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"[ABSTRAKTujuan: Menentukan hubungan obesitas dengan proporsi ukuran tumor, keterlibatan KGB aksila dan derajat histopatologi pada pasien kanker payudara stadium I – IIIA di RSUPNCM, serta membantu meningkatkan kualitas tatalaksana bagi klinisi.Metode: Analisa menggunakan data sekunder pada pasien kanker payudara stadium I – III A. Dikatan obesitas bila indeks massa tubuh ≥ 25 kg/m2 dan non obesitas < 25 kg/m2. Hasil ukuran tumor dikelompokkan menjadi < 2 cm, 2-5 cm dan > 5 cm berdasarkan sistem staging TNM AJCC. Ukuran tumor diperoleh melalui pencitraan ultrasonografi payudara yang tersimpan pada sistem PACS. Keterlibatan KGB aksila serta derajat histopatologi diperoleh dari hasil ekspertise patologi anatomi.Hasil: Jumlah subyek penelitian sebanyak 52 pasien kanker payudara stadium I– IIIA tahun 2012 - 2014 di RSUPNCM terdiri dari 26 pasien obesitas dan 26 pasien non obesitas. Tidak ada hubungan yang bermakna antara ukuran tumor berdasarkan staging dengan obesitas (P= 0,795 (uji chi square)). Tidak terdapat hubungan yang bermakna antara obesitas dengan derajat histopatologi (P=0,610, (uji mutlak fisher)). Tidak terdapat hubungan yang bermakna antara obesitas dan keterlibatan KGB aksila (P =0,404 (uji chi square)). Median ukuran tumor pada pasien obesitas 2,95 cm dan pasien non obesitas 2,73 cm. Dari 26 pasien obesitas, 25 diantaranya memiliki derajat tinggi. Dari 26 pasien non obesitas, 14 memiliki keterlibatan KGB aksila.Kesimpulan: Pasien kanker payudara yang obesitas tidak berhubungan dengan besarnya ukuran tumor, keterlibatan KGB aksila dan derajat histopatologi yang tinggi. Namun terdapat kecenderungan pasien kanker payudara yang obesitas memiliki ukuran tumor yang lebih besar dan tingginya derajat histopatologi. Sedangkan keterlibatan KGB aksila lebih cenderung pada pasien yang non obesitas.

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ABSTRACTObjective: Determine the relationship of obesity with tumor size proportion, axillary lymph node involvement and histopathological grading in breast cancer patients stage I-IIIA in Cipto Mangunkusomo hospital and to help improvement the quality of management by clinician.Methods: Analysis using secondary data of breast cancer patient stage I-IIIA. Obesity grouped if body mass index ≥ 25 kg/m2 and non obese < 25 kg/m2. The results of tumor size are grouped into 0-2 cm, 2-5 cm and > 5 cm based on the AJCC TNM staging system. Tumor size obtained through breast ultrasound imaging from PACS system. Axillary lymph node involvement and histopathological grading obtained from the anatomical pathology expertise.Results: The study subjects are 52 patients with stage I-IIIA breast cancer in 2012-2014 in Cipto Mangunkusumo consisted of 26 obese and 26 non-obese patients. There is no significant relationship between tumor size based on staging with obesity (P = 0.795 (chi square test)). There was no significant relationship between obesity and grading histopathology (P = 0.610, (absolute test fisher)). There was no significant relationship between obesity and the involvement of axillary lymph nodes (P = 0.404 (chi square test)). The median tumor size of 2.95 cm in obese patients and 2,73 cm in non-obese patients. From 26 obese patients, 25 of them had a high grading histopathology. From 26 non-obese patients, 14 of them had involvement of axillary lymph nodes.Conclusion: Breast cancer patients who are obese are not related to the larger tumor size , involvement of axillary lymph nodes and a high grading of histopathology. However, there is a tendency that breast cancer patients who are obese had larger tumor size and high grading of histopathology. Where as the involvement of axillary lymph nodes are more likely in non-obese patients., Objective: Determine the relationship of obesity with tumor size proportion, axillary lymph node involvement and histopathological grading in breast cancer patients stage I-IIIA in Cipto Mangunkusomo hospital and to help improvement the quality of management by clinician.Methods: Analysis using secondary data of breast cancer patient stage I-IIIA. Obesity grouped if body mass index ≥ 25 kg/m2 and non obese < 25 kg/m2. The results of tumor size are grouped into 0-2 cm, 2-5 cm and > 5 cm based on the AJCC TNM staging system. Tumor size obtained through breast ultrasound imaging from PACS system. Axillary lymph node involvement and histopathological grading obtained from the anatomical pathology expertise.Results: The study subjects are 52 patients with stage I-IIIA breast cancer in 2012-2014 in Cipto Mangunkusumo consisted of 26 obese and 26 non-obese patients. There is no significant relationship between tumor size based on staging with obesity (P = 0.795 (chi square test)). There was no significant relationship between obesity and grading histopathology (P = 0.610, (absolute test fisher)). There was no significant relationship between obesity and the involvement of axillary lymph nodes (P = 0.404 (chi square test)). The median tumor size of 2.95 cm in obese patients and 2,73 cm in non-obese patients. From 26 obese patients, 25 of them had a high grading histopathology. From 26 non-obese patients, 14 of them had involvement of axillary lymph nodes.Conclusion: Breast cancer patients who are obese are not related to the larger tumor size , involvement of axillary lymph nodes and a high grading of histopathology. However, there is a tendency that breast cancer patients who are obese had larger tumor size and high grading of histopathology. Where as the involvement of axillary lymph nodes are more likely in non-obese patients.]"

"[ABSTRAKTujuan: Menentukan hubungan ukuran tumor dan derajat histopatologi dengan metastasis tulang pada pasien kanker payudara berusia dibawah 40 tahun di RS Kanker Dharmais, membantu meningkatkan kualitas tatalaksana bagi klinisi.Metode: Analisa menggunakan data sekunder. Hasil ukuran tumor dikelompokkan menjadi ≤ 5 cm dan > 5 cm berdasarkan AJCC TNM staging system diperoleh melalui pencitraan radiologi payudara dari sistem PACS dan derajat histopatologi menurut derajat histopatologi Nottingham kombinasi diperoleh dari hasil ekspertise patologi anatomi, serta evaluasi metastasis tulang menggunakan skintigrafi tulang berdasarkan total populasi pasien kanker payudara berusia dibawah 40 tahun.Hasil: Jumlah subyek penelitian 32 perempuan kanker payudara berusia dibawah 40 tahun periode Januari 2011 hingga Juli 2014 di RS Kanker Dharmais. Tidak ada hubungan yang bermakna antara ukuran tumor dengan metastasis tulang (P= 0,715 (Fisher exact test), OR=1,71 (0,32-9,36)). Terdapat hubungan yang bermakna antara derajat histopatologi dengan metastasis tulang (P=0,010, P < 0,05).Dari 10 subyek derajat histopatologi tinggi, ternyata semua subyek mengalami metastasis tulang negatif. Pada subyek dengan derajat histopatologi sedang didapatkan 8 dari 15 subyek yang mengalami metastasis tulang. Pada subyek penelitian dengan derajat histopatologi rendah didapatkan 6 dari 7 subyek mengalami metastasis tulang negatif. Rerata usia 33,2 tahun dan simpang baku 3,7 tahun memiliki kejadian metastasis tulang lebih tinggi (P=0,024). Terdapat data tambahan dan ditemukan hubungan yang bermakna antara Cerb-b2/HER-2 positif dengan metastasis tulang (P=0,049 (P < 0,05), Odds Ratio=5,67 (0,84 ? 43,16)).Prevalensi metastasis tulang yaitu sebesar 28,1%.Kesimpulan: Pasien kanker payudara berusia dibawah 40 tahun dengan ukuran tumor besar tidak memiliki kejadian metastasis tulang lebih tinggi. Pasien dengan derajat histopatologi tinggi tidak memiliki kejadian metastasis tulang lebih tinggi, namun ditemukan angka kejadian metastasis tulang lebih tinggi pada derajat histopatologi sedang. Terdapat dua faktor lain yang juga mempunyai hubungan dengan kejadian metastasis tulang yaitu usia dan Cerb-br/HER-2. Rerata usia 33,2 tahun dengan simpang baku 3,7 tahun pada pasien kanker payudara berusia di bawah 40 tahun memiliki kejadian metastasis tulang lebih tinggi. Cerb-b2/HER-2 positif pada pasien kanker payudara berusia di bawah 40 tahun memiliki kejadian metastasis tulang lebih tinggi dengan resiko kejadian sebesar 5,67 kali. Prevalensi metastasis tulang cukup tinggi pada pasien kanker payudara berusia dibawah 40 tahun yaitu sebesar 28,1%.

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ABSTRACTObjective: Determine the relationship of tumor size and histopathology grade with bone metastases in breast cancer patients under 40 years old in Dharmais Cancer Hospital, to help improve the quality of management of the clinician.Methods: Analysis using secondary data. The results of tumor size are grouped into ≤ 5 cm and> 5 cm based on the AJCC TNM staging system from PACS system, obtained through breast radiology imaging and histopathologic grade according to histopathological Nottingham combination obtained from the anatomical pathology expertise, the evaluation of bone metastases using bone scintigraphy. These analyses are based on the total population of breast cancer patients under 40 years old.Results: The study subjects are 32 female breast cancer under 40 years old from January 2011 to July 2014 Dharmais Cancer Hospital. There is no significant relationship between the tumor size with bone metastasis (P = 0.715 (Fisher exact test), OR = 1.71 (0.32 to 9.36)). There is a significant relationship between the histopathology grade with bone metastases (P = 0.010, P <0.05). From 10 subjects with high grade histopathology, all subjects have no bone metastases. In subjects with moderate grade histopatholog, 8 of 15 subjects have bone metastases. In subjects with a low grade histopathology showed 6 of 7 subjects have no bone metastases. The mean age of 33.2 years and standard deviations of 3.7 years had a higher incidence of bone metastases (P = 0.024). There are additional data and found a significant association between Cerb-b2 / HER-2 positive patients with bone metastases (P = 0.049 (P <0.05), odds ratio = 5.67 (0.84 to 43.16)). The prevalence bone metastasis is equal to 28.1%.Conclusion: Breast cancer patients under 40 years with large tumor size did not have a higher incidence of bone metastases. Patients with a high grade histopathology do not have higher incidence of bone metastases, but found the incidence of bone metastases was higher in moderate grade histopathology. There are two other factors that also have a relationship with the incidence of bone metastases, that are age and Cerb-br / HER-2. The mean age of 33.2 years with standard deviations of 3.7 years in patients with breast cancer under 40 years old have a higher incidence of bone metastases. Cerb-b2 / HER-2 positive breast cancer patients under 40 years old have a higher incidence of bone metastases with the risk of occurrence 5.67 times. The prevalence of bone metastases in breast cancer patients under the age of 40 years is quite high equal to 28.1%.;Objective: Determine the relationship of tumor size and histopathology grade with bone metastases in breast cancer patients under 40 years old in Dharmais Cancer Hospital, to help improve the quality of management of the clinician.Methods: Analysis using secondary data. The results of tumor size are grouped into ≤ 5 cm and> 5 cm based on the AJCC TNM staging system from PACS system, obtained through breast radiology imaging and histopathologic grade according to histopathological Nottingham combination obtained from the anatomical pathology expertise, the evaluation of bone metastases using bone scintigraphy. These analyses are based on the total population of breast cancer patients under 40 years old.Results: The study subjects are 32 female breast cancer under 40 years old from January 2011 to July 2014 Dharmais Cancer Hospital. There is no significant relationship between the tumor size with bone metastasis (P = 0.715 (Fisher exact test), OR = 1.71 (0.32 to 9.36)). There is a significant relationship between the histopathology grade with bone metastases (P = 0.010, P <0.05). From 10 subjects with high grade histopathology, all subjects have no bone metastases. In subjects with moderate grade histopatholog, 8 of 15 subjects have bone metastases. In subjects with a low grade histopathology showed 6 of 7 subjects have no bone metastases. The mean age of 33.2 years and standard deviations of 3.7 years had a higher incidence of bone metastases (P = 0.024). There are additional data and found a significant association between Cerb-b2 / HER-2 positive patients with bone metastases (P = 0.049 (P <0.05), odds ratio = 5.67 (0.84 to 43.16)). The prevalence bone metastasis is equal to 28.1%.Conclusion: Breast cancer patients under 40 years with large tumor size did not have a higher incidence of bone metastases. Patients with a high grade histopathology do not have higher incidence of bone metastases, but found the incidence of bone metastases was higher in moderate grade histopathology. There are two other factors that also have a relationship with the incidence of bone metastases, that are age and Cerb-br / HER-2. The mean age of 33.2 years with standard deviations of 3.7 years in patients with breast cancer under 40 years old have a higher incidence of bone metastases. Cerb-b2 / HER-2 positive breast cancer patients under 40 years old have a higher incidence of bone metastases with the risk of occurrence 5.67 times. The prevalence of bone metastases in breast cancer patients under the age of 40 years is quite high equal to 28.1%.;Objective: Determine the relationship of tumor size and histopathology grade with bone metastases in breast cancer patients under 40 years old in Dharmais Cancer Hospital, to help improve the quality of management of the clinician.Methods: Analysis using secondary data. The results of tumor size are grouped into ≤ 5 cm and> 5 cm based on the AJCC TNM staging system from PACS system, obtained through breast radiology imaging and histopathologic grade according to histopathological Nottingham combination obtained from the anatomical pathology expertise, the evaluation of bone metastases using bone scintigraphy. These analyses are based on the total population of breast cancer patients under 40 years old.Results: The study subjects are 32 female breast cancer under 40 years old from January 2011 to July 2014 Dharmais Cancer Hospital. There is no significant relationship between the tumor size with bone metastasis (P = 0.715 (Fisher exact test), OR = 1.71 (0.32 to 9.36)). There is a significant relationship between the histopathology grade with bone metastases (P = 0.010, P <0.05). From 10 subjects with high grade histopathology, all subjects have no bone metastases. In subjects with moderate grade histopatholog, 8 of 15 subjects have bone metastases. In subjects with a low grade histopathology showed 6 of 7 subjects have no bone metastases. The mean age of 33.2 years and standard deviations of 3.7 years had a higher incidence of bone metastases (P = 0.024). There are additional data and found a significant association between Cerb-b2 / HER-2 positive patients with bone metastases (P = 0.049 (P <0.05), odds ratio = 5.67 (0.84 to 43.16)). The prevalence bone metastasis is equal to 28.1%.Conclusion: Breast cancer patients under 40 years with large tumor size did not have a higher incidence of bone metastases. Patients with a high grade histopathology do not have higher incidence of bone metastases, but found the incidence of bone metastases was higher in moderate grade histopathology. There are two other factors that also have a relationship with the incidence of bone metastases, that are age and Cerb-br / HER-2. The mean age of 33.2 years with standard deviations of 3.7 years in patients with breast cancer under 40 years old have a higher incidence of bone metastases. Cerb-b2 / HER-2 positive breast cancer patients under 40 years old have a higher incidence of bone metastases with the risk of occurrence 5.67 times. The prevalence of bone metastases in breast cancer patients under the age of 40 years is quite high equal to 28.1%., Objective: Determine the relationship of tumor size and histopathology grade with bone metastases in breast cancer patients under 40 years old in Dharmais Cancer Hospital, to help improve the quality of management of the clinician.Methods: Analysis using secondary data. The results of tumor size are grouped into ≤ 5 cm and> 5 cm based on the AJCC TNM staging system from PACS system, obtained through breast radiology imaging and histopathologic grade according to histopathological Nottingham combination obtained from the anatomical pathology expertise, the evaluation of bone metastases using bone scintigraphy. These analyses are based on the total population of breast cancer patients under 40 years old.Results: The study subjects are 32 female breast cancer under 40 years old from January 2011 to July 2014 Dharmais Cancer Hospital. There is no significant relationship between the tumor size with bone metastasis (P = 0.715 (Fisher exact test), OR = 1.71 (0.32 to 9.36)). There is a significant relationship between the histopathology grade with bone metastases (P = 0.010, P <0.05). From 10 subjects with high grade histopathology, all subjects have no bone metastases. In subjects with moderate grade histopatholog, 8 of 15 subjects have bone metastases. In subjects with a low grade histopathology showed 6 of 7 subjects have no bone metastases. The mean age of 33.2 years and standard deviations of 3.7 years had a higher incidence of bone metastases (P = 0.024). There are additional data and found a significant association between Cerb-b2 / HER-2 positive patients with bone metastases (P = 0.049 (P <0.05), odds ratio = 5.67 (0.84 to 43.16)). The prevalence bone metastasis is equal to 28.1%.Conclusion: Breast cancer patients under 40 years with large tumor size did not have a higher incidence of bone metastases. Patients with a high grade histopathology do not have higher incidence of bone metastases, but found the incidence of bone metastases was higher in moderate grade histopathology. There are two other factors that also have a relationship with the incidence of bone metastases, that are age and Cerb-br / HER-2. The mean age of 33.2 years with standard deviations of 3.7 years in patients with breast cancer under 40 years old have a higher incidence of bone metastases. Cerb-b2 / HER-2 positive breast cancer patients under 40 years old have a higher incidence of bone metastases with the risk of occurrence 5.67 times. The prevalence of bone metastases in breast cancer patients under the age of 40 years is quite high equal to 28.1%.]"

"Latar Belakang: Limfadenektomi memainkan peranan penting dalam operasi surgical staging kanker ovarium. Limfadenektomi merupakan prosedur yang kompleks dan berpotensi menyebabkan berbagai komplikasi intra- dan pascaoperasi. Beberapa penelitian menunjukkan bahwa subtipe histologi dan derajat histopatologi kanker ovarium yang berbeda memiliki kejadian metastasis kelenjar limfe yang berbeda pula, sehingga dapat mempengaruhi pengambilan keputusan klinis.Tujuan: Mengetahui prevalensi metastasis kelenjar limfe pada pasien kanker ovarium tipe epitel stadium klinis 1 pada berbagai subtipe histologi dan derajat histopatologi.Metode: Penelitian menggunakan metode potong lintang pada pasien kanker ovarium tipe epitel stadium klinis 1 yang menjalani limfadenektomi di RSUPN Dr. Cipto Mangunkusumo, Jakarta, pada tahun 2014-2023. Data yang dikumpulkan mencakup karakteristik demografi, subtipe histologi, derajat histopatologi, dan status metastasis kelenjar limfe. Hubungan antar variabel dianalisis menggunakan uji chi-square atau uji Fisher's exact.Hasil: Terdapat 106 subjek yang memenuhi kriteria inklusi. Peningkatan stadium akibat metastasis kelenjar limfe ditemukan pada 6.6% subjek. Metastasis kelenjar limfe paling banyak ditemukan pada subtipe histologi serosum derajat tinggi (15.4%) dan derajat diferensiasi buruk (10.6%). Hubungan yang signifikan secara statistik ditemukan antara kejadian metastasis kelenjar limfe dengan derajat diferensiasi (P=0.043), namun tidak dengan subtipe histologi. Tidak terdapat subjek dengan derajat diferensiasi baik-sedang yang mengalami metastasis kelenjar limfe.Kesimpulan: Keputusan untuk melakukan limfadenektomi perlu dipertimbangkan kembali saat melakukan operasi surgical staging pada kanker ovarium tipe epitel stadium klinis 1 dengan derajat diferensiasi baik-sedang. Penelitian lanjutan dengan jumlah sampel yang lebih besar dibutuhkan untuk kesimpulan yang lebih kuat.

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Background: Lymphadenectomy plays an integral role in the surgical staging of ovarian cancer. However, it is a complex procedure that is potentially associated with intra- and post-operative complication. Some studies showed that distinct histologic subtype and grade have different frequencies of lymph node metastases and these might have potential implication for clinical decision making.

Objective: To evaluate the prevalence of lymph node metastasis in patients with clinically stage 1 epithelial ovarian cancer of various histologic subtype and grade.

Methods: This was a cross sectional study including clinically stage 1 epithelial ovarian cancer patient who underwent lymphadenectomy at Dr. Cipto Mangunkusumo Hospital, Jakarta, during the period of 2014-2023. Demographics, histologic subtype, tumor grade, and lymph node status were collected. Comparisons were made with Chi square or Fisher's exact test.

Results: A total of 106 subjects were included in the study. Upstaging due to lymph node metastases were found in 6.6% of subjects. Lymph node metastases were most common in high-grade serous histology (15.4%) and poorly differentiated tumor grade (10.6%). However, a significant association with lymph node metastases rate was found only on tumor grade (P=0.043) and not histologic subtype. Furthermore, no subjects with well-to-moderately differentiated tumor had lymph node metastases.

Conclusions: The decision to perform lymphadenectomy should be reconsidered when performing surgical staging in patients with well-to-moderately differentiated clinically stage 1 epithelial ovarian carcinoma. Additional studies with larger samples are needed for exact conclusion."

"Latar Belakang : FGF2 merupakan ligan bagi Fibroblast Growth Factor Receptor2(FGFR2). Interaksi dengan reseptor ini memediasi dimerisasi reseptor, fosforilasi, dan aktivasi jalur pensinyalan, seperti jalur Ras-MAPK dan PI3K. Mutasi yang berlebihan melalui sumbu FGF / FGFR dapat menginduksi proliferasi sel kanker, memicu angiogenesis dan limfogenesis, yang mendorong terjadinya metastasis. Penelitian ini mencoba mengevaluasi peran FGF2 pada metastasis kelenjar getah bening aksila pada pasien kanker payudara stadium dini. Tujuan : Mengetahui hubungan nilai ekspresi FGF 2 pada tumor primer terhadap kejadian metastasis kelenjar getah bening aksila. Metode : Digunakan studi potong lintang dengan mengevaluasi ekspresi FGF2 pada 47 pasien kanker payudara stadium dini yang menjalani mastektomi di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSCM) pada periode Januari 2014 sampai Desember 2018. Ekspresi FGF2 diperiksa dengan pemeriksaan imunohistokimia, kemudian dievaluasi dan dihubungkan antara ekspresi FGF2 dengan metastasis kelenjar getah bening aksila. Hasil : Uji Chi Square memperlihatkan nilai p=0.044 (p<0.05) yang menunjukkan bahwa terdapat hubungan yang signifikan antara nilai FGF2 pada tumor payudara dengan kejadian metastasis kelenjar getah bening aksila. Odds ratio 4,22 (CI 95% 0,983-18,1). Kesimpulan : Peran FGF2 dalam metastasis kelenjar getah bening berhubungan dengan interaksi antara berbagai faktor limfangiogenik dalam mempromosikan limfangiogenesis dan metastasis limfatik. Ekspresi FGF2 yang tinggi memiliki korelasi signifikan dengan angka kejadian metastasis kelenjar getah bening aksila.

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Background : FGF2 is a ligand for Fibroblast Growth Factor Receptor 2 (FGFR2). Interaction with this receptor mediate dimerization of receptor, phosphorilation, and activation of signaling pathway, such as Ras-MAPK and PI3K. Overmutation through FGF/FGFR induced proliferation of cancer cells, promoted angiogenesis, lymphogenesis, and metastasis. This study tried to evaluate the role of FGF2 in axillary lymph node metastasis in early-stage breast cancer patients.

Aim : To determined the relationship of FGF 2 expression values in primary tumors to the incidence of axillary lymph node metastases.

Methods :A cross-sectional study was used by evaluating the expression of FGF2 in 47 early-stage breast cancer patients who underwent a mastectomy at the Cipto Mangunkusumo National Center General Hospital (RSCM) from January 2014 to Desember 2018. FGF2 expression was examined by immunohistochemistry, then evaluated and linked between expression FGF2 with axillary lymph node metastases.

Results : The Chi Square test had a value of p=0.044 (p<0.05) that showed there was a significant relationship between FGF2 value in breast tumors with the incidence of axillary lymph node metastasis. Odds ratio 4.22 (95% CI 0.983-18.1).

Conclusions The role of FGF2 in lymph node metastasis is related to the interaction between various lymphangiogenic factors in promoting lymphangiogenesis and lymphatic metastasis. High expression of FGF2 has a significant correlation with the incidence of axillary lymph node metastasis."

"Latar Belakang: USG payudara dan mamografi secara luas digunakan sebagai modalitas diagnostik yang efektif untuk mengevaluasi kelainan payudara. Derajat keganasan histopatologis berperan penting dalammanajemen karsinoma payudara. Ketersediaan pemeriksaan histopatologis yang terbatas dan sebaran pemeriksaan USG dan mamografi yang lebih luas diharapkan dapat membantu klinisi dalam menentukan penatalaksanaan karsinoma payudara lebih dini. Tujuan penelitian ini adalah meningkatkan nilaimamografi serta USG payudara dengan mengetahui keterkaitan temuan morfologis lesi berdasarkan USG payudara dan mamogram yang dapat mengidentifikasi derajat keganasan histopatologis karsinoma payudara. Metode: Studi retrospektif ini melibatkan subyek dengan karsinoma payudara primer yangmenjalani USG dan mamografi serta belum menjalani prosedur apapun. Temuan USG dan mamogram dianalisis dan dikorelasikan dengan derajat keganasan histopatologis. Variabel dianalisis menggunakan uji chi-square dan Kolmogorov-Smirnov. Hasil: Diperoleh 174 subyek karsinoma payudara. Usia rerata subyek 52 tahun. Ukuran massa <5 cm paling banyak ditemukan (61,1%) dan memiliki hubungan yang signifikan dengan derajat keganasan histopatologis (p<.05). Batas lesi, ekhogenisitas lesi dan kalsifikasilesi pada USG (p <.05) berhubungan dengan derajat keganasan histopatologis. Sedangkan untuk bentuk lesi, bentuk irregular lebih banyak ditemukan dibandingkan lesi lain dengan distribusi yang hampir sama antara derajat 1, 2, dan 3. Proporsi batas lesi paling banyak di derajat 3 yakni batas tidak tegas.Ekhogenisitas heterogen lebih sering ditemukan pada tumor derajat 2 dan lesi hipoekhoik lebih banyak ditemukan pada tumor derajat 3. Saat dilakukan analisis tambahan dengan membagi derajat keganasan menjadi 2 grup (derajat rendah dan derajat tinggi), batas dan orientasi lesi pada USG (p <.05) berhubungan dengan derajat keganasan histopatologis sedangkan kalsifikasi lesi dan ekhogenisitas lesi tidak berhubungan. Tidak ada hubungan antara karakteristik lesi pada mamogram (densitas payudara, bentuk,batas, densitas lesi, dan kalsifikasi) dengan derajat keganasan histopatologis (nilai p > 0,05). Proporsi batas spikulasi lebih banyak ditemukan pada lesi derajat rendah. Simpulan: Orientasi pararel lebih banyakditemukan pada tumor derajat tinggi. Batas tidak tegas paling banyak ditemui di kedua kelompok derajat keganasan namun proporsi lebih banyak ditemukan pada lesi derajat tinggi. Tidak ditemukan hubungan signifikan antara morfologis lesi pada mamogram dengan derajat keganasan.

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Background: Breast ultrasonography (USG) and mammography are widely used as effective diagnostic modalities to evaluate breast abnormalities. Histological grade plays big role in management of breast

carcinoma. The purpose of this study was to increase the value of mammography and ultrasound. Also, knowing which features on ultrasound and mammogram that can predict histological grade. The limited

availability of histopathological examinations and better access of ultrasound and mammography can assist clinicians in management of breast carcinoma. Method: A retrospective study was conducted by

reviewing imaging of women with breast cancer who had not undergone any procerdure. Mammogram and US findings were analyzed in compliance with operational definition and later compared with histopathological data. All variables were analyzed using chi-square and Kolmogorov-Smirnof. Result:

Mean age at diagnosis of breast cancer was 52 years. Tumor size <5 cm was the most common (61.1%) and had significant relation with tumor grade (p<.05). In terms of ultrasound findings, the only differential

findings between ultrasound findings and histopathological grade were margin, echogenicity, and calcifications (p < .05). As for the shape of the lesions, an irregular shape was more observed compared to other lesions with almost equal distribution between grade 1, 2, and 3. Heterogene echogenicity was more frequently found on grade 2 and hypoechoic lesions were more common in grade 3 tumor. When additional analysis was carried out by dividing the histological grade into 2 groups (low grade and high grade), margin and orientation on the ultrasound (p <.05) had relation to tumor grade while the

calcification of the lesion and the echigenicity were not related. No significant difference between mammogram features (breast density, shape, margin, lesion density, and calcifications) and tumor grade

(p>.05). The proportion of spiculated margin in mamogram is more common in low-grade lesions. No significant association between ultrasound features (shape, echogenicity, posterior pattern, and calcifications) with histological grade. Conclusion: Margin and orientation of the lesion on ultrasound have a relationship with histological grade. Parallel orientation is more common seen in high-grade

tumors. Indistinct borders were commonly found in both groups; however, a higher proportion was found

in high-grade lesions. No significant relation was found between mammogram features and tumor grade"

"ABSTRAKKanker payudara merupakan tumor ganas pada jaringan payudara yang bersifat invasif dan paling sering terjadi pada wanita. Mastektomi adalah salah satu operasi kanker payudara yang mengangkat jaringan payudara beserta otot pektoralis dan nodus limfe aksila. Komplikasi lebih lanjut pada pasien yang menjalani operasi mastektomi dan diseksi nodus limfe aksila yaitu terjadinya limfedema. Studi kasus ini dilakukan untuk menganalisis intervensi keperawatan berupa latihan mobilisasi lengan pada pasien kanker payudara pasca operasi mastektomi dan diseksi nodus limfe aksila. Hasil intervensi menujukkan adanya pengaruh signifikan dari pemberian latihan mobilisasi lengan pada pasien yang ditandai dengan penurunan tingkat nyeri dan peningkatan kekuatan otot, serta tidak adanya kemerahan, edema, kesemutan dan kekakuan pada lengan. Rekomendasi dari studi kasus ini adalah perawat perlu mengetahui tanda dan gejala limfedema pada pasien kanker payudara, sehingga komplikasi pasca operasi mastektomi dan diseksi nodus limfe aksila dapat dicegah dan kualitas hidup pasien dapat meningkat.

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ABSTRACTBreast cancer is an invasive malignant tumor in breast tissues which commonly occurred in women. Mastectomy is a breast cancer surgery which breast tissues alongside pectoral muscles and axillary lymph nodes are dissected. Further complications in patients undergoing mastectomy and dissection of axillary lymph nodes is the occurrence of lymphedema. This case study was conducted to analyze nursing intervention, which is arm mobilization exercise, in post operative mastectomy and axillary lymph nodes dissection patient. The results of the intervention showed the significant effect of arm mobilization exercise in patient proven by decreased pain levels, increased muscle strength, and absence of redness, edema, tingling and stiffness in the arms. This study recommend nurses need to know the signs and symptoms of lymphoedema in breast cancer patients. Therefore, post operative complications of mastectomy and axillary lymph node dissection can be prevented and patients rsquo quality of life may increase."

"Faktor perturnbuhan cndote1 vaskular atau Vascular Endothelial Growth Factor (selanjutnya disebut VEGF) adalah suatu glikoprotein dimer yang dihasilkan oleh sel tumor dan jaringan yang memerlukan pasokan pembuluh darah baru. Beberapa penelitian membuktikan bahwa terdapat hubungan antara penyebaran ke kelenjar gctah bening ketiak dengan ekspresi VEGF C dan D terutama pada kanker payudara jenis duktal invasif. Ekspresi berlebihan dari VEGF disenai ekspresi berlebihan dari HER2 kanker payudara. Lebih jauh diketahui bahwa ekspresi VEGF berhubungan dengan penyebaran ke kelenjar getah bening ketiak. Pengaruh faktor ini mendorong peneliti untuk mempelajari kanker payudara stadium II dengan HER-2 posltif karena penyebaran ke kelenjar getah benlng ketiak pada sisi yang sama dengan kanker payudara, mulai ditemukan pada stadium II baik pada tumor ukuran di bawah 2 em ataupun pada tumor berukuran lebih dari 2 em. Dalam penelitian ini dinilai poia ekspresi VEGF pada subjek dengan penyebaran ke kelenjar getah bening (N l) dan pada keadaan belum adanya keterlibatan kelenjar getah bening (NO). Ekspresi VEGF dapat diamati dan diukur derajatnya pada jaringan kanker payudara dengan teknik imunohistokimia. Pola ekspresi yang didapatkan dari hasil penelitian ini diharapkan dapat melihat sifat biologik kanker payudara dalam hal penyebarannya ke kele11iar gctah bening ketiak dan dapat digunakan sebagai faktor prediksi dalam hal penyebarannya.

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Vascular Endotbelia1 Growth Factor (VEGF) is a chimeric glycoprotein produced by tumor cells and tissues that require ample blood supply. Some studies have suggested that there is an association between metastasis of cancer cells to the axillary lymph nodes and VEGF C and D especially in ductile invasive breast carcinoma. The over expression from VEGF together with HER-2 were found in 77.2 percent of breast cancer patients. Furthermore evidence suggest that VEGF expression is connected with the spread of cancer to the axillary lymph nodes. We examined breast cancer stage II with HER-2 positive, as the spread of cancer cells to the axillary lymph nodes from the same breast cancer side will only be found at stage H for both tumor under 2 em or more than 2 em. We examined VEGFC the its relationship with axillary lymph node. The results from this research is aimed at monitoring the spread of breast cancer to the axillary lymph nodes and to predict its spread and therefore to find the most effective treatment management for this type of cancer. We analyzed VEGF-C expression in 95 sample breast cancer stage ll with HER-2 positive from 1999 2009. There is no significant associated between VEGF-C expression and axillary lymph node (p = 0.089)."

"Latar Belakang: Obesitas menjadi faktor risiko independen dan faktor prognostik pada kanker payudara primer. Jaringan lemak berlebih akan meningkatkan kadar estrogen dalam darah, sehingga memicu proliferasi sel kanker, terutama sel dengan reseptor estrogen dan progesteron yang positif. Belum ada studi mengenai hubungan antara obesitas dengan karakteristik reseptor hormon kanker payudara primer di Indonesia. Metode: Kami mengumpulkan kasus kanker payudara primer yang terdiagnosis dan menjalani pemeriksaan imunohistokimia di RSUPN Cipto Mangunkusumo tahun 2017. Subyek kemudian dikelompokkan menjadi kelompok obesitas dan nonobesitas. Karakteristik ER dan PR kedua kelompok dibandingkan. Hasil dan Diskusi: Kami memperoleh 202 kasus kanker payudara primer, dengan 89 kasus (44%) obesitas dan 113 kasus (56%) non-obesitas. Rerata IMT dari subyek adalah 24,45 (SD±4,3). Kedua kelompok seragam dari segi usia, status menopause, stadium, gambaran histopatologis, dan derajat keganasan. Tidak didapatkan hubungan yang bermakna antara obesitas dengan ER maupun PR. Dilakukan analisis korelasi antara IMT dengan persentase ekspresi reseptor hormon, namun tidak ditemukan hubungan yang bermakna. Hasil ini berbeda dengan studi lainnya. Perbedaan hasil dapat disebabkan oleh perbedaan karakteristik subyek dan faktor lain yang dapat mempengaruhi ekspresi reseptor hormon. Kesimpulan: Tidak didapatkan hubungan antara obesitas dan karakteristik reseptor hormon kanker payudara primer RSUPN Cipto Mangunkusumo tahun 2017.Backgrounds: Obesity is an independent risk factor and prognostic factor of primary breast cancer. Abundant adipose tissue would lead to increment of blood estrogen level, thus promoting proliferation of cancer cell, especially those with positive estrogen receptor (ER) and progesterone receptor (PR). No previous study explained the association between obesity and hormone receptor characteristics of primary breast cancer in Indonesia. Methods: We collected cases of primary breast cancer which are diagnosed and undergone immunohistochemistry examination at Cipto Mangunkusumo General Hospital in 2017. The subjects were divided into obese group and non-obese group. The ER and PR characteristics of both groups were compared. Result and Discussion: We collected 202 cases of primary breast cancer, with 89 cases (44%) in obese group and 113 cases (56%) in non-obese group. The mean body mass index (BMI) of the subjects was 24,45 (SD±4,3). Both groups were similar in terms of age, menopausal status, stage, histopathological morphology and grade. No significant association was found between obesity and ER or PR. We analysed correlation between BMI and the percentage of expressed hormone receptor, but no correlation was found. This finding did not conform with other Western studies. Difference in characteristics of the subjects and other hormonal factors might contribute to the outcome. Conclusion: There was no association between obesity and hormone receptor characteristics of primary breast cancer at Cipto Mangunkusumo General Hospital in 2017."

"Latar Belakang: Kanker serviks menduduki peringkat ke tiga di seluruh dunia sebagaipenyebab kematian perempuan dan merupakan penyebab kematian utama perempuan dinegara berkembang. Diperlukan evaluasi kesintasan berkala yang secara tidak langsungmenjadi cermin tatalaksana.Tujuan: Mengetahui kesintasan pasien kanker serviks di RSCM.Metode: Penelitian ini menggunakan desain kohort retrospektif terhadap data rekammedis pasien kanker serviks pada tahun 2012-2014 dengan metode total populationsampling. Analisis data dilakukan menggunakan kurva Kaplan Meier, uji Log Rank dan Regresi Cox untuk mencari kemaknaan hubungan antarvariabel.Hasil: Terdapat 1.303 subjek penelitian dengan angka kesintasan kanker serviks hingga tahun ke-5 sebesar 76%, 66%, 60%, 43% dan 36% dengan median kesintasan sebesar 1355 hari secara keseluruhan. Terdapat perbedaan hazard bermakna pada variabel stadium kanker (p<0,001). Analisis regresi cox menunjukkan faktor yang berpengaruh terhadap kesintasan adalah stadium kanker. Kesimpulan: Kesintasan 5 tahun kanker serviks di RSCM tahun 2012-2014 sebesar 36%.

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Background: Cervical cancer is ranked third as female cause of death worldwide and isthe leading cause of death of women in developing countries. A periodic survivalevaluation is required that implies the treatment implicitly.Objective: To know the survival rate of cervical cancer patients at CiptoMangunkusumo Hospital.Methods: This retrospective cohort study used medical records data of cervical cancerpatients in 2012- 2014 using total population sampling method. Data analysis was doneusing Kaplan Meier curve, Rank Log test and Cox Regression to find the associationbetween variables.Results: There were 1.303 subjects with overall kesintasan rates of cervical cancer up tothe fifth year of 76, 66, 60, 43 dan 36 with a median survival 1355 days. There were significant hazard differences in cancer stage variables (p <0.001). Cox regression analysis showed that factors affecting survival were cancer stage. Conclusion: The 5-year kesintasan rate of cervical cancer at Cipto Mangunkusumo hospital in 2012-2014 is 36%."

"ABSTRAKLatar belakang dan tujuan: Kanker payudara merupakan kanker yang menempati urutan pertama dari keseluruhan kanker pada perempuan di Indonesia dan menurut data dari Indonesia Journal of Cancer 2012 menyebabkan kematian sebesar 458.000 perempuan. Kepadatan payudara merupakan salah satu faktor resiko terjadinya kanker payudara yang dipicu oleh adanya estrogen yang menjadi prekursor jaringan fibrogladular menjadi padat. Pada perempuan dengan kanker payudara dan densitas payudara yang tinggi ditemui juga adanya perlemakan hati yang tinggi. Hubungan antara pasien dengan kanker payudara dengan densitas payudara yang tinggi dan perlemakan hati masih belum banyak diteliti. Penelitian ini bertujuan mengevaluasi kepadatan jaringan payudara yang diperiksa dengan mammografi dan perlemakan hati yang diperiksa dengan ultrasonografi serta melihat hubungannya dengan estrogen reseptor yang diperiksa dengan immunohistokimia.Metode: Penelitian potong lintang menggunakan data sekunder ultrasonografi abdomen dan mammografi dari sistem PACS RS Kanker Dharmais. Penilaian yang dilakukan dengan melihat derajat kepadatan payudara yang diperiksa dengan mammografi dan derajat perlemakan hati yang diperiksa dengan ultrasonografi serta melihat status estrogen reseptor dari immunohistokimia pada pasien kanker payudara tersebut. Analisa data dilakukan dengan mengelompokan kepadatan payudara sampai 50 % dan kelompok lain dengan kepadatan lebih dari 50% dan membandingkan dengan perlemakan hati ringan dan berat.Hasil: Pengelompokan pasien dengan kepadatan payudara sampai 50% menunjukkan terdapat banyak perlemakan hati berat, demikian juga pada kepadatan payudara yang lebih besar dari 50% menunjukkan terdapat lebih banyak lagi perlemakan hati derajat berat namun secara statistik tidak terdapat hubungan yang signifikan dengan Nilai Odds Ratio (OR) = 0.60 dengan 95% Interval Kepercayaan 0.12 – 3.01.Kesimpulan: Hasil penelitian ini menunjukkan adanya kecenderungan hubungan antara kepadatan jaringan payudara yang tinggi dengan perlemakan hati yang juga tinggi walaupun secara statistik tidak menunjukkan hasil yang signifikan.

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ABSTRACTBackground and Objectives: Breast cancer are the most common cancer and the first in all cancer that affected women in Indonesia and the data from Indonesian Journal of Cancer 2012 said, it cause death for about 458.000 women. Breast density are one of the risk factor that cause breast cancer and estrogen are the precursor for high density of the fibroglandular tissue. Women with breast cancer and high breast density are found to have a high degree of fatty liver. The relationship between breast cancer with high breast density and high fatty liver was unknown. The aim of these research wants to evaluation the breast density on mammography and fatty liver on ultrasound and the relationship with estrogen reseptor which was examined with immunohistochemistry.Method: A cross sectional research is perform using mammography and ultrasound from PACS system. These research wants to evaluation the high breast density with mammograms and fatty liver with ultrasound and their relationship with estrogen receptor by immunohistochemistry. Data was merged in to two groups, one group with breast density until 50% and the other group was breast density more than 50% and compared it with mild and severe fatty liver.Result: Patient with breast density until 50% showed more severe fatty liver as well as patient with breast density more than 50% had more severe fatty liver, although statistically had no significant relationship with Odds Ratio (OR) = 0,60 and confidence interval 0,12-3.01.Conclusion: There are tendency relationship between higher breast density and higher fatty liver although statistically showed no significant relationship."