radiologist's scrolling down over zoomed slices, we reduce the amount of uninformative signs collected in DBT exams by preserving the large variability of AD appearance. Results: Using 37 sets of DBT slices containing at least one AD locus indicated by a radiologist, the proposed methodology reaches an AUC of 0.84, with only one false negative exam at sensitivity of 0.9. Conclusions: The results show that the proposed algorithm can be a promising tool for the automatic detection of AD locii. Future work will address the extension of the dataset of DBT slices as well the improvement of algorithm performance toward the application in the clinical practice. (C) 2019 Published by Elsevier Ltd.
- Mammography findings following electron intraoperative radiotherapy or external radiotherapy for breast cancer treatment(2011) CARVALHO, B. P. S. A.; FRASSON, A. L.; SANTOS, M. M.; BARROS, N. deRadiotherapy following breast cancer conserving surgery decreases the risks of local recurrence. Because 85% of breast cancers relapse in or around the surgical bed there has been some debate on the need for irradiating the whole breast. Electron intraoperative radiotherapy (ELIOT) has been used as a viable alternative for conventional external radiotherapy (RT). While the former requires a single dose of 21 Gy in the tumoral bed, the latter requires 5-6 weeks of irradiation with a total dose of 50 Gy and a boost of 10 Gy that irradiates the surgical bed. Herein, we investigated whether any significant differences exist between the mammography findings obtained from patients submitted to one of the two techniques. Two groups of 30 patients each were included in this study. All patients had mammographies taken at 12 and 24 months after finishing treatment. The mammography findings evaluated were: cutaneous thickening (>2 mm), architectural distortion secondary to fibrosis, edema, calcifications (both benign and malignant), and fat necrosis. For all variables studied, there was no statistical difference between the two groups. This indicates that the mammography findings obtained in either 12- or 24-month follow-up periods after breast cancer conserving surgery are similar, regardless of which of the two radiotherapy techniques (ELIOT or RT) is employed as a treatment for breast cancer. (C) 2010 Published by Elsevier Ireland Ltd.