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Abstrak :
Latar Belakang : Penggunaan terapi hormon memiliki efek samping pada payudara yang dapat terdeteksi pada ultrasonografi (USG) berupa peningkatan ketebalan jaringan fibroglandular yang berhubungan dengan peningkatan risiko kanker payudara. Hingga saat ini masih terdapat kontroversi mengenai efek samping terapi hormon tibolone terhadap payudara. Tujuan Penelitian : Mengetahui perubahan ketebalan jaringan fibroglandular payudara setelah terapi hormon tibolone. Metode : Penelitian ini berlangsung dari bulan Desember 2013 hingga Agustus 2015 di Departemen Radiologi RSUPN dr. Cipto Mangunkusumo dengan desain penelitian berupa studi kuasi eksperimental dengan amandemen berupa pengambilan data USG payudara sebelum dan sesudah terapi hormone tibolon. Pengukuran dengan USG payudara dilakukan di empat regio (superior, inferior, medial dan lateral) yang kemudian dilakukan analisis terhadap rerata perubahan ketebalan jaringan fibroglandular sebelum dan sesudah terapi hormon tibolone. Hasil : Dari 40 subjek yang dianalisis, terdapat 36 subjek yang mengalami peningkatan ketebalan jaringan fibroglandular. Terdapat perbedaan bermakna (p<0,001) pada ketebalan jaringan fibroglandular payudara sebelum dan sesudah 3 bulan pemberian tibolon. Indeks massa tubuh (p = 0,020) dan riwayat kontrasepsi hormonal (p=0,015) merupakan faktor yang memengaruhi peningkatan ketebalan jaringan fibroglandular payudara sesudah terapi hormon tibolon. Sedangkan paritas, usia melahirkan anak pertama, riwayat menyusui, usia menarke, usia menopause dan riwayat kontrasepsi hormonal tidak berhubungan. Kesimpulan : Terdapat peningkatan ketebalan jaringan fibroglandular berdasarkan pemeriksaan USG payudara perempuan menopause yang mendapat terapi hormon tibolone. ......Background : The use of hormone therapy has side effects in the breast which detected on ultrasound by increasing the thickness of breast fibroglandular tissue associated with increased risk of breast cancer. Until now there is still controversy regarding the side effects of tibolone on the breast tissue. Purpose : This study aims to determine the thickness changes of the fibroglandular tissue due to tibolone hormone therapy. Methods : This research was done between December 2013 untill August 2015 in Department of Radiology, dr. Cipto Mangunkusumo Hospital. Design of this research is a quasi-experimental study with the amendment in the form of data retrieval breast ultrasound before and after tibolon hormone therapy. Measurements with breast ultrasound was done in four regions (superior, inferior, medial and lateral) then the average change in fibroglandular thickness was analyzed. Results : Of the 40 subjects were analyzed, there were 36 subjects showed significant increase (p <0.001) of breast fibroglandular tissue thickness after 3 months of tibolone hormone therapy. The body mass index (p = 0.02) and a history of hormonal contraception (p = 0,01) were factors that influence the increase of fibroglandular thickness post tibolone hormone therapy. While parity, age of first child, history of breastfeeding, age of menarche, age of menopause and history of hormonal contraception were not related. Conclusions : There is an increase of fibroglandular tissue thickness by breast ultrasound examination of menopausal woman who received tibolone hormone theraphy.

Abstrak :
[ABSTRAK
Tujuan: 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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ABSTRACT
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., 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.]