Clinicopathological aspects of breast cancer: A joint study between Indonesia and Japan

  • Didid Tjindarbumi Department of Surgery, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta.
  • Muchlis Ramli Department of Surgery, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta.
  • Susumu Watanabe Departement of Surgery, Cancer Institute, Tokyo 170.
  • Idral Darwis Department of Surgery, Faculty of Medicine, Universitas Indonesia Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta.
  • Goi Sakamoto Departement of Pathology, Cancer Institute, Tokyo 170.
  • Santoso Cornain Department of Anatomic Pathology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430
  • Gunawan Tjahjadi Department of Anatomic Pathology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430
  • Esti Soetrisno Department of Anatomic Pathology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430
  • Yoshiyuki Ohno Department of Preventive Medicine, School of Medicine, Nagoya University, Nagoya 466.
  • Endang S. Roostini Department of Anatomic Pathology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430
  • Joedo Prihartono Department of Community Medicine, Faculty of Medicine, Universitas lndonesia, Jakarta 10320.
  • Sadao Suzuki Department of Preventive Medicine, School of Medicine, Nagoya University, Nagoya 466.
  • Setyawati Budiningsih Department of Community Medicine, Faculty of Medicine, Universitas lndonesia, Jakarta 10320.
  • Kenzi Wakai Department of Preventive Medicine, School of Medicine, Nagoya University, Nagoya 466.
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Abstract

Masalah penatalaksanaan klinik dari kanker payudara tetap penting dalam hal diagnosis dan pengobatan. Telah disarankan oleh penelitian-penelitian terdahulu bahwaperlu dipikirkan dua subset kankerpayudara, yaitu penyakit yang agresif danyang pertumbuhan­ nya tidak nyata secara klinis (indolen). Oleh karena itu, penelitian aspek klinikopatologik kankerpayudara berkaitan denganfenomena semacam itu menjadi penting untuk dilakukan pada wanita Indonesia juga. Bersamaan dengan penelitian epidemiologik secara kasus-kontro 300 kasus kanker payudara telah dianalisa terhadap aspek klinikopatologiknya. Semua kasus dievaluasi secara klinis menggunakan klasifikasi intemasional TNM dan Manchester yang baku dan secara histopatologik menggunakan modifikasi klasifikasi WHO seperti yang dianjurkan oleh Perhimpunan Kanker Payudara Jepang. Protokol penatalaksanaan kanker payudara dari Perhimpunan Ahli Bedah Onkologi Indonesia yang disesuaikan dengan pedoman yang diterima secara luas diterapkan seperlunya. Hasilnya menunjukkan bahwa kasus-kasus kanker payudara paling sering ditemukan pada golongan umur dibawah 35 tahun dan di antara 40 dan 44 tahun. Sebagian besar (87 %)pada stadium lanjut (stadium IJIA, IIIB dan!V) sedangkan hanya 13 % pada stadium dini (stadium I,2,3 dan stadium 4). Di antara 300 kasus hanya 110 kasus yang operabel. Prosedur bedah yang diterapkan adalah sebagai berikut: mastektomi radikal pada 50 kasus (16.6 %), mastektomi sederhana pada 40 kasus (13.37 %) dan bedah konservasi payudara pada 2 kasus (0.67 %). Kejangkitan kelenjar getah bening ditemukan pada 20 dari 50 kasus dengan mastektomi radika dan jumlah rata-rata kelenjar getah bening yang didiseksi adalah 6.8. Sebagian besar (88.33 %) adalah karsinoma duktal invasif dan sisanya jenis khusus (9.67 %) dan karsinoma non-invasif (1.33 %). Dua kasus (0.67 %) adalahpenyakit Paget payudara. Di antara karsinoma duktal invasif jenis skirus merupakan jenis yang paling sering (49 %). Abstracts Theproblem of clinical management of breast cancer remains important in respect toboth diagnosis and treatment. It has been suggested from earlier studies that two subsets of breast cancer might be considered, namely the agressive disease and the indolent one. Therefore, the study of clincicopathological aspects of breast cancer in respect to suchphenomena became important to be conducted in Indonesian females as well. In parallell to the epidemiological case-control study, 300 breast cancer cases have been analyzed for their clinicopathological aspects. All cases were evaluated clinically using standard International TNM and Manchester Classification and histopathologically using modified WHO classification as recommended by the Japanese Breast Cancer Society. Breast cancer management protocols of the Indonesian Surgical Oncology Association as adapted from the widely accepted standards were applied accordingly. The results showed that the breast cancer cases were mostly found in the age group under 35 years and between 40 to 44 years. The majority (87 %) were in advanced stage (stage II/A, IIIB and IV) while only 13 % were in early stage (stage I, JI). Out of 300 cases only 110 cases were operable. The surgical procedures which were applied were asfollows: radical mastectomy on 50 cases (16.6 %), simple mastectomy on 40 cases (13.37 %) and breast conserving surgery on 2 cases (0.67 %). Lymph node involvement was found in 20 out 50 cases with radical mastectomy, and the average number of dissected lymph nodes were 6.8. The majority (88.33 %) was of invasive ductal carcinoma and the rest were special types (9.67 %) and non-invasive carcinoma (1.33 %). Two cases (0.67 %) were Paget' s disease of the breast. Among the invasive ductal carcinoma the scirrhous type was the most common type (49 %). Keywords: breast cancer, clinicopathological aspects, surgical procedures
Published
1995-07-01
How to Cite
1.
Tjindarbumi D, Ramli M, Watanabe S, Darwis I, Sakamoto G, Cornain S, Tjahjadi G, Soetrisno E, Ohno Y, Roostini ES, Prihartono J, Suzuki S, Budiningsih S, Wakai K. Clinicopathological aspects of breast cancer: A joint study between Indonesia and Japan. Med J Indones [Internet]. 1995Jul.1 [cited 2020Oct.25];4(3):148-55. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/911
Section
Medical Journal of Indonesia

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