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Indria Purnama Sari
"[ABSTRAK
Tujuan: 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%.

ABSTRACT
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%., 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%.]"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Wanita Idola
"[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.

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.]"
2015
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Jons Peri
"Praktik residensi spesialis Keperawatan Medikal Bedah peminatan Onkologi berfokus pengaplikasian perawat dalam pemberi asuhan keperawatan, pendidik, dan peneliti. Peran sebagai pemberian asuhan keperawatan dilaksanakan dengan melakukan pengelolaan 30 pasien keganasan kanker dan satu kasus yang dijadikan kasus kelolaan pasien yang terdiagnosa kanker payudara metastase paru, hati dan tulang menggunakan pendekatan teori Peacefull End Of Life (PEOL). Pelaksanaan penerapan intervensi keparawatan berbasis bukti ilmiah merupakan perawat sebagai peneliti dalam bentuk ponerapan Progresif Muscle Relaxation (PMR) terhadap penurunan kecemasan dan nyeri pasca pembedahan abdomen. peran perawat sebagai pendidik dilaksanakan dalam bentuk implementasi penggunaan aplikasi J-Hati (jalan sehat berenergi) dengan memberikan latihan fisik walking exercise berbasis android kepada pasien kanker dengan masalah fatigue. Seluuruh rangkaian kegiatan praktek residensi ini mempunyai tujuan untuk meningkatkan kualitas dan profesionalitas keperawatan secara komprehensif.

Medical Surgical Nursing specialist residency practice with a specialization in Oncology focuses on the application of nurses in nursing care providers, educators, and researchers. The role as the provision of nursing care is carried out by managing 30 patients with cancer malignancy and one case which is used as a managed case for a patient diagnosed with metastatic breast cancer of the lung, liver and bone using the theoretical approach by Peaceful End Of Life (PEOL). The implementation of the application of scientific evidence-based nursing interventions is a nurse as a researcher in the form of Progressive Muscle Relaxation (PMR) application to reduce anxiety and pain after abdominal surgery. The role of nurses as educators is carried out in the form of implementing the use of the J-Hati application (healthy energy walking) by providing physical training of Android-based walking exercise to cancer patients with fatigue problems. The entire series of residency practice activities has the goal of comprehensively improving the quality and professionalism of nursing.
"
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2023
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Situmorang, L. Rumiris
"Kanker payudara merupakan salah sam jenis kanker yang teroapat pada wanita dan masih merupakan masalah kesehatan pada wanita, karena selain merupakan salah satu penyakit keganasan kedua terbanyak juga sering menyebabkan kematian. Di Indonesia kanker payudara adalah kanker nomor dua tersering. dan di Rurmah Sakit Kanker Dharmais merupakan angka kunjungan tertinggi setiap tahunnya. Salah satu faktor protektif yang berperan menurunkan risiko kanker payudara pada wenita adalah menyusui. Tujuan penelitian ini adalah untuk rnengeta.hui hubungan antara menyusui dengan kanker payudara pada pasien Rumnh Sakit Kanker Dharmais Jakarta yang berkunjung pada periode bulan Mei - Juli 2007.
Penelitian ini menggunakan disain kasus kontrol dengan sampel peneiitian wanita melahirkan semua kelompok umur yang menderita kanker dan berkunjung ke poliklinik onkologi Rumah Sakit Kanker Dhannais Jakarta periode bulan Mei - Juli 2007. lumlah sampe1266 orang terdiri dari 127 orang kasus penderita kanker payudara dan 139 orang kontrol penderita kanker lainnya. Data yang dikumpulkan adalah data primer yang diperoleh melalui wawancara o1eh perawat yang telah diberikan penjelasan mengenai daftar pertanyaa-pertanyaan da1am kuesioner. Data diuji dengan unconditional logistic regressiQu dengan program Stata versi 7,0.
Hasil penelitian diperoleh : proporsi responden yang menyusui selama >6 bulan sebesar 75,19 0/0, sisanya 24,81% menyusui selama 0 - 6 bulan; karakteristik responden rata-rata berumur 46,5 tahun, usia m£l1larche 13,5 tahun dan usia saat paritas pertama 25 tahun. Rata-rata jUn1Iah paritas adalah 2,5 kali dan rata~rata jumlah anak yang disusui adalah 2/6 anak. Rata~rata lama menyusui tiap anak adalah 12.04 bulan dan rata~rata lama menyusui sepanjang hidup adalah 32,62 bulan.
Disimpulkan terdapat hubungan dosis respon antara lama menyusui dengan risiko kanker payudara yaitu sema"kin lama menyusui sernakin kecil risiko untuk menderita kanker payudara. Hasil penelitian juga menunjukkan efek protektif lama menyusui tiap anak selaroa>6 bulan terhadap penurunan risiko kanker payudara setelah dikontrol dengan variabel umur, riwayat kanker payudara pada keluarga, usia saat menarche, jumlah paritas dan usia saat paritas pertama dengan (OR Adjusted 0,43; 95% CI : O.24~OJ80;). Efek protektif ini lebih kuat pada wanita postmenopause dibandingkan wanita premenopausal pada responden yang menyusui tiap anaknya selama >6 bulan (OR Adjusted ~ 0,14; 95% CI ; 0,03 ... 0,62) setelah dikendalikan dengan variabel umur, usia saat menopause. jumlah paritas dan usia saat paritas pertama. Disarankan pada wanita yang pemah melahirkan untuk menyusui tiap anaknya >6 bulan untuk menurunkan risiko terkena kanker payudara.

Breast cancer is cancer found in women and poses serious health problem. it rank second as the most frequent cancer and usually fatal. In Indonesia, among other cancers. breast cancer ranks second in frequency and Dharmais Cancer Hospital has highest visit each year. One known protective factor of breast cancer is breastfeeding. The aim of this study is to understand the association between breastfeeding and breast cancer among Dharmais Cancer Hospital patients in May - July 2007 period.
The study employs case-control design with sampJes of delivered mothers at all age groups who visit oncology polyclinic Dhannais Cancer Hospital during May - July 2001 period. Total sample was 266 consisted of 127 breast cancer patients and 139 other cancer controls. Primary data were coHected through interview conducted by nurse who had been explained about the questionnaire. Data were tested using unconditional logistic regression using Stata version 1.0.
The results shows that proportion of respondents who breastfed between 0--6 months was 75.190/0, 24.81% for breasfed for >6 months; average age of respondent 'WaS 46.5 years. average menarche was 13.5 years. and average first parity age of 25 years. Average parity was 2.5 times and average number of breastfed children was 2.6 children. The average duration of breasfeeding was 12.04 months and average longlife duration of breastfeeding was 32.62 months.
It is concluded that there is a significant relationship between breastfeeding and breast cancer among those who has average breastfeeding of >6 months after controlled by age, famity cancer history. menarche age, parity, and first parity age with adjusted OR of 0.43 (95% CI : 0.24-0.80). The study also concludes that breasfeeding has stronger protective effect among postmenopausal women with adjusted OR of 0.14 (95% CI : 0,03 - 0,62) after controlled by age, menopause age, parity. and first parity age. It is suggested that every mothers should breastfeed their children at least 7 months to reduce the risk of breast cancer.
"
Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2007
T32025
UI - Tesis Membership  Universitas Indonesia Library
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Philip Waruna
"ABSTRAK
Latar 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.

ABSTRACT
Background 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."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Tandjung, Rini Agustien
"Latar Belakang: Akhir-akhir ini peristiwa epigenetik turut berperan menjadi penyebab keganasan. Peristiwa epigenetik meliputi metilasi DNA dan modifikasi histon. Gen penekan tumor adalah salah satu golongan gen yang merupakan target utama kcrusakan DNA. Contohnya gen penekan tumor dapat tidak berfungsi karena termutasi, termetilasi dan mengalami LOH (Loss of heterozygosity), gen WRN adalah termasuk gen penekan tumor. Gen WRN termutasi pada penyakit Werner Syndrome, gen WRN yang terletak pada kromosom 8p 11.2-12 sering mengalami LOH dan pada lokus genetik ini terdapat pada pasien usia muda kanker payudara, laporan terakhir mcnyatakan bahwa gen WRN dapat mengalami metilasi, semua kejadian pada gen WRN tersebut dapat mengarah ke kanker.
Tujuan: Penelitian ini untuk mengetahui karakteristik status gen WRN yang temietilasi pada pasien kanker payudara di Rumah sakit Kanker Dharmais dan hubungan gen WRN yang termetilasi tersebut dengan ekspresi mRNA nya.
Desain: Analitik.
Metode: Jaringan segar kanker payudara di isolasi sehingga didapat DNA dan RNA. Untuk mengecek kualitas DNA yang didapat dilakukan PCR konvensional dengan primer Interferon-Gamma. Dilanjutkan perlakuan sodium bisuliit, untuk mengkonversi sitosin yang tidak termetilasi menjadi urasil sedangkan sitosin yang termetilasi tetap menjadi sitosin. Primer myod-1 untuk megecek hasil perlakuan sodium bisuliit kemudian dilakukan teknik MSP dengan masing-masing Primer metilasi dan Primer tidak metisi. RNA yang didapatdi reverse rranscripiase menjadi cDNA kemudian di perlakukan bersama cDNA B-actin diperiksa dcngan Real Time PCR. Uji Mann- Whitney U dipakai untuk menguji hubungan antara gen WRN yang termetilasi dengan ekspresi mRNA dan uji Fisher untuk menguji hubungan antara gen WRN yang temietilasi dcngan data klinik meliputi usia penderita, hasil pemeriksaan lmmunohistokimia (ER, PR, IIer2, p53) dan TNM.
Hasil: Gen WRN yang termetilasi sebanyak 9 sampel dari 60 sampel (l5%). Ekspresi mRNA yang dapat dinilai datanya sebanyak 49 sampel dari 60 sampel (8 I ,67%) dan Rasio ekspresi WRN terhadap B-actin sekitar 0,00 hingga 27,75.
Kesimpulan: Tidak ada hubungan antara gen WRN yang tcrmetilasi dengan ekspresi mRNA dengan P = 0,61 dan tidak ada hubungan antara gen yang termetilasi dengan data klinik yang terdiri dari hasil pemeriksaan ER, PR, Her2, Triple negatif, p53, dan TNM, tapi ada hubungan yang signiiikan antara usia pcnderita yang muda (dibawah dan sama dcngan 40 tahun) dengan gen WRN yang termctilasi dengan P = 0,02.

Background: Epigenetic events including DNA methylation and histone modifications contribute to the cause of malignancy. Tumor suppressor genes belong to class of genes which may be subjected to DNA damage or modification. For instance, tumor suppressor gene may be inactivated by mutation, methylation and LOH ( Loss of heterozigosity), the WRN gene is an example of tumor suppressor gene. Mutated in the premature aging Werner syndrome, WRN gene is located on chromosome 8p 11.2-12. Futhermorc, L01-I in this genetic locus is found in a subset of early onset breast cancer patients. Recent report also indicated that WRN gene may be susceptible to methylation. These data suggest that WRN gene inactivation may lead to cancer.
Objective : This study aims to examine the characteristic of a methylation status of WRN gene in breast cancer patients at Dhamiais National Cancer Hospital and the relationship between WRN gene methylation with its mRNA expression.
Design: Analytical.
Methods: DNA and RNA were isolated from archieved frozen breast cancer tissue sample. DNA quality was checked by PCR amplification of Interferon gamma gene. To determine promoter methylation, DNA was treated with bisultite to distinguish methylated cytosine from unmethylatated ones. The quality of converted DNA was determined by amplification of Myod-1 locus with contain cytosine rich sequences that are susceptible to uracil conversion upon bisultite treatment. Subsequently, WRN methylation was determined using Methylation Specific PCR (MSP) using 2 set of primers recognizing either methylated or unmethylated WRN sequence. WRN expression was determined bythe level of cDNA upon conversion of total, RNA using reverse transcriptase. Expression of WR.N was calibrated to B-actin expression using Real-Time PCR and Pffafl method. Mann-Whitney U test was used to examine the relationship between WRN gene methylation and its mRNA expression. Fisher test was used to examine the relationship between WRN gene methylation status with clinical data include age, lmmunohistokimia test (ER,PR,I-ler2,p53) and TNM.
Results: WRN gene is methylated in nine samples out of 60 samples (I5%). mRNA expression data was assessed from 49 samples out of 60 samples only (8l,67%). Although there is a trend of mRNA silencing in methylated WRN gene, the relationship does not reach statistical significance. WRN expression ratio of B- actin around 0,00 to 27,75.
Conclusion: There is no relationship between the WRN gene methylation and mRNA expression, P = 0.61 and no relationship between the WRN gene methylated with clinical data that consists of ER, PR, Ht-:r2, Triple negative, p53, and TNM. Interestingly, WRN methylation was found more frequently in early onset breast cancer patients, P=0,02.
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2010
T32357
UI - Tesis Open  Universitas Indonesia Library
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Diah Artanti Sekarayu Budi Sarwono
"Kanker payudara merupakan salah satu jenis kanker yang paling umum. Sebagaimana diketahui, kanker suatu jaringan dapat menyebar atau bermetastasis ke jaringan lain sebagai kanker sekunder, di mana pada kanker payudara 90% kematian selama pengobatan dikaitkan pada metastasis. Penelitian ini fokus kepada karakteristik metastasis bone only sebagai subtipe metastasis tulang kanker payudara yang belum banyak diteliti walaupun angka kelangsungan hidup (survival)nya paling bagus dibandingkan bila metastasis ke organ/tempat lainnya. Gambaran karakteristik pasien KPD BMO yg berobat di RSCM juga belum pernah diteliti. Penelitian ini menggunakan desain penelitian observasional deskriptif dengan desain studi cross sectional dengan teknik sampel total sampling. Terdapat 1278 pasien KPD metastasis yg berobat di RSCM 2017-2022. Didapatkan 148 pasien KPD BMO, namun karena ketidak lengkapan informasi di hasil pemeriksaan penunjang maka yang masuk kriteria inklusi penelitian ini adalah 47 pasien. Dari 47 pasien, ditemukan karakteristik 100% perempuan, rentang usia terbanyak 45-64 tahun (70,2%), 46,8% bersuku Jawa, 85,1% dalam usia menopause, dengan sebagian besar kanker karsinoma duktal invasif (85,1%) grade 2 (68,1%) dan subtipe luminal A (42,6%). Kasus Denovo sebanyak 48,9%. Ditemukan metastasis multiple (91,5%) lesi osteolitik(29,8%) , dan berlokasi di Os. Vertebrae (31,7%). Sejalan dengan penelitian sebelumnya dan faktor risiko metastasis bone only, sehingga dapat dilakukan studi lanjutan berupa studi analitik maupun genomic untuk mengkonfirmasi hubungan kausalitas tiap variabel.

Breast cancer is one of the most common types of cancer. As we know, cancer in one tissue can spread or metastasize to other tissues as secondary cancer, where in breast cancer 90% of deaths during treatment are attributed to these metastases. This study focuses on the characteristics of bone only metastases as a subtype of breast cancer bone metastases that has not been widely studied although its survival is better than breast cancer which metastases to other organs. This research uses a descriptive observational research design with a cross sectional study design with a total sampling technique. We found 1278 breast cancer with metastasis treated in RSCM within 2017-2022. There are 148 breast cancer bone metastasis only, but only 47 patients were included in the research due to the completed radiology data. Of the 47 patients, the characteristics of the 47 patients were 100% female; 70,2% aged 45-64 years-old ;46,8% Javanese ; 85,1% in menopausal age, 68,1% with grade 2 invasive ductal carcinoma and 42,6% luminal A subtype; 48,9% Denovo cases ; 91,5% suffered from Multiple osteolytic lesion metastases and 31,7% were located in Os. Vertebrae. In line with previous research and risk factors for bone only metastasis, further studies can be carried out in the form of analytical or genomic studies to confirm the causal relationship between each variable."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Skripsi Membership  Universitas Indonesia Library
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Via Dolorosa Halilintar
"Kanker Payudara KPD merupakan jenis penyakit Kanker dengan risiko insidensi mortalitas tertinggi di Indonesia. Tesis ini membahas tingkat kepatuhan dan faktor ndash; faktor yang mempengaruhi kepatuhan pengobatan pasien Kanker Payudara KPD yang menjalani terapi hormonal dengan Tamoxifen pada pasien RS Kanker Dharmais tahun 2018. Penelitian ini adalah penelitian observasional dengan desain potong lintang cross-sectional. Penelitian diikuti oleh sebanyak 109 orang responden. Tingkat kepatuhan pengobatan dinilai melalui kuesioner MARS-5 yang dimodifikasi. Karaktersitik sosiodemografi dan klinis diperoleh dari wawancara dengan menggunakan kuesioner.
Hasil penelitian menunjukkan tingkat kepatuhan pengobatan KPD dengan Tamoxifen adalah 90,9 dengan proporsi pasien yang patuh adalah 75,2 82 dari 109 orang. Umur pasien, pendapatan, tingkat pendidikan, pemberian informasi dan edukasi tentang pengobatan, dan tingkat pengetahuan pasien mempunyai pengaruh yang bermakna dalam mempengaruhi tingkat kepatuhan pengobatan. Analisis multivariat menunjukkan bahwa Umur responden, tingkat pendidikan, tingkat pengetahuan merupakan faktor yang paling berpengaruh dan menentukan tingkat kepatuhan pengobatan. Tingkat Pendidikan merupakan variabel yang paling besar pengaruhnya terhadap kepatuhan pengobatan. Melalui penelitian ini disarankan untuk memberikan perhatian khusus untuk pasien ndash; pasien dengan karakteristik tertentu seperti pasien dengan tingkat pendidikan atau berpendapatan rendah.

Breast Cancer BC is. type of cancer disease with the highest incidence of mortality in Indonesia. The focus of the study was to determine the level of adherence and factors influencing the adherence of the treatment of BC patients undergoing hormonal therapy with Tamoxifen in patients with Dharmais Cancer Hospital in year 2018. The study is an observational study with. cross sectional design. The study was followed by 109 respondents. Medication adherence levels assessed via questionnaire MARS. modified. Sociodemographic and clinical characteristic obtained from interviews using questionnaires.
The results showed that the medication adherence level of KPD with Tamoxifen was 90.9 with the proportion of adherent patients was 75.2 82 of 109 patients. Patient age, income, education level, information and education about treatment, patient 39. level of knowledge have. significant influence on the level of medication adherence. Multivariate analysis showed that the age of respondents, level of education, level of knowledge is the most influential factor and determine the level of treatment adherence. Education level is the variable that has the greatest effect on medication adherence. Through this study, it is advisable to pay particular attention to patients with certain characteristics such as patients with low education or low income levels.
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Depok: Fakultas Farmasi Universitas Indonesia, 2018
T51466
UI - Tesis Membership  Universitas Indonesia Library
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Tiara Pramudita
"Ketidaknyamanan seringkali dirasakan pasien kanker payudara seiring perjalanan penyakit dan efek samping pengobatan. Kesejahteraan spiritual dianggap dapat menjadi mekanisme koping dalam menghadapi situasi sulit sehingga dapat membantu meningkatkan kenyamanan. Penelitian ini bertujuan untuk mengidentifikasi hubungan antara kesejahteraan spiritual dengan kenyamanan. Desain penelitian berupa analitik korelasi dengan pendekatan cross-sectional, melibatkan 92 responden yang dipilih dengan teknik consecutive sampling. Studi ini menggunakan kuesioner SWBQ (Spiritual Well-Being Questionnaire) dan PKKP (Pengkajian Kenyamanan Kanker Payudara). Hasil penelitian menunjukkan 52,2% responden memiliki kesejahteraan spiritual tinggi serta terdapat proporsi yang imbang antara responden yang merasa nyaman dan yang tidak nyaman. Hasil uji chi-square didapatkan adanya hubungan antara kesejahteraan spiritual dengan kenyamanan pasien kanker payudara dengan p-value 0,007 (p < 0,05). Dapat disimpulkan bahwa kesejahteraan spiritual menjadi aspek penting dalam asuhan keperawatan untuk meningkatkan kenyamanan pasien kanker payudara.

Discomfort is often felt by breast cancer patients along with the course of the disease and the side effects of the treatment. Spiritual well-being is considered to be a coping mechanism in dealing with difficult situations so that it can help increase comfort. This study aims to identify the relationship between spiritual well-being and comfort. The research design is analytic correlation with a cross-sectional approach, involving 92 respondents selected by consecutive sampling technique. This study used the instrument of SWBQ (Spiritual Well-Being Questionnaire) and PKKP (Breast Cancer Convenience Assessment) questionnaires. The results showed that 52.2% of respondents had high spiritual well-being and there was an even proportion of respondents who felt comfortable and those who were uncomfortable. The results of the chi-square test found that there was a relationship between spiritual well-being and the comfort of breast cancer patients with a p-value of 0.007 (p <0.05). It can be concluded that spiritual well-being is an important aspect of nursing care to increase the comfort of breast cancer patients."
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2023
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UI - Skripsi Membership  Universitas Indonesia Library
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Retno Indah Pertiwi
"Kanker payudara banyak diderita perempuan. Penelitian ini bertujuan menggambarkan pengetahuan dan perilaku mencari pelayanan kesehatan pasien kanker payudara dengan desain penelitian deskriptif sederhana. Responden berjumlah 80 orang secara non probability convenience sampling. Mayoritas responden berpengetahuan baik tentang pengetahuan umum, faktor risiko, tanda gejala, skrining serta perawatan, sedangkan mengenai pengobatan masih kurang. Respon awal saat menyadari perubahan payudara diantaranya tidak bertindak, bercerita, mencari pelayanan kesehatan, melakukan pengobatan alternatif, dan herbal. Keterlambatan pemeriksaan dialami sebagian besar responden. Suami menjadi pilihan terbanyak saat diskusi awal. Dokter bedah dan fasilitas kesehatan pemerintah menjadi pilihan terbanyak saat pemeriksaan awal. Perawat perlu meningkatkan edukasi kanker payudara pada perempuan dan pasien kanker payudara.

Breast cancer occurs to many women. This study aimed to describe the knowledge and health care seeking behavior of breast cancer patients with simple descriptive research design. The respondents were 80 who are chosen by non probability convenience sampling. Majority of respondents have good knowledge about the general knowledge, the risk factors, the signs and symptoms, the screening and nursing care, but they lack about the treatment. The initial responses when there were changes in their breast included no action, telling somebody, seeking health care, getting alternative medicine and herbal. The delayed diagnosis experienced by most of the respondents. The husband became the largest selected person for the initial discussion. The surgeons and the government?s health facilities were chosen by most respondents at the first examination. Nurses need to improve the education provision about breast cancer to women and the breast cancer patients."
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2013
S46443
UI - Skripsi Membership  Universitas Indonesia Library
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