Hasil Pencarian  ::  Simpan CSV :: Kembali

"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.

---

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"

"Latar belakang :Angka kekerapan rekonstruksi payudara pascamastektomi di Indonesia lebih kecil dibandingkan dengan angka kekerapan mastektomi, banyak faktor yang menyebabkan rendahnya angka kekerapan rekonstruksi antara lain faktor tingkat pengetahuan rekonstruksi payudara dan sikap terhadap rekonstruksi yang dimiliki oleh penderita kanker payudara.Tujuan : Untuk mendapatkan hubungan antara faktor demografik dan jenis spesialis bedah dengan tingkat pengetahuan dan sikap subyek terhadap rekonstruksi payudara.Metodologi : suatu studi potong lintang (cross sectional) yang melibatkan 96 subyek pasien kanker payudara yang sudah menjalani mastektomi (71 subyek) dan yang belum menjalani mastektomi (25 subyek) di divisi bedah onkologi RSCM,RS Dharma Nugraha dan RS Kanker Dharmais dalam kurun waktu Agustus sampai Desember 2005. Instrumen yang digunakan didalam penelitian adalah kuesioner yang dibuat sendiri untuk mengetahui tingkat pengetahuan rekonstruksi dan sikap terhadap rekonstruksi. Data yang terkumpul dilakukan analisa dan uji statistik bivariat dan multivariat dengan komputer menggunakan program SPSS 11,5 Windows.Hasil : Hanya satu subyek yang memiliki tingkat pengetahuan baik, sebagian besar subyek (92%) memberikan sikap positif terhadap rekonstruksi payudaraVariabel yang memiliki hubungan dengan tingkat pengetahuar. adalah jenis spesialis bedah yang melakukan operasi (p = 0,016). Faktor demografik dan jenis spesialis bedah tidak memengaruhi sikap terhadap rekonstruksi.Simpulan : Pasien yang mendapat pelayanan spesialis bedah tumor memiliki pengetahuan lebih baik bila dibandingkan dengan subyek yang mendapat pelayanan dari spesialis bedah atau fellow bedah tumor.Kata kunci : Kanker payudara, rekonstruksi payudara, spesialis bedah tumor, pengetahuan , sikap.

---

Back ground: The prevalence of breast reconstruction post mastectomy in Indonesia is very rare (underreported) comparing with the prevalence of mastectomy alone, Many factors were reported had responsible for the low incidence breast reconstruction such as breast reconstruction knowledge level or attitude toward breast reconstruction.

Purpose: To search for correlation between demographic factors and type of surgeon who did the surgery with the patient's breast reconstruction knowledge level and patient's attitude toward breast reconstruction.

Methodology: A cross sectional study was done from October through December 2005, a total of 96 subjects who had breast cancer, 71 subjects underwent mastectomy and 25 subjects who did not. The research was done at RSCM, Dharma Nugraha hospital and Dharmais hospital.Self made questionnaire was used to establish the knowledge level and attitude toward breast reconstruction. Analysis of variables was done by bivariate analysis and multivariate analysis with logistic regression using SPSS 11, 5 Windows program. Result: There was the only one subject had a good knowledge level about breast reconstruction but most of the subjects had positive attitude toward breast reconstruction. The only significant variable for the patient's knowledge level is the type of surgeon who did the surgery (p = 0,016).

Conclusion: The subjects whom were taken care by oncology surgeon had breast reconstruction knowledge level better than the subjects whom were taken care by general surgeon or fellow oncology surgeon.

Keywords: Breast cancer, breast reconstruction, oncology surgeon, knowledge, attitude."

"Latar Belakang: Kanker payudara adalah salah satu keganasan yang paling sering dan penyebab utama kematian terkait kanker pada perempuan. Ultrasonografi (USG) merupakan modalitas radiologis yang paling banyak dipakai dan banyak tersedia untuk menilai kelainan payudara. Pemeriksaan imunohistokimia bertujuan untuk mengetahui karakteristik molekular kanker payudara di antaranya adalah subtipe luminal A dan luminal B. Hasil imunohistokimia menjadi dasar dalam pemberian terapi dan prognosis pasien kanker payudara, namun pemeriksaan tersebut belum tersedia secara luas. Data temuan morfologis lesi berdasarkan USG payudara dalam membedakan kanker payudara subtipe luminal A dan luminal B masih terbatas dan memberikan hasil yang bervariasi. Penelitian ini bertujuan untuk mengetahui temuan morfologis lesi berdasarkan USG payudara yang dapat membedakan kanker payudara subtipe luminal A dan luminal B.Metode: Studi retrospektif ini melibatkan subyek dengan kanker payudara yang belum mendapat terapi serta memiliki data USG dan data imunohistokima subtipe luminal A dan luminal B. Dilakukan analisis menggunakan uji Chi Square antara temuan morfologis USG (echogenic rim, batas spikulasi, posterior shadowing, dan indeks Adler) dengan imunohistokimia subtipe luminal A dan luminal B. Hasil: Diperoleh 188 subyek dengan usia rerata subyek 49,4 tahun, nilai median ukuran lesi 6 cm, dan sebesar 68% subyek adalah stadium lokal lanjut. Proporsi kelompok luminal B 62% sedangkan luminal A 38%. Terdapat perbedaan bermakna antara stadium kanker payudara dengan kelompok subtipe luminal (p = 0,014). Ditemukan perbedaan yang bermakna antara morfologis lesi echogenic rim dengan kelompok luminal, dengan nilai p = 0,03 dan OR 1,94 (95% CI 1,06 – 3,55). Pada analisis subyek usia ≥ 50 tahun ditemukan perbedaan proporsi yang signifikan pada ukuran tumor (p = 0,043), stadium (p = 0,001), echogenic rim (p = 0,05), dan penebalan kutis subkutis (p = 0,007). Simpulan: Proporsi temuan echogenic rim berdasarkan USG payudara di kelompok kanker payudara subtipe luminal A secara bermakna lebih tinggi dibandingkan subtipe luminal B. Adanya lesi dengan echogenic rim maka kemungkinan untuk diagnosis kanker payudara subtipe luminal A adalah 1,94 kali dibandingkan lesi tanpa echogenic rim.

---

Background: Breast cancer is one of the most common malignancies and the leading cause of cancer-related death in women. Ultrasonography (USG) is the most widely used radiology modality for assessing breast abnormalities. Immunohistochemistry examination allow to determine the molecular characteristics of breast cancer, includes luminal A and luminal B subtypes. The results are used as the treatment guidance and prognosis, but these tests are not widely available. The study of morphologic lesions based of breast ultrasound to differentiate luminal A and luminal B subtypes of breast cancer are still limited and give varied results. The aim of this study is to determine the morphologic lesions on breast ultrasound that can be used to differentiate luminal A and luminal B subtype.

Method: A retrospective study was conducted by reviewing imaging of subjects with untreated breast cancer who had undergone ultrasound examination and immunohistochemistry examination of luminal A and luminal B subtypes. Chi Squared test was performed to evaluate the relationship between morphological findings of ultrasound (echogenic rim, spiculation, posterior shadowing, and Adler's index) and luminal A and luminal B subtypes breast cancer.

Result: Total subject was 188 with the mean age of the subjects was 49,4 years, the median value of the lesion size was 6 cm, and 68% of the subjects were locally advanced stage. Luminal B group was 62% of the subject while luminal A was 38%. There was a significant difference between the stage of breast cancer and the luminal subtype group (p = 0,014). A significant difference also was found between the echogenic rim lesions and the luminal group, with p value = 0,03 and OR 1,94 (95% CI 1,06 – 3,55). In the subgroup analysis (aged ≥ 50 years), also noted that there were significant differences in the proportion of tumor size (p = 0,043), stage (p = 0,001), echogenic rim (p = 0,05), and skin thickening (p = 0,007).

Conclusion: The proportion of echogenic rim findings in the luminal A subtype breast cancer group was significantly higher than the luminal B subtype. The presence of a lesion with an echogenic rim means the probability of a diagnosis of luminal A subtype breast cancer is 1,94 times compared to lesion without an echogenic rim."

"Pendahuluan: Kanker payudara adalah keganasan paling sering terjadi pada perempuan dan merupakan penyebab kematian tertinggi di Indonesia. Evaluasi dapat dilakukan pemeriksaan USG guna menentukan karakteristik lesi. Pemeriksaan indeks proliferasi Ki-67 berperan dalam menentukan prognosis dan memprediksi keberhasilan neoadjuvant chemotherapy pada kanker payudara. Namun distribusi pemeriksaan indeks proliferasi Ki-67 belum merata, sedangkan, pemeriksaan USG sudah cukup banyak di tempat pelayanan kesehatan di Indonesia karena pemeriksaannya yang mudah dengan harga yang relatif murah. Data untuk mengevaluasi kesesuaian karakteristik lesi kanker payudara pada USG dengan indeks proliferasi Ki-67 masih sangatlah terbatas. Tujuan: Mengetahui kesesuaian pada karakteristik morfologis USG dengan indeks proliferasi Ki-67 untuk menentukan faktor prognosis. Metode: Dilakukan pembacaan ulang hasil USG 96 pasien yang didapatkan dari PACS, dicatat bentuk lesi, batas lesi, orientasi lesi, pola ekogenitas, posterior lesi, kelenjar limfe, vaskularisasi dan kalsifikasi. Kemudian dicatat hasil indeks proliferasi Ki-67 dan dikelompokan berdasarkan Tashima, dkk yaitu rendah (< 20%) dan tinggi (≥ 20%). Analisis dilakukan dengan uji Mc Nemar disertai analisis Kappa Cohen dan Konkordansi.Hasil: Pada uji Mc nemar, penilaian karakteristik ultrasonografi kanker payudara dengan hasil Ki-67 yang tidak terdapat perbedaan bermakna secara statistik (p > 0,05) adalah temuan vaskularisasi ( n = 0,405). Pada analisis Kappa Cohen, tidak terdapat asosiasi antara temuan ultrasonografi kanker payudara dengan hasil Ki-67 < 20% dan ≥ 20%. Pada analisis Konkordansi, terdapat kesesuaian lemah (50 %-65%) antara hasil temuan posterior lesi (51,3%) dan kalsifikasi (51,0%) dengan hasil Ki-67 < 20% dan ≥ 20%, terdapat pula kesesuaian sedang (65%-80%) antara hasil temuan bentuk lesi (72,9%), batas lesi (76,0%), kelenjar limfe (71,6%) dan vaskularisasi (71,6%). Simpulan: Dari 8 karakteristik morfologi USG yang diperiksa, hanya vaskularisasi yang tidak berbeda bermakna dengan Ki-67, sehingga hanya vaskularisasi yang sesuai dengan ekspresi Ki-67.

---

Introduction: Breast cancer is the most common malignancy in women and is the leading cause of death in Indonesia. USG examination can be done to determine the characteristics of the lesion. The examination of the Ki-67 proliferation index plays a role in determining prognosis and predicting the success of neoadjuvant chemotherapy in breast cancer. However, the distribution of the Ki-67 proliferation index examination has not been evenly distributed, meanwhile, USG examination are quite common in health care centers in Indonesia because of the easy examination at a relatively cheap price. The data to evaluate the suitability of the characteristics of breast cancer lesions on ultrasound with the Ki-67 proliferation index are still very limited.

Purpose: Determine whether there is agreement on the morphological characteristics of USG with the Ki-67 proliferation index to determine prognostic factors. Methods: Re-expertise the USG results of 96 patients obtained from PACS, noted the shape, the margin and the orientation of the lesion, also the echo pattern, the posterior lesions, the lymph nodes, vascularization and calcification. Then performed recording the results of the Ki-67 proliferation index and grouped according to Tashima et al, divided into low (<20%) and high (≥ 20%). The analysis was carried out by using the Mc Nemar test accompanied by Kappa Cohen's analysis and Concordance.

Results: In the Mc Nemar test, the assessment of the characteristics of the ultrasound findings of breast cancer with a Ki-67 index that did not have a statistically significant difference (p> 0.05) was a finding of vascularity (n = 0.405). In Cohen's Kappa analysis, there was no association between breast cancer ultrasound findings and Ki-67 index <20% and ≥ 20%. In the concordance analysis, there was a weak agreement (50% -65%) between the findings of posterior lesions (51.3%) and calcification (51.0%) with Ki-67 index <20% and ≥ 20%, there was also moderate agreement (65% -80%) between the findings of the lesion shape (72.9%), the margin of the lesion (76.0%), lymph nodes (71.6%) and vascularization (71.6%).

Conclusion: From 8 morphological characteristics of USG examined, only vascularization was not significantly different from Ki-67, so only vascularity was in accordance (match) with Ki-67 expression."

"Latar Belakang: Kanker payudara merupakan keganasan yang dapat bermetastasis ke kelenjar limfe aksila dan/atau organ jauh. Studi-studi sebelumnya menunjukkan terdapat kaitan antara sejumlah morfologi mamogram dan gambar ultrasonografi (USG) payudara dengan adanya metastasis kelenjar limfe. Seringkali pasien dengan kecurigaan kanker payudara diperiksakan di rumah sakit ketika sudah dalam stadium lanjut atau bahkan terdapat metastasis yang seharusnya dapat dideteksi lebih awal. Mamografi dan USG payudara merupakan modalitas radiologis yang mudah untuk dikerjakan untuk diagnosis kanker payudara dan tersedia di banyak rumah sakit. Sampai saat ini, belum ada penelitian mengaitkan secara langsung temuan morfologis mamografi dan USG payudara pada pasien kanker payudara yang mengalami metastasis. Tujuan: Mengetahui perbedaan temuan morfologis mamografi dan USG payudara pada pasien kanker payudara dengan metastasis dengan pasien kanker payudara tanpa metastasis di RSUPN Dr. Cipto Mangunkusumo (RSCM). Metode: Dilakukan pembacaan ulang hasil mamogram dan gambar USG payudara dari 112 pasien yang didapatkan dari sistem Picture Archiving and Communication System (PACS) di Departemen Radiologi RSCM dengan klinis karsinoma payudara berdasarkan patologi anatomi. Data riwayat pasien didapatkan dengan melihat catatan di rekam medis melalui Electronic Health Record (HER) atau Hospital Information System (HIS). Dilakukan analisis pada usia dan karakteristik morfologis lesi meliputi variabel bentuk lesi, ukuran terbesar lesi, jarak tumor ke kutis, adanya kalsifikasi, jenis kalsifikasi, distribusi kalsifikasi, dan adanya distorsi arsitektur pada mamogram, dan bentuk lesi, ukuran terbesar lesi, jarak tumor ke kutis, vaskularisasi lesi, adanya kalsifikasi, dan adanya distorsi arsitektur pada gambar USG payudara menggunakan uji Chi-Square atau Fisher. Dilakukan juga analisis multivariat regresi logsitik pada variabel yang signifikan secara statistik menggunakan metode backward yang disajikan dalam bentuk odds ratio (OR). Hasil: Terdapat perbedaan yang bermakna secara statistik pada variabel usia (p=0,032), ukuran terbesar lesi pada mamogram (p<0,001), jarak tumor ke kutis pada mamogram (p=<0,001), ukuran terbesar lesi pada gambar USG payudara (p<0,001), dan jarak tumor ke kutis pada gambar USG payudara (p=0,001) antara pasien kanker payudara dengan metastasis dengan tanpa metastasis. Pada analisis multivariat gabungan temuan morfologis mamogram dan gambar USG payudara, didapatkan perbedaan bermakna secara statistik pada ukuran terbesar lesi pada mamogram dengan nilai OR 3,73 (p=0,003) dan jarak tumor ke kutis pada mamogram dengan nilai OR 3,34 (p=0,006). Simpulan: Terdapat perbedaan bermakna temuan mamogram dan USG payudara yaitu masing-masing ukuran terbesar lesi>5 cm dan jarak tumor ke kutis ≤0,5 cm dengan adanya metastasis pada kanker payudara. Temuan ukuran terbesar lesi>5 cm dan jarak tumor ke kutis ≤0,5 cm pada mamogram dapat memprediksi kemungkinan terjadinya metastasis pada kanker payudara.

---

Background: Breast cancer is a malignancy that can metastasize to axillary lymph nodes and distant organs. Previous studies have shown an association between the morphological findings of mammograms and ultrasound images of the breast and the presence of lymph node metastasis. Patients with suspected breast cancer are often examined in the hospital when they are in an advanced stage or even have metastasis that should have been detected earlier. Mammography and breast ultrasound are radiological modalities that are easy to perform to diagnose breast cancer and are available in many hospitals. To date, no studies have directly compared the morphological findings of mammography and breast ultrasound in patients with metastatic breast cancer. Purpose: To identify the differences in the morphological findings of mammography and breast ultrasound in breast cancer patients with metastasis compared to those without metastasis at Dr Cipto Mangunkusumo General Hospital (RSCM). Methods: Mammogram results and breast ultrasound images from 112 patients diagnosed with breast carcinoma based on anatomical pathology were obtained from the Picture Archiving and Communication System (PACS) at the Department of Radiology RSCM. The images were then reviewed. Patient history is obtained from the Electronic Health Record (EHR) or Hospital Information System (HIS). Analyzes were performed on age and morphological characteristics of the lesion, including the shape of the lesion, the largest diameter of the lesion, the distance of the tumor to the skin, the presence of calcification, the type of calcification, the distribution of calcifications, and the presence of architectural distortion on mammograms, and the shape of the lesion, the largest diameter of the lesion, the distance of the tumor to the skin, the vascularity of the lesion, the presence of calcification, and the presence of architectural distortion on breast ultrasound images using Chi-Square or Fisher method. Multivariate logistic regression analysis was also conducted on statistically significant variables using the backward method, which was presented as an odds ratio (OR). Results: There was a statistically significant difference in age (p=0,032), the largest diameter of the lesion on the mammogram (p<0,001), the distance of the tumor to the skin on the mammogram (p<0,001), the largest diameter of the lesion on breast ultrasound (p<0,001), and the distance of the tumor to the skin on breast ultrasound images (p=0,001) between metastatic and non-metastatic breast cancer patients. In the multivariate analysis of the combination of morphological findings of the mammogram and breast ultrasound images, there were statistically significant differences in the largest diameter of the lesion on mammograms with an OR value of 3.73 (p=0,003) and the distance of the tumor to the skin on mammograms with an OR value of 3.34 (p= 0,006). Conclusion: There is a significant difference in mammogram and breast ultrasound findings, such as the largest diameter of the lesion >5 cm and the distance of the tumor to the skin ≤0,5 cm with the presence of metastasis in breast cancer. The findings of the largest diameter of the lesion >5 cm and the distance of the tumor to the skin ≤0,5 cm on the mammogram can predict the probability of metastasis in breast cancer."

"Latar Belakang: Mastitis adalah inflamasi kelenjar payudara dengan berbagai macam etiologi yang mendasarinya mulai dari infeksi, non infeksi serta inflamasi akibat keganasan payudara. Kanker payudara adalah penyebab kematian terbanyak pada perempuan di dunia maupun di Indonesia. Gambaran klinis dan radiologis mastitis non-maligna dapat tumpangtindih dengan gambaran keganasan payudara. Sehingga diperlukan korelasi gambaran radiologis dan patologi anatomi serta evaluasi karakteristik morfologis yang lebih detil lesi payudara pada mastitis non-maligna dan kanker payudara, berupa pemeriksaan ultrasonografi (USG) sebagai salah satu modalitas radiologis yang cukup terjangkau, tanpa radiasi dan efisien sehingga penatalaksanaan pasien dapat lebih optimal. Tujuan: Mengetahui perbedaan temuan USG pada mastitis non-maligna dan kanker payudara berdasarkan patologi anatomi di RSUPN Dr. Cipto Mangunkusumo. Metode: Dilakukan pembacaan ulang hasil USG 110 pasien yang didapatkan dari sistem PACS di Departemen Radiologi dengan klinis tumor payudara T1-T3 dan atau mastitis non-maligna yang telah dilakukan pemeriksaan patologi anatomi di RSUPN Dr. Cipto Mangunkusumo. Data riwayat pasien didapatkan dengan melihat catatan rekam medis. Dilakukan analisis pada variabel kualitatif (usia, riwayat laktasi dan temuan tanda inflamasi) dan karakteristik temuan lesi pada USG terhadap hasil patologi anatomi yang dinilai dengan uji komparatif chi square atau fischer. Dilanjutkan analisis multivariat regresi logistik variabel yang signifikan secara statistik dengan metode enter dan backward disajikan dalam bentuk oddsratio. Hasil: Terdapat perbedaan yang bermakna secara statistik pada variabel usia (p = 0,000), gambaran posterior accoustic lesi (p = 0,000), temuan ill defined fluid collection (p = 0,001), temuan rongga abses (p = 0,013) dan morfologi kelenjar limfe (p = 0,000) antara mastitis non-maligna dengan kanker payudara. Analisis multivariat variabel temuan USG mencakup gambaran posterior lesi, penebalan kulit, ill defined fluid collection, rongga abses, kelenjar limfe dan dilatasi duktus retroareolar. Didapatkan perbedaan bermakna secara statistik pada temuan USG ill defined fluid collection dengan nilai odds ratio 0,07 (p = 0,006) dan kelenjar limfe maligna dengan nilai odds ratio 11,17 (p = 0,001) terhadap kejadian kanker payudara. Simpulan: Terdapat perbedaan bermakna temuan USG pada mastitis non-maligna dengan kanker payudara yaitu pada gambaran posterior accoustic lesi, temuan ill defined fluid collection, temuan rongga abses dan morfologi kelenjar limfe. Temuan USG kelenjar limfe morfologi maligna bisa memprediksi kemungkinan terjadinya keganasan. Sedangkan temuan USG berupa ill defined fluid collection memiliki resiko rendah terhadap kejadian keganasa

---

Background: Mastitis is an inflammation of the breast glands with various underlying etiologies range from infection, non-infection and inflammation due to breast cancer.

Breast cancer is the leading cause of death in women in the world and also in Indonesia.

The clinical and radiological features of non-malignant mastitis may overlap with those of breast cancer. Therefore, it is necessary to correlate radiological images and anatomical pathology as well as more detailed evaluation morphological characteristics of breast lesions in non-malignant mastitis and breast cancer, by utilize ultrasonography (USG) as

one of the radiological modalities that is quite affordable, without radiation and efficient.

Therefore patient management can be more optimal. Purpose: Knowing the difference in ultrasound findings of non-malignant mastitis with breast cancer based on anatomical pathology at Cipto Mangunkusumo General Hospital. Methods: Ultrasound images of 110 patients obtained from the PACS system in the Radiology Department with clinical diagnosis breast tumor T1-T3 and / or non-malignant mastitis who has been examined for anatomical pathology at Cipto Mangunkusumo General Hospital are reevaluated. Patient history data is obtained by looking at medical records. Analyzes of qualitative variables (age, history of lactation and findings of signs of inflammation) and the characteristics of the lesion findings on ultrasound based on anatomical pathology were presented using chi square or fischer comparative test. Multivariate logistic regression analysis of statistically significant variables using the enter and backward methods presented in the form of odds ratios. Results: There were a statistically significant difference in the variable age (p = 0.000), posterior acoustic lesion (p = 0.000), ill defined fluid collection (p = 0.001), abscess cavity (p = 0.013) and lymph node morphology (p. = 0.000) between nonmalignant mastitis and breast cancer. Multivariate analysis of the ultrasound findings including posterior features of the lesion, skin thickening, ill-defined fluid collection, abscess cavity, lymph nodes and retroareolar duct dilatation. There were a statistically significant difference in the findings of USG ill defined fluid collection with an odds ratio 0.07 (p = 0.006) and malignant lymph nodes with an odds ratio 11.17 (p = 0.001) on the incidence of breast cancer. Conclusions: There were significant differences in ultrasound findings of non-malignant mastitis with breast cancer, including age, posterior acoustic lesion, ill defined fluid collection finding, abscess cavity and the lymph node morphology. Malignant morphology of lymph nodes can predict the possibility of malignancy. Meanwhile, USG findings in the form of an ill defined fluid collection have a low risk of malignancy."

"Kanker payudara masih menjadi salah satu jenis kanker yang paling sering dihadapi oleh masyarakat dunia, termasuk di Indonesia. Sampai saat ini, belum ditemukan penyebab pasti kanker payudara tetapi hanya berbagai kemungkinan faktor risiko. Salah satu faktor risiko yang diduga berkaitan dengan kanker payudara adalah jumlah paritas. Pada penelitian ini dilakukan analisis mengenai hubungan faktor jumlah paritas dengan kejadian kanker payudara pada wanita di RSUPN Dr. Cipto Mangunkusumo Jakarta tahun 2010-2014. Studi desain yang digunakan adalah potong lintang dengan sampel yang berjumlah 123 kasus yang diperoleh dengan cara random sampling. Data didapatkan dari data rekam medik pasien berdasarkan hasil pemeriksaan patologi anatomik dan dilakukan uji analisis dengan uji Fisher. Hasil yang didapatkan adalah secara statistik jumlah paritas tidak memiliki hubungan yang bermakna terhadap kejadian kanker payudara pada wanita di RSUPN Dr. Cipto Mangunkusumo Jakarta tahun 2010-2014 p>0,05.

---

Breast cancer remains as one of the many types of cancer that is commonly faced in all countries, including Indonesia. To this day, the leading cause of breast cancer has not yet been found but there are evidences of the probability on risk factors. One of the risk factors that may be related to breast cancer is the number of parity. This study analyzes the relationship between number of parity and breast cancer in woman at Dr. Cipto Mangunkusumo National General Hospital Jakarta in 2010 ndash 2014.

The study design that is used is cross sectional with 123 cases which were obtained using random sampling. Data were acquired from the patient rsquo s medical records based on their anatomical pathology examination results and were analyzed using Fisher test. The result is that statistically the number of parity doesn rsquo t have a significant relation to breast cancer in woman at Dr. Cipto Mangunkusumo National General HospitalJakarta in 2010 ndash 2014 p 0,05."

"Kanker payudara merupakan salah satu jenis kanker yang paling sering terjadi pada perempuan di Indonesia. Berbagai faktor risiko dapat meningkatkan peluang terjadinya kanker payudara. Faktor hormonal dicurigai menjadi salah satu faktor penting dalam kejadian kanker payudara. Tujuan penelitian ini adalah untuk mengetahui hubungan usia saat menstruasi pertama dengan kejadian kanker payudara di RSUPN Dr. Cipto Mangunkusumo Jakarta tahun 2010-2014. Penelitian ini adalah penelitian retrospektif dengan studi desain cross sectional dengan pengambilan sampel secara random sampling. Sampel yang digunakan sebanyak 98 kasus. Data diambil dari Arsip Departemen Patologi Anatomik FKUI-RSCM dengan penelusuran di bagian Unit Rekam Medik dan Departemen Ilmu Bedah RSUPN Dr. Cipto Mangunkusumo Jakarta. Sampel penelitian dianalisis dengan uji chi square kemudian uji Fisher. Hasil yang didapat adalah faktor risiko usia saat menstruasi pertama tidak berpengaruh terhadap kejadian kanker payudara di RSUPN Dr. Cipto Mangunkusumo Jakarta tahun 2010-2014 p>0,05.

---

Breast cancer is one of the most common cancer among Indonesian females. Many risk factors can increase the chance of developing breast cancer. Hormonal factor seems to play a role in many cases of breast cancer. The aim of this research is to determine the relationship between age at menarche and breast cancer in Dr. Cipto Mangunkusumo National General Hospital Jakarta in 2010 2014. The retrospective research is using cross sectional design study with random sampling technique. There are 98 samples. The samples were taken in Archive Unit of Anatomical Pathology of FMUI with a further investigation in Medical Record Unit and Medical Department of Surgery in Dr. Cipto Mangunkusumo National General Hospital Jakarta. The data were analyzed by using chi square test then Fisher test. There is no significant effect between age at menarche and breast cancer in Dr. Cipto Mangunkusumo National General Hospital Jakarta in 2010 2014 p 0,05."

"Kanker payudara merupakan jenis kanker dengan prevalensi tertinggi di Indonesia pada pasien wanita. Penggunaan kontrasepsi oral pada wanita usia reproduktif merupakan salah satu pilihan kontrasepsi yang sering digunakan di Indonesia. Pada tahun 2012, angka kematian akibat kanker payudara meningkat sebesar 20 jika dibandingkan dengan angka kematian pada tahun 2008. Penelitian ini dilakukan untuk mengetahui hubungan pemakaian kontrasepsi oral terhadap kejadian kanker payudara pada pasien wanita di RSUPN Cipto Mangunkusumo pada tahun 2010-2014. Pada penelitian dengan desain studi potong lintang cross sectional ini, data diambil dari unit arsip Departemen Patologi Anatomik FKUI-RSCM sesuai dengan hasil uji histopatologik, kemudian ditelusuri ke Unit Rekam Medik RSCM sebagai data sekunder yang diolah menggunakan uji Fisher menggunakan SPSS versi 21. Hasil penelitian menunjukan nilai p = 0.03 dari 88 data yang terkumpul. Dari penelitian ini, dapat disimpulkan bahwa penggunaan kontrasepsi oral memiliki hubungan yang bermakna dengan kejadian kanker payudara pada pasien wanita di RSUPN Cipto Mangunkusumo pada tahun 2010-2014.

---

Breast cancer is one of the most prevalence types of cancers among women in Indonesia. Oral contraceptive consumption in reproductive age is one of the favorable choices for contraception in Indonesia. In 2012, the mortality rate increases to 20 compared with the mortality rate in 2008. The aim of this study is to find the relationship between oral contraceptive consumption and the occurrence of breast cancer among female patients in Cipto Mangunkusumo Hospital in 2010 2014. This cross sectional study is using collected secondary data taken from patients rsquo medical record based on patients rsquo histopathological examination results that can be analyzed using Fisher test with SPSS version 21. The result of this research shows p value that is 0.03 collected from 88 datas. From this research, it can be concluded that oral contraceptive consumption has statistically significant association on the occurence of breast cancer among female patients in Dr. Cipto Mangunkusumo National General Hospital in 2010 2014."

"[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.

---

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.]"