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Abstrak :
ABSTRAK Skrining maupun diagnostik mamografi merupakan pemeriksaan yang dianjurkan dalam mendeteksi kanker payudara sehingga dapat menurunkan angka mortalitas kanker payudara. Kekurangan mamografi adalah pada payudara dengan densitas tinggi yang banyak ditemui pada perempuan Indonesia. Pemeriksaan kombinasi mamografi dan USG dapat meningkatkan hasil sensitivitas dan spesifisitas deteksi lesi, namun tidak efisien dan efektif dalam segi pembiayaan dan waktu. Mengetahui hasil mamografi berdasarkan densitas payudara dan rasio volume lesi dan volume payudara berguna dalam optimalisasi penggunaan ultrasonografi dalam mendeteksi lesi.

Tujuan : Mengetahui penggunaan modalitas mamografi dan ultrasonografi dalam upaya mendeteksi lesi dan pengukuran rasio volume lesi pada pemeriksaan diagnostik payudara untuk efisiensi waktu dan biaya.

Metode : Menggunakan dua jenis disain penelitian yang saling terkait. Penilaian tingkat kesesuaian hasil temuan lesi berdasarkan pemeriksaan mamografi dengan ultrasonografi, dan mamografi saja dengan kombinasi mamogafi dan ultrasonografi dilakukan disain studi asosiasi. Untuk pengukuran rerata rasio volume lesi dan volume payudara menurut tingkat densitas payudara dilakukan dengan disain survei deskriptif. Kesimpulan : Deteksi lesi menggunakan mamografi pada payudara densitas a dan b dikombinasikan dengan ultrasonografi hanya dilakukan hanya bila perlu saja, namun pada payudara densitas c dan d dilakukan kombinasi dengan ultrasonografi. Volume lesi dan volume payudara dapat dicantumkan sebagai salah satu pertimbangan informasi tata laksana.

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ABSTRACT Mammography is recommended tool for breast cancer screening and diagnostic to decrease mortality. Lack of mammography in detecting lesions related with high breast density, which founded in Indonesian women. The use of diagnostic ultrasonography combined with mammography able to improve the specificity and sensitivity on lesions detection, but it has an issue with cost and time effective. Knowing the result of mammography based on breast density and the ratio of volume lesions and breast volume is useful in optimizing the use of ultrasonography in lesions detection. Purpose : To determine the ability of mammography and ultrasonography on lesion detection and assess the volume lesion ratio and breast volume with the purpose of cost and time efficient. Method : Using two related research design. Assessment of breast lesion findings based on mammography and ultrasonography and the combination findings were carried out with association study design, and the assessment of lesion volume ratio and breast volume was carried out with descriptive study design. Conclusion : The use of ultrasonography combined with mammography for lesions detection is carried out for breast density c and d. The implementation for this combination method for breast density a and b is only for necessary purpose. Lesions volume and breast volume can be included in the report as a consideration for therapy.

Abstrak :
Latar belakang: Kanker payudara pada wanita menjadi penyebab kejadian kanker tertinggi di dunia dengan jumlah kasus sebanyak 2,3 juta kasus dengan 685 ribu kematian. Sedangkan kejadian kanker pada wanita di Indonesia yang tertinggi adalah kanker payudara dengan prevalensi 42,1 per 100.000 penduduk dengan rata-rata kematian 17 per 100.000 penduduk. Oleh sebab itu, sangat diperlukan upaya pencegahan secara dini dengan melakukan pemeriksaan payudara sendiri (SADARI). Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan efikasi diri dengan perilaku pemeriksaan payudara sendiri pada mahasiswi. Metode: Metode kuantitatif dan desain cross-sectional. Sampel 257 mahasiswi S1 reguler di Universitas Indonesia. Hasil: Pada analisis univariat menunjukkan bahwa mayoritas mahasiswi melakukan SADARI, namun tidak melakukan secara rutin setiap bulan. Ada hubungan antara pengalaman keberhasilan, pengalaman orang lain, dukungan orang sekitar, keadaan fisiologis dan suasana hati, serta efikasi diri dengan perilaku SADARI. Variabel pengalaman keberhasilan tinggi 1,69x akan cenderung melakukan perilaku SADARI. Variabel pengalaman orang lain tinggi, 1,94x akan cenderung melakukan perilaku SADARI. Variabel dukungan orang sekitar tinggi 3,34x akan cenderung melakukan perilaku. Variabel keadaan fisiologis dan suasana hati memperlihatkan bahwa responden yang memiliki tingkat keadaan fisiologis dan suasana hati tinggi 3,32x akan cenderung melakukan perilaku SADARI. Variabel efikasi diri yang tinggi 7,65x akan cenderung melakukan perilaku SADARI ......Background: Breast cancer in women is the cause of the highest incidence of cancer in the world, with a total of 2.3 million cases and 685 thousand deaths. Meanwhile, breast cancer is the most common cancer in women in Indonesia, with a prevalence of 42.1 per 100,000 people and a death rate of 17 per 100,000 people. Therefore, early prevention efforts are needed through breast self-examination (BSE). Purpose: This study aims to determine the relationship between self-efficacy and breast self-examination behavior in female students. Methods: Quantitative method and cross-sectional design. A sample of 257 regular undergraduate students at the University of Indonesia. Results: According to the univariate analysis, the majority of female students took BSE but did not do so on a monthly basis. There is a relationship between the experience of success, the experiences of other people, the support of those around them, physiological states and moods, and self-efficacy with BSE behavior. The high success experience variable (1.69 times) is more likely to exhibit BSE behavior. Other people's variable experience is high; (1.94 times) more people will tend to do BSE behavior. The variable support of those around you is high, and they will tend to do the behavior (3.34 times). According to the physiological state and mood variables, respondents who have a high level of physiological state and mood (3.32 times) are more likely to engage in BSE behavior. A high self-efficacy variable (7.65 times) will tend to exhibit BSE behavior.

Abstrak :
Mamografi merupakan pemeriksaan baku emas dan merupakan modalitas satu-satunya untuk skrining payudara perempuan. Namun efektivitas mamografi menurun terutama pada payudara berdensitas padat. Handheld ultrasonography (HHUS) sering diperlukan sebagai pelengkap mamografi dan dapat meningkatkan sensitivitas dan spesifisitas untuk deteksi kanker payudara berdensitas padat. Automated breast ultrasound (ABUS) merupakan modalitas relatif baru dengan beberapa kelebihan dibandingkan dengan HHUS antara lain reproducible, variabilitas yang rendah, waktu akuisisi lebih singkat dan konsisten, serta ukuran transduser yang lebar sehingga mencakup payudara lebih menyeluruh dan dapat melakukan karakterisasi lesi yang ukurannya melebihi lebar transduser HHUS dengan lebih baik. Saat ini penggunaan ABUS belum merata di rumah sakit di Indonesia, dan penelitian mengenai ABUS masih terbatas, sehingga perlu dilakukan penelitian mengenai ABUS dibandingkan dengan modalitas lain secara lebih obyektif. Tujuan : Penelitian ini bertujuan untuk mengetahui kesesuaian temuan, morfologis, dan lokasi lesi di payudara berdasarkan densitas mamografi dan HHUS dengan densitas mamografi dan ABUS. Metode: Dilakukan pemeriksaan payudara menggunakan mamografi, HHUS GE tipe Logic S8 dengan transduser linear 7-12 MHz, dan ABUS GE Invenia dengan transduser konkaf linear 6-12 MHz. Seluruh pemeriksaan HHUS dan ABUS dilakukan sendiri oleh peneliti di Departemen Radiologi RSCM, dan dikonfirmasi oleh Dokter Spesialis Radiologi konsultan payudara bersertifikasi ABUS untuk menentukan ada atau tidaknya lesi, morfologis, dan lokasi lesi. Kesesuaian hasil pemeriksaan mamografi-ABUS dan mamografi HHUS dianalisis menggunakan uji Mc Nemar. Hasil: Terdapat 30 subyek penelitian dan diperoleh 48 sampel payudara, dengan rentang usia 36-66 tahun (rerata ± SD 51,4 ± 8,5 tahun). Dalam menentukan ada tidaknya lesi, pemeriksaan mamografi- HHUS dan mamografi-ABUS memiliki kesesuaian dengan level sedang (moderate agreement), nilai Kappa 0,43 dan 0,49 (p 0,002 dan p 0,001); dalam menentukan morfologis lesi memiliki kesesuaian dengan level sedang (moderate agreement) dengan nilai Kappa 0,51 dan 0,43 (p 0,000 dan 0,000); serta dalam menentukan lokasi lesi memiliki kesesuaian dengan level fair agreement dengan nilai Kappa 0,37 dan 0,36 (p 0,000 dan 0,000). Simpulan: Kombinasi mamografi-HHUS memiliki kesesuaian dengan level relatif setara dalam menentukan ada tidaknya lesi dan lokasi lesi, namun sedikit lebih tinggi dalam menilai morfologis lesi dibandingkan dengan kombinasi mamografi- ABUS. ......Background: Mammography is the gold standard and well known to be a powerful screening tool in the detection of breast cancer. However its sensitivity is reduced in women with dense breasts. Additionally, women with dense breasts have an increased risk of developing breast cancer while mammography has a lower sensitivity. Handheld ultrasonography (HHUS) is often needed as a adjunction to mammography, can increase sensitivity and specificity for detection of cancer in dense breast breasts. Automated breast ultrasound (ABUS) is a relative new modality with several advantages compared to HHUS including reproducible, low variability, shorter and consistent acquisition time, and a wide transducer size that covers the breast more thoroughly and can characterize lesions whose size exceeds the width of the transducer HHUS better. At present the use of ABUS is not evenly distributed in hospitals in Indonesia, and research on ABUS is still limited, so it is necessary to conduct research on ABUS compared to other modalities more objectively. Objective : This study aims to determine the alternative selection of HHUS and ABUS examination to detect abnormalities in the breast based on mammographic density. Method: Breast examination using mammography, HHUS GE Logic S8 with 7-12 MHz linear transducer, and GE Invenia ABUS with 6-12 MHz linear concave transducer. All HHUS and ABUS examinations are carried out solely by researchers in the Radiology Department of the RSCM, and are confirmed by an ABUS certified breast consultant radiologist to determine the presence, morphology, and location of the lesion. The suitability of ABUS mammography and HHUS mammography results were analyzed using the Mc Nemar test. Result: There were 30 subjects and 48 breast samples were obtained, with an age range of 36-66 years (mean ± SD 51.4 ± 8.5 years). In determining the presence or absence of lesions, examination of mammography- HHUS and mammography-ABUS is in accordance with moderate agreement and Kappa values 0.43 and 0.49 (p 0.002 and p 0.001); in determining the morphology of the lesion is in accordance with moderate agreement and Kappa value 0.51 and 0.43 (p 0,000 and 0,000); and in determining the location of the lesion is in accordance with fair agreement and Kappa values of 0.37 and 0.36 (p 0,000 and 0,000). Conclusion : The mammographic-HHUS combination is compatible with a relatively equal level in determining the presence or absence of the lesion and location of the lesion, but is slightly higher in assessing the morphology of the lesion compared with the mammographic- ABUS combination.

Abstrak :
Encompassing the entire spectrum of breast imaging and diagnostics, this acclaimed text provides a systematic and pragmatic guide for all clinicians involved in diagnosing breast disease. The new third edition has been fully updated to include advances in mammography, ultrasound, breast MRI, percutaneous interventions, and emerging technologies, with pros and cons and evidence-based approaches throughout. Special features of the third edition: Coverage of the field, with comprehensive sections on examination procedures and technical requirements; histologic, clinical, and radiologic appearance of a wide range of breast pathologies; results of international screening studies; and much more. Nearly 1,200 clear radiographic images showing normal findings, benign and malignant disorders, and post-traumatic, post-surgical, and post-therapeutic changes to the breast. Innovations in digital mammography, tomosynthesis, and computer assisted detection (CAD); new chapters on imaging of implants, lesions of uncertain malignant potential, developing technologies; and more. A systematic, highly reproducible methodology for detection, diagnosis, and assessment of findings. Easy-to-follow flowcharts for the diagnostic work-up of both typical and atypical cases. Written by world-renowned authorities with decades of clinical experience, this book provides a brilliant orientation to the multimodality diagnostic approach and therapeutic significance of breast imaging findings. It is an essential reference and board review for radiologists, residents and fellows, gynecologists, oncologists, surgeons, technologists, and any other interdisciplinary specialist working to improve outcomes in breast disease

Abstrak :
A practical guide for the diagnostic surgical pathologist, this new edition of Biopsy Interpretation of the Breast presents the diverse spectrum of pathologic alterations that occur in the breast in a manner analogous to that in which they are encountered in daily practice. Lesions are grouped together according to their histologic patterns rather than by the traditional benign-malignant categorization in order to simulate the way pathologists face these lesions as they examine microscopic slides on a daily basis. The role of adjunctive studies in solving diagnostic problems in breast pathology is emphasized where appropriate. In addition, the clinical significance and impact on patient management of the various diagnoses are discussed and key clinical and management points highlighted.

Abstrak :
This book provides comprehensive guidance to the assessment of symptoms, and how to manage all common breast conditions and provides guidelines on referral. It covers congenital problems, breast infection and mastalgia, before addressing the epidemiology, prevention, screening and diagnosis of breast cancer. It outlines the treatment and management options for breast cancer within different groups and includes new chapters on the genetics, prevention, management of high risk women and the psychological aspects of breast diseases. This 4th ed. remains a practical guide for general practitioners, family physicians, practice nurses and breast care nurses as well as for surgeons and oncologists both in training and recently qualified as well as medical students.

Abstrak :
A practical approach to the early detection and management of breast cancer. This lavishly illustrated atlas provides radiologists with essential information for the differential diagnosis of breast diseases on the basis of clinical presentation, mammography, and ultrasound. The book begins with chapters on tumor biology, prognostic factors, and histology. The authors then provide a thorough evaluation of various methods for early detection and accurate diagnosis, including analog and digital mammography, ultrasound, MR imaging, PET/​CT, and interventional procedures. They discuss in detail the strengths and limitations of each imaging modality, aspects of quality control, test intervals, peri- and postoperative management principles, and follow-up care.Highlights:- Presentation of difficult cases that effectively demonstrate the diagnostic hurdles and forensic pitfalls in breast diagnosis- Special sections on breast cancer in men and young women, with discussion of women who are pregnant or lactating- Color-coded practical tips and clinical notes for optimal comprehension of the material- Extensive Q&​A sections for self-testing in two major chapters

Abstrak :
Frozen section library : breast provides an easy reference and pocket book about the nuances of adequately handling breast specimens in a fashion that meets the increasingly complex environment of breast pathology. The pros and cons of frozen section versus use of touch imprint as well as related quality assurance requirements are addressed. Other less common uses of intraoperative evaluation, such as diagnosis and margin evaluation are described. The volume includes recommended guidelines for evaluation and documentation of specific gross pathologic features, in conjunction with radiological imaging. Techniques and protocols for such examinations are illustrated. The volume closes with an overview of the newly published guidelines for handling a variety of breast specimens, which are intended to be used for assessment of predictive factors.