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"Pasien dengan kanker payudara banyak yang mengalami gangguan dan hampir seluruhnya mengalami depresi yang dapat memperberat gejala fisik, meningkatkan gangguan fungsional, dan membuat kepatuhan berobat menjadi rendah. Kami melakukan tinjauan pustaka yang tersedia di PubMed tentang prevalensi, besar gangguan, kemampuan coping, dan metode penatalaksanaan depresi berat pada wanita dengan kanker payudara dari tahun 1978 sampai 2010. Diagnosis dan penatalaksanaan episode depresi pada wanita dengan kanker payudara merupakan tantangan karena gejala yang tumpang tindih dan kondisi penyerta. Depresi berat sering disepelekan dan penatalaksanaan tidak adekuat pada pasien kanker payudara. Tinjauan ini menekankan pada masalah dalam identifikasi dan pengelolaan depresi pada pasien kanker payudara dengan latar klinis.

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AbstractMany of breast-cancer patients experience distress and most of them experience depression which may lead to amplification of physical symptoms, increased functional impairment, and poor treatment adherence. We did a review on available literature from PubMed about prevalence, distress magnitudes, coping styles, and treatment methods of major depression in women with breast cancer from 1978 to 2010. Diagnosis and treatment of depressive episodes in women with breast cancer is challenging because of overlapping symptoms and co-morbid conditions. Major depression is often under-recognized and undertreated among breast cancer patients. This review highlighted the issues on identifying and managing depression in breast cancer patients in clinical settings."

"The book is the first one published exclusively on the field of nutritional epidemiology of breast cancer. It summarizes the currently existing knowledge, with an updated and comprehensive international bibliography (~ 1.000 references). The authors also performed a review on the epidemiological studies on nutrition and breast cancer carried out in Uruguay between 1994 and 2011, which allowed exploring and identifying the main risk and protective factors for the disease in this high-risk country. "

"This book is the one of the few textbooks that summarizes the latest information dated to inflammatory breast cancer. The uniqueness of this book is that it has summarized the latest molecular and mechanistic findings, which may lead to novel diagnostic tool or therapeutic approach to fight this deadly disease."

"ABSTRAKLatar Belakang: Kanker payudara akan mengekspresikan CD36 lebih rendah pada stroma kanker payudara bila dibandingkan sel sehat. CD36 berperan dalam pertumbuhan dan perkembangan metastasis tumor. Pemeriksaan CD36 plasma dilaporkan pada populasi selain kanker payudara, yang bersifat kurang invasif dan hemat biaya. Belum diketahuinya pemeriksaan CD36 plasma pada kanker payudara dan diharapkan memberikan hasil yang sejalan dengan pemeriksaan histopatologis.Tujuan: Mengetahui (1) perbedaan konsentrasi CD36 plasma pada kanker payudara dibandingkan dengan orang sehat, (2) perbedaan konsentrasi CD36 plasma pada kanker payudara berdasarkan status metastasisis, metastasis kelenjar getah bening, subtipe molekular, jenis histopatologis, grade histologi ukuran tumor, dan indeks massa tubuh.Metode: Penelitian dengan desain potong lintang dalam periode Juni 2018 hingga Februari 2019 dan pengambilan sampel secara konsekutif. Dilakukan pemeriksaan plasma ELISA dengan reagen Bioassay Technology Laboratory. Kriteria inklusi: wanita berusia antara 18 hingga 70 tahun, kanker payudara invasif yang patologis, patologi awal: tumor ≥ 1 cm dengan status reseptor hormone dan faktor pertumbuhan epidermal positif atau negatif manusia 2 (HER2/neu), subjek bersedia menandatangani persetujuan penelitian. Kriteria eklusi: subjek yang mengalami progresifitas penyakit selama dalam pengobatan, diabetes melitus, penyakit jantung koroner, stroke, gangguan hati, gangguan ginjal. Data dianalis dalam mencari perbedaan konsentrasi CD36 plasma rerata 2 kelompok.Hasil: Pada 118 subjek, perbedan median konsentrasi CD36 plasma pada kanker payudara dan sehat, yakni 0,21 dan 0,57, p < 0,05. Selain itu, tidak terdapat perbedaan median konsentrasi CD36 plasma pada kanker payudara berdasarkan status metastasis, metastasis kelenjar getah bening, subtipe molekular, jenis histopatologis, grade histologi, ukuran tumor dan indeks massa tubuh.Kesimpulan : Median konsentrasi CD36 plasma populasi kanker payudara lebih rendah dibandingkan populasi orang sehat. Tidak terdapat perbedaan bermakna konsentrasi CD36 plasma pada kanker payudara berdasarkan status metastasis, metastasis kelenjar getah bening, subtipe molekular, jenis histopatologis, grade histologi, ukuran tumor, dan indeks massa tubuh.

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ABSTRACTBackground: Breast cancer will express low CD 36 within stroma tumor cell. CD36 is involved in tumorigenesis. Research of soluble CD36 plasma has been done in another population. It is unclear whether profile of plasma CD36 concentration in breast cancer will give the same with histopatology result.Aim, (1) to investigate the differences of plasma CD 36 concentration of the breast cancer patients, compared with the healthy, (2) to analyze profile of plasma CD36 concentration in breast cancer patients based on metastatic status, lymph node metastatic, molecular subtype, histopathologic type, invasive cancer histologic grade, lymphovascular invasion, Ki-67 index, and body mass index.Methods: This is a cross-sectional study during June 2018 to February 2019 with a consecutive sampling method. Plasma was analyzed using Bioassay Technology Laboratory ELISA reagen. Inclusion criteria included women aged 18 to 70 years old, having pathological invasive breast cancers, having beginning pathological manner of tumor size ≥ 1 cm with the hormonal receptor status and positive epidermal grow factor or negative human-2 (HER2/neu), and subjects were willing to sign the informed consent sheets. Exclusion criteria included subjects with disease progressivity during therapy, diabetes mellitus, stroke, liver, and renal disfunctions. Data was analyzed using SPSS for windows version 20 to get two means difference of plasma soluble CD36.Results: From 118 subjects, Median of plasma CD36 in breast cancer, and healthy subjects show 0.21, and 0.57, with p value < 0,05. There are insignificant differences profile of plasma CD36 concentration patients based on metastasic status, lymph node metastatic, molecular subtype, histopathologic type, invasive cancer histologic grade, and body mass index.Conclusion: Plasma CD36 concentration of breast cancer is lower than the healthy population. There are insignificant differences of plasma CD36 concentration profile breast cancer patients based on metastatic status, lymph node metastatic, molecular subtype, histopathologic type, invasive cancer histologic grade, and body mass index."

"Penatalaksanaan kanker payudara mungkin merupakan suatu hal yang amat kontrovesial dan telah mengalami perubahan luarbiasa dengan berjalannya waktu."

"Penatalaksanaan kanker payudara mungkin merupakan suatu hal yang amat kontroversial dan telah mengalami perubahan luarbiasa dengan berjalannya waktu. MRI dengan kontras muncul sebagai alat diagnostik pencitraan yang paling efisien. Pendekatan yang mutakhir untuk biopsi kanker payudara yang tidak sesuai untuk pembedahan, ditujukan untuk mendapatkan sampel jaringan yang cukup untuk keperluan diagnostik namun meminimalkan penyebaran dan resiko komplikasi. Penanganan regional yang dilakukan Halstead secara ketat, walaupun berhasil mengendali lokal regional secara bermakna, namun tidak berhasil meningkatkan kesintasan (survival) jangka panjang. Dengan berjalannya waktu, orang telah memahami disposisi sistemik penyakit ini dan pentingnya menggabungkan terapi sistemik bahkan sejak tahap dini dan melengkapi teknik ablatif surgikal. Peranan terapi sistemik primer dalam manajemen kanker payudara dengan cepat muncul sebagai suatu pilihan yang vital. Pada pasien dengan ekspresi berlebih gen HER 2/neu, tambahan ?transtuzumab? pada pengobatan sistemik menghasilkan peningkatan yang jelas pada kesintasan secara keseluruhan.

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AbstractThe management of breast cancer is perhaps the most controversial of all and has evolved a sea change over the years. Contrast enhanced MRI imaging is emerging as the most efficient imaging diagnostic tool. Newer approaches for the biopsy of inoperable breast cancer are aimed at obtaining diagnostically adequate tissue samples while minimizing invasiveness and the risk of complications. The regional vigour that Halsted followed rigorously, albeit, achieved significant locoregional control, could not lead to improved long-term survival. With the passage of time, people have understood the systemic nature of the disease and the paramount need to incorporate systemic treatment even in relatively earlier stages and curtain surgical ablative techniques. The role of primary systemic therapy in the management of breast cancer is fast emerging as a vital option. In HER 2/neu gene overexpressed patients, addition of trastuzumab to the systemic treatment is a distinct improvement in overall survival. "

"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.

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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."

"A simple introduction explaining the broad principles underlying chemotherapy, this book gives trainees a framework within which they can place the specific aspects of cancer chemotherapy they encounter in their everyday experience. The first part of this book is unique in explaining the recent developments in the field in terms of their point of action in the natural history of cancer. The second and third sections contain a more straightforward description of practical aspects of chemotherapy, and the current place of drug treatment in everyday cancer management, including the outcomes of that treatment."

"Kanker payudara merupakan salah satu masalah kesehatan terbesar di Indonesia di mana sekitar 42,7% datang pada stadium lanjut lokal. Pemberian kemoterapi neoajuvan pada stadium lanjut lokal bertujuan mengecilkan ukuran tumor sehingga dapat dilakukan operasi dan menurunkan mortalitas. Salah satu prediktor untuk mengetahui keberhasilan kemoterapi neoajuvan adalah Ki-67, yaitu protein non-histone yang ekspresinya tinggi saat proliferasi sementara obat-obatan kemoterapi bekerja efektif pada fase proliferasi. Tujuan penelitian ini adalah untuk mengetahui peran Ki-67 sebagai faktor prediktor terhadap respons kemoterapi neoajuvan pada pasien KPDLL. Metode: Penelitian ini merupakan studi kohort retrospektif dengan kriteria inklusi adalah pasien dengan diagnosis kanker payudara stadium lanjut lokal dan mendapatkan kemoterapi neoajuvan di Rumah Sakit Cipto Mangunkusumo (RSCM) sejak 1 Januari 2014- 31Desember 2019. Cut-off ekspresi Ki-67 adalah 20%. Respons klinis kemoterapi neoajuvan dinilai berdasarkan kriteria WHO yang diukur setelah pemberian kemoterapi ketiga. Respons kemoterapi ini dikelompokkan menjadi respons baik (complete response dan partial response) dan respons buruk (stable disease dan progresive response). Hasil: Pasien kanker payudara lanjut lokal rata-rata berusia 50 tahun, ukuran tumor terbanyak T4 (90,4%), keterlibatan kelenjar getah bening N1 (52,1%), jenis histopatologi NST (71,3%), grade 2 (54,4%), ER positif (78,7%), PR positif (70,2%), HER2negatif (58,5%), Ki67 tinggi (70,2%), dan luminal B (56,4%). Lima puluh dua koma satu persen subjek memiliki respons kemoterapi buruk. Tidak terdapat perbedaan bermakna secara statistik antara ekspresi Ki-67 dengan respons kemoterapi (p= 1). Bila dihitung presentase sisa tumor, pasien dengan ekspresi Ki-67 tinggi memiliki persentase sisa tumor 74,6%, pasien dengan ekspresi Ki-67 rendah rata-rata tidak mengalami penurunan ukuran tumor dengan sisa tumor 103,8% (p= 0,977). Simpulan: Tidak terdapat perbedaan bermakna secara statistik antara ekspresi Ki-67 dan respons kemoterapi neoajuvan pada kanker payudara stadium lanjut lokal di RSCM.

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Breast cancer is one of the most common health problems in Indonesia where 42.7% of patients have been diagnosed with Locally Advanced Breast Cancer (LABC). Neoadjuvant chemotherapy (NAC) is aimed to decrease the tumor size to be operable and decrease mortality. Ki-67 is highly expressed in the cell proliferation phase, while chemotherapy agents work effectively by targeting this proliferation. This study evaluates the utility of Ki-67 in LABC patients of the Asian-Indonesian population. Methods: This is a retrospective cohort study. Ki-67 data was from the medical record based on the immunohistochemistry staining with >20% cut off point. Clinical response was measured based on the WHO criteria after the third chemotherapy cycle, classified as good response (complete response and partial response) and poor response (stable disease and progresive response). Result: The majority of subjects in this study were 50 years old, with T4 tumor size (90.4%), N1 lymph node involvement (52.1%), NST histopathological type (71.3%), grade 2 (54.4%), ER-positive (78.7%), PR-positive (70.2%), HER2-negative (58.5%), high Ki67 expression (70.2%), and luminal B subtype (56.4%). 52.1% of all subjects showed ‘poor’ clinical responses to NAC. There was no significant association between subjects’ characteristics and the NAC Clinical response. Moreover, there was no significant association between Ki-67 and chemotherapy clinical response (p=1). Residual tumor size was 74.6% in high Ki-67 group and 103.8% in low Ki-67 group (p= 0.977). Conclusion: There is no statistically significant association between Ki-67 expression and NAC clinical response of LABC patients in Indonesia."