CARLOS ALBERTO RUIZ
Índice h a partir de 2011
2
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, 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
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Management of early-stage triple-negative breast cancer: recommendations of a panel of experts from the Brazilian Society of Mastology(2022) FREITAS-JUNIOR, Ruffo; OLIVEIRA, Vilmar Marques de; FRASSON, Antonio Luiz; CAVALCANTE, Francisco Pimentel; MANSANI, Fabio Postiglione; MATTAR, Andre; ZERWES, Felipe Pereira; FREITAS, Adriana Magalhaes de Oliveira; SOUZA, Alessandra Borba Anton de; DAMIN, Andrea P.; SANTOS, Annamaria Massahud Rodrigues dos; RUIZ, Carlos Alberto; LUCENA, Clecio Enio Murta de; MILLEN, Eduardo Camargo; BAGNOLI, Fabio; ANDRADE, Felipe; RODRIGUES, Frank Lane Braga; FACINA, Gil; NOVITA, Guilherme; PEDRINI, Jose Luiz; GUARA, Jose Pereira; SOARES, Leonardo Ribeiro; CORPA, Marcus Vinicius de Nigro; PASSOS, Mauro; FERREIRA, Nancy Cristina Ferraz de Lucena; FREITAS, Nilceana Maya Aires; MACHADO, Rafael Henrique Szymanski; AMARAL, Roberto Kepler da Cunha; REINERT, Tomas; BUDEL, Vinicius MilaniBackground Triple-negative breast cancer (TNBC) is a heterogenous subtype involving different patterns of behavior and clinical course, demanding a complex, individualized sequence of treatment. The knowledge and attitudes of the affiliated members of the Brazilian Society of Mastology regarding TNBC were evaluated and a consensus regarding management and treatment was reached. Methods Affiliates completed a survey involving 44 objective questions. In addition, a specialist meeting was held with 27 experts and 3 ad hoc consultants. The panelists completed the survey before and after brainstorming. Answers achieving 70% of agreement were considered consensual. The chi-square test was used to compare answers between panelists and affiliates and the Kappa coefficient to calculate agreement. Results Consensus among the panelists increased from 26 (59.1%) to 32 questions (72.7%) following brainstorming (p = 0.17), including 7/10 questions on systemic treatment. Among the affiliates, consensus was achieved for 24 questions (54.5%), resulting in moderate agreement (kappa = 0.445). Neoadjuvant chemotherapy should be indicated for almost all cases (except cT1a-b N0) and should include platinum agents. When indicated, immunotherapy is part of the standard of care. The panel reaffirmed the concept of no ink on tumor as indicative of adequate margins and the possibility of sentinel lymph node biopsy for cN1 patients who become cN0 following neoadjuvant therapy. Controversies remain on combining immunotherapy with capecitabine/olaparib in pertinent cases. Conclusion Expert consensus was achieved for > 70% of the questions, with moderate agreement between panelists and affiliates. Educational interventions on systemic breast cancer treatment affected decision-making in 60% of the questions.
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.- 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.
- 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).