MARCOS DESIDERIO RICCI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
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 Câncer de Mama(2016) RICCI, Marcos Desidério; FILASSI, José RobertobookPart Doenças Benignas da Mama(2016) RUIZ, Carlos Alberto; PIATO, José Roberto Morales; MAESAKA, Jonathan Yugo; FREITAS, Gabriela Boufelli de; RICCI, Marcos Desidério; FILASSI, José Roberto- Predictive factors for positive surgical margins in the treatment of breast ductal carcinoma in situ(2016) HASSAN, Rafael A. M.; MAESAKA, Jonathan Y.; RICCI, Marcos D.; SOARES JR., Jose M.; DORIA, Maira Teixeira; BARACAT, Edmund C.; FILASSI, Jose R.Context: Surgery is the main form of treatment for ductal carcinoma in situ (DCIS) of the breast. Among other factors, treatment success requires that the surgical margins are free of disease, to reduce the risk of recurrence. Aims: The purpose of this study was to analyze factors that might be associated with positive margins in patients diagnosed with DCIS. Settings and Design: A retrospective analysis was performed of hospital databases from the year 2006 to 2014, to identify patients with an initial diagnosis of DCIS made by percutaneous biopsy. Subjects and Methods: Age, the presence of disease symptoms, lesion size on mammogram, and the presence of estrogen receptors, and their relationship to the surgical margins were evaluated in 249 patients. Statistical Analysis Used: Shapiro and WilcoxonuMannuWhitney tests were used to verify that the data were normally distributed. Chi-squared test was used to verify the independence of the variables. Results: Lesions measuring 1.55 cm or greater had a relative risk of positive margins after conservative surgery of 1.39 (95% confidence interval [95% CI]: 1.02u1.90). The presence of symptoms had a relative risk of positive margins after conservative surgery of 1.54 (95% CI: 1.17u2.02). Conclusion: Lesions measuring 1.55 cm or greater and the presence of symptoms are risk factors for positive margins in the treatment of ductal carcinoma in situ. Therefore, these patients need a better surgical planning in order to reduce the risk of positive margins. There is a clear need for large prospective studies to validate our findings and define other factors that might contribute to the success of surgical resection for ductal carcinoma in situ.
- Improved frozen section examination of the retroareolar margin for prediction of nipple involvement in breast cancer(2016) PIATO, J. R.; AGUIAR, F. N.; MOTA, B. S.; DORIA, M. T.; ALVES-JALES, R. D.; MESSIAS, A. P.; GONCALVES, R.; MANO, M. S.; SOARES, J. M.; RICCI, M. D.; FILASSI, J. R.; BARACAT, E. C.
conferenceObject Skin-sparing mastectomy for the treatment of breast cancer(2016) MOTA, B.; BEVILACQUA, J. L.; RICCI, M.; ATALLAH, A.; RIERA, R.conferenceObject Nipple- and areola-sparing mastectomy for the treatment of breast cancer(2016) MOTA, B.; BEVILACQUA, J. L.; RICCI, M. D.; RIEIRA, R.; ATALLAH, A.; BARRET, J.bookPart Rastreamento do Câncer de Mama(2016) FILASSI, José Roberto; RICCI, Marcos Desidério; BARACAT, Edmund Chada- Nipple- and areola-sparing mastectomy for the treatment of breast cancer(2016) MOTA, Bruna S.; RIERA, Rachel; RICCI, Marcos Desiderio; BARRETT, Jessica; CASTRIA, Tiago B. de; ATALLAH, Alvaro N.; BEVILACQUA, Jose Luiz B.Background The efficacy and safety of nipple-sparing mastectomy and areola-sparing mastectomy for the treatment of breast cancer are still questionable. It is estimated that the local recurrence rates following nipple-sparing mastectomy are very similar to breast-conserving surgery followed by radiotherapy. Objectives To assess the efficacy and safety of nipple-sparing mastectomy and areola-sparing mastectomy for the treatment of ductal carcinoma in situ and invasive breast cancer in women. Search methods We searched the Cochrane Breast Cancer Group's Specialized Register, the Cochrane Center Register of Controlled Trials (CENTRAL), MEDLINE (via PubMed), Embase (via OVID) and LILACS (via Biblioteca Virtual em Saude [BVS]) using the search terms ""nipple sparing mastectomy"" and ""areola-sparing mastectomy"". Also, we searched theWorld HealthOrganization's International Clinical Trials Registry Platform and ClinicalTrials.gov. All searches were conducted on 30th September 2014 and we did not apply any language restrictions. Selection criteria Randomised controlled trials (RCTs) however if there were no RCTs, we expanded our criteria to include non-randomised comparative studies (cohort and case-control studies). Studies evaluated nipple-sparing and areola-sparing mastectomy compared tomodified radical mastectomy or skin-sparing mastectomy for the treatment of ductal carcinoma in situ or invasive breast cancer. Data collection and analysis Two review authors (BS and RR) performed data extraction and resolved disagreements. We performed descriptive analyses and metaanalyses of the data using Review Manager software. We used Cochrane's risk of bias tool to assess studies, and adapted it for nonrandomised studies, and we evaluated the quality of the evidence using GRADE criteria. Main results We included 11 cohort studies, evaluating a total of 6502 participants undergoing 7018 procedures: 2529 underwent a nipple-sparing mastectomy (NSM), 818 underwent skin-sparing mastectomy (SSM) and 3671 underwent traditional mastectomy, also known as modified radical mastectomy (MRM). No participants underwent areola-sparing mastectomy. There was a high risk of confounding for all reported outcomes. For overall survival, the hazard ratio (HR) for NSM compared to SSM was 0.70 (95% CI 0.28 to 1.73; 2 studies; 781 participants) and the HR for NSM compared to MRM was 0.72 (95% CI 0.46 to 1.13; 2 studies, 1202 participants). Local recurrence was evaluated in two studies, the HR for NSM compared to MRM was 0.28 (95% CI 0.12 to 0.68; 2 studies, 1303 participants). The overall risk of complications was different in NSM when compared to other types of mastectomy in general (RR 0.10, 95% CI 0.01 to 0.82, 2 studies, P = 0.03; 1067 participants). With respect to skin necrosis, there was no evidence of a difference with NSMcompared to other types of mastectomy, but the confidence interval was wide (RR 4.22, 95% CI 0.59 to 30.03, P = 0.15; 4 studies, 1948 participants). We observed no difference among the three types of mastectomy with respect to the risk of local infection (RR 0.95, 95% CI 0.44 to 2.09, P = 0.91, 2 studies; 496 participants). Meta-analysis was not possible when assessing cosmetic outcomes and quality of life, but in general the NSMstudies reported a favourable aesthetic result and a gain in quality of life compared with the other types of mastectomy. The quality of evidence was considered very low for all outcomes due to the high risk of selection bias and wide confidence intervals. Authors' conclusions The findings from these observational studies of very low-quality evidence were inconclusive for all outcomes due to the high risk of selection bias.
bookPart Carcinoma inflamatório: diagnóstico e tratamento(2016) RICCI, Marcos Desidério; MENDES, Daniele Carvalho Calvano; MANO, Max; CALVANO FILHO, Carlos Marino Cabral; FILASSI, José RobertobookPart Carcinoma ductal in situ: diagnóstico e tratamento(2016) RICCI, Marcos Desidério; FILASSI, José Roberto