BRUNA SALANI MOTA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
15 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 15
- Variations in the body mass index in Brazilian women undergoing adjuvant chemotherapy for breast cancer(2014) RICCI, Marcos Desídérío; FORMIGONI, Maria Carolina; ZULIANI, Lucia Maria Martins; AOKI, Denis Seiiti; MOTA, Bruna Salani; FILASSI, José Roberto; PIATO, José Roberto Morales; BARACAT, Edmund ChadaPURPOSE: To evaluate variations in the body mass index in patients undergoing adjuvant chemotherapy for breast cancer, and to associate these changes with patient's age and adjuvant chemotherapy regimen. METHODS: We performed a retrospective cohort study in order to correlate any variation in the body mass index before and after adjuvant chemotherapy with patient's age and adjuvant chemotherapy regimen. Patients who received any form of prior hormone therapy, such as tamoxifen or aromatase inhibitors, were excluded. We selected data for 196 patients with stage I to III breast cancer who were treated by radical or conservative surgery and received adjuvant chemotherapy at the Cancer Institute of the State of São Paulo, Brazil. RESULTS: Before adjuvant chemotherapy, 67.8% of patients were classified as overweight or obese according to their body mass indices. Around 66.3% (95% CI 59.7–73.0) of the patients exhibited an increase in the body mass index after adjuvant chemotherapy. The average age of all patients was 56.3±11.3 years. Participants whose body mass index increased were younger than those with no increase (54.7±11.1 versus 59.3±11.2 years; p=0.007). Patients were treated with the following adjuvant chemotherapy regimens: doxorubicin, cyclophosphamide, and paclitaxel (AC-T, 129 patients, 65.8%); 5-fluoracil, doxorubicin, and cyclophosphamide (36 patients, 18.4%); cyclophosphamide, methotrexate, and 5-fluoracil (16 patients, 8.2%); docetaxel and cyclophosphamide (7 patients, 3.6%); and other regimen (8 patients, 4.1%). The AC-T regimen showed a statistically significant association with increase in the body mass index (p<0.001 by ANOVA). CONCLUSIONS: Most patients with breast cancer showed an increase in the body mass index after adjuvant chemotherapy, especially after the AC-T chemotherapy regimen.
bookPart Doença de Paget da mama(2013) RICCI, Marcos Desidério; MOTA, Bruna Salani; FILASSI, José Roberto- Pathological macroscopic evaluation of breast density versus mammographic breast density in breast cancer conserving surgery(2023) REIS, Yedda Nunes; MOTA, Bruna Salani; MOTA, Rosa Maria Salani; SHIMIZU, Carlos; RICCI, Marcos Desiderio; AGUIAR, Fernando Nalesso; SOARES-JR, Jose Maria; BARACAT, Edmund Chada; FILASSI, Jose RobertoCorrelation between imaging and anatomopathological breast density has been superficially explored and is heterogeneous in current medical literature. It is possible that mammographic and pathological findings are divergent. The aim of this study is to evaluate the association between breast density classified by mammography and breast density of pathological macroscopic examination in specimens of breast cancer conservative surgeries. Post-hoc, exploratory analysis of a prospective randomized clinical trial of patients with breast cancer candidates for breast conservative surgery. Breast mammographic density (MD) was analyzed according to ACR BI-RADS (R) criteria, and pathologic macroscopic evaluation of breast density (PMBD) was estimated by visually calculating the ratio between stromal and fatty tissue. From 412 patients, MD was A in 291 (70,6%), B in 80 (19,4%) B, C in 35 (8,5%), and D in 6 (1,5%). Ninety-nine percent (201/203) of patients classified as A+B in MD were correspondently classified in PMBD. Conversely, only 18.7% (39/209) of patients with MD C+D were classified correspondently in PMBD (p < 0.001). Binary logistic regression showed age (OR 1.06, 1.01-1.12 95% CI, p 0.013) and nulliparity (OR 0.39, 0.17-0.96 95% CI, p 0.039) as predictors of A+B PMBD.Conclusion: Mammographic and pathologic macroscopic breast density showed no association in our study for breast C or D in breast image. The fatty breast was associated with older patients and the nulliparity decreases the chance of fatty breasts nearby 60%.
- 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.
- Levonorgestrel-releasing intrauterine system and breast cancer risk: A systematic review and meta-analysis(2020) CONZ, Livia; MOTA, Bruna Salani; BAHAMONDES, Luis; DORIA, Maira Teixeira; DERCHAIN, Sophie Francoise Mauricette; RIEIRA, Rachel; SARIAN, Luis OtavioIntroduction Epidemiological studies have shown that some hormonal contraceptive methods are associated with increased breast cancer risk, especially if used over long periods. Our objective was to conduct a systematic review and meta-analysis of the literature on the risk of breast cancer development in women using the 52-mg levonorgestrel-releasing intrauterine system (LNG-IUS). Material and methods We performed a thorough review of peer-reviewed publications from 10 January 1999, through 31 July 2019, using combinations of search terms for breast cancer risk and LNG-IUS in the Medline, EMBASE, LILACS (Latin American and Caribbean Health Sciences Literature), and Scielo databases. This review was registered in PROSPERO (CRD42017059076). Studies reporting breast cancer risk estimates among healthy users of LNG-IUS were included according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) criteria. Two authors performed data extraction, and a third author resolved disagreements. The quality of evidence was evaluated using the Downs and Black instrument. A funnel plot was generated, and a linear regression test of funnel plot asymmetry was used to assess publication bias. Finally, we performed a random-effects model (owing to high study heterogeneity) meta-analysis of 7 suitable studies, stratified by the age distribution of patients (<50 years, >= 50 years, and mixed). Results We identified 96 studies and manually cross-referenced and excluded duplicate articles. Seventy articles were excluded on the basis of the inclusion and exclusion criteria, resulting in the assessment of 26 full-text articles. Eight articles were considered adequate for inclusion in this systematic review, and 7 studies were included in the meta-analysis. Three publications were case-control studies and 5 were cohort studies. According to the Downs and Black instrument, 5 studies were rated as ""good"" and 3 studies were deemed ""fair"". Our meta-analysis results indicated increased breast cancer risk in LNG-IUS users: for all women, odds ratio (OR) = 1.16 (95% CI 1.06-1.28, I-2 = 78%, P < .01); for women aged <50 years, OR = 1.12 (95% CI 1.02-1.22, I-2 = 66%, P = .02); and for women aged >= 50 years, OR = 1.52 (95% CI 1.34-1.72, I-2 = 0%, P = .84). Conclusions Current evidence suggests that LNG-IUS users have an increased breast cancer risk regardless of age and indication. The effect of LNG-IUS on breast cancer risk seems to be larger in older users. However, our systematic review detected methodological issues across the available studies, and confounding factors may be responsible for at least a fraction of the risk effects associated with LNG-IUS use. Nevertheless, users of LNG-IUS should be aware of these trends. We believe that caution is needed, and risks should be balanced against proven health benefits (eg effective treatment of heavy menstrual bleeding and avoidance of surgical interventions), when prescribing LNG-IUS for long periods of use, especially in women with other known breast cancer risk factors such as old age, obesity, and familial predisposition.
- Breast cancer survivals and horetone therapy: estrogen and melatonin(2023) SOARES JUNIOR, Jose Maria; MOTA, Bruna Salani; NOBREGA, Gabriela Bezerra; FILASSI, Jose Roberto; SORPRESO, Isabel Cristina Esposito; BARACAT, Edmund Chada
- 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.
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 RobertobookPart Cirurgia como prevenção do câncer(2013) PARISE JR., Orlando; BELIVACQUA, José Luiz Barbosa; MOTA, Bruna Salani; COTTI, Guilherme Cutait de Castro; KAWAMURA, Carolina; GARICOCHEA, Bernardo- Validation of the Residual Cancer Burden Index as a prognostic tool in women with locally advanced breast cancer treated with neoadjuvant chemotherapy(2023) CUNHA, Juliana Pierobon Gomes da; GONCALVES, Rodrigo; SILVA, Fernando; AGUIAR, Fernando Nalesso; MOTA, Bruna Salani; CHEQUIM, Bruna Bello; SOARES, Jose Maria; BARACAT, Edmund C.; FILASSI, Jose RobertoAims To correlate the 'Residual Cancer Burden' (RCB) index with overall survival (OS) and disease-free survival (DFS) in women undergoing neoadjuvant chemotherapy at the Cancer Institute of the State of Sao Paulo. Methods We analysed the medical records of patients with breast cancer who underwent neoadjuvant chemotherapy and breast surgery, from 2011 to December 2017. Variables analysed were age, clinical and pathological staging, molecular subtype, number of recurrences or metastases, number of deaths, value and class of the RCB index. We used the Kaplan-Meier and the log-rank statistics to evaluate the possible association between RCB and OS and DFS. A regression model was used to determine the independent association of the RCB with the outcomes controlling for confounding factors. Results 347 patients were included in the analysis with a mean age of 49.39 years. Initial clinical staging was T3 in 57.9% of patients and 43.8% of patients had N1 axillary status. Survival analysis showed a statistically significant better prognosis for the RCB 0 (pCR) subgroup compared with RCB 1, 2 and 3 (log rank p=0.01). In a multivariate analysis, only the RCB classification showed a statistically significant correlation with DFS (RCB 1, HR 6.9, CI 1.9 to 25.4, p=0.004; RCB 2, HR 4.2, CI 1.6 to 10.8, p=0.03; and RCB 3, HR 7.6, CI 2.76 to 20.8, p=0.00). Conclusion We demonstrated a positive and significant relationship between the RCB index and the risk of relapse and death.