ABSTRAKKanker payudara merupakan kanker paling umum pada wanita di seluruh dunia dan merupakan kanker paling banyak terjadi pada wanita. WHO telah merekomendasikan klasifikasi IMT termasuk derajat underweight atau overweight berhubungan dengan peningkatan risiko beberapa penyakit tidak menular. Differensiasi tingkat keganasan untuk kanker payudara, menggunakan kriteria WHO yaitu system grading Nottingham (juga disebut modifikasi Elston_Ellis dari sistem grading Scarff-Bloom-Richardson). Penelitian ini bertujuan untuk mengetahui hubungan Index Massa Tubuh dengan Grading pada kanker payudara. Penelitian ini merupakan studi observasional analitik dengan desain Cross Sectional untuk mempelajari hubungan Indeks Massa Tubuh dengan Grading kanker payudara. Karaktersitik berdasarkan umur minimum 28 tahun dan usia maksimum 64 tahun, berat badan pasien minimum 40 kg dan maksimum 75 kg. Tinggi badan pasien minimum 141 cm dan maksimum 163 cm,skor IMT minimum 17.22 dan maksimum 31.18. Berdasarkan IMT dalam kategori Underwight ada 2 orang (6,7%), IMT dalam kategori normowight ada 18 orang (60,0%), dan pasien dengan IMT dalam kategori overwight ada 10 orang (33.3%), dengan demikian responden mayoritas dengan hasil pengukuran IMT dalam kategori normowight. Derajat diferensiasi sel dalam kategori Grade I ada 2 orang (6,7%), derajat diferensiasi sel dalam kategori Grade II ada 8 orang (26,7%), dan derajat diferensiasi sel dalam kategori Grade III ada 20 orang (66.7%), dengan demikian responden mayoritas dengan hasil pengukuran derajatdiferensiasiseldalam kategori Grade III. Pasien dengan grading kanker payudara grade 1 dengan IMT underweight ada 1 orang dan normowight ada 1 orang, pada grading kanker payudara grade II yang normoweight ada 7 orang dan overweight ada 1 orang, dan pada grading kanker payudara grade III dengan IMT underweight ada 1 orang normoweight ada 10 orang dan overweight ada 9 orang. IMT overwight lebih berisiko terhadap tingginya grade pada grading kanker payudara, nilai koefisen korelasi sebesar 0,396 dengan nilai p=0,045 (p<0,05) yang berarti terdapat hubungan yang signifikan antara Index Masa Tubuh dengan Grading pada kanker payudara. Kata Kunci: Kanker Payudara, Index Masa Tubuh, Differensiasi Histopatologi ABSTRACT Breast cancer is the most common cancer in women worldwide and is the most common cancer in women. WHO has recommended the classification of IMT including underweight or overweight degree related to increased risk of some non-infectious diseases. Differentiation of malignancy stages for breast cancer, using the WHO criteria of Nottingham's grading system (also called Elston_Ellis modification of the Scarff-Bloom-Richardson grading system). This study aims to determine the relationship of Body Mass Index with Grading on breast cancer. This study is an analytic observational study with Cross Sectional design to study the relationship of Body Mass

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Background: The mortality rate of breast cancer patients was relatively high 80% -60% while the survival rate was only <40%. High estrogen levels and longterm exposure were associated with an increased risk of breast cancer. Recent studies have reported that estradiol can act independently and contribute to the risk of distant metastases in breast cancer patients with negative Estrogen Receptor (ER) tumors. The aim of this study was to estimate the estradiol effect on remission and survival in breast cancer patients in Dr. Moewardi Hospital, Surakarta, Central Java. Subjects and Method: This was a cohort study conducted at the Department of Surgical Oncology, Dr. Moewardi Hospital, Surakarta, Central Java, from March to May 2015. A sample of 303 breast cancer patients was selected for this study and followed up until 3 years. The independent variable was estradiol level. The dependent variables were remission and survival. The data were collected by clinical examination and analyzed by Cox Proportional Hazard Model and Kapplan-Meier. Results: High estradiol level decreased the possibility of remission (HR= 0.31; 95% CI= 0.09 to 1.11, p= 0.003) in breast cancer patients. Normal estradiol level increased survival (HR= 4.03; 95% CI= 1.94 to 8.37; p<0.001). Conclusion: High estradiol level decreases the possibility of remission, while normal estradiol level increases survival in breast cancer patients.

<p><strong>Pendahuluan</strong>: Kanker payudara merupakan keganasan pada wanita yang memiliki prosentasi dan angka mortalitas cukup tinggi baik di dunia maupun Indonesia. Pada kanker payudara memiliki reseptor untuk hormon estrogen, progesteron, dan protein Her–2 yang berperan dalam proses terjadinya sel kanker. Dimana keberadaan ER, PR dan Her-2/Neu serta Grading Histopatologi sangat mempengaruhi manajemen dan prognosis pada pasien dengan karsinoma payudara.</p><p><strong>Tujuan:</strong> Mengetahui hubungan antara Reseptor Estrogen, Reseptor Progesteron dan ekspresi Her-2/neu dengan grading histopatologi pada penderita wanita dengan kanker payudara.</p><p><strong>Bahan &amp; Metode:</strong> Pasien kanker payudara sejumlah 73 orang yang berobat di Poliklinik dan dirawat di bangsal serta pengambilan sample di sub Bagian Bedah Onkologi RSUD dr. Moewardi Surakarta antara April sd Desember 2018. Pemeriksaan Immunohistokimia dan Histopatologi di bagian Patologi Anatomi RSUD dr. Moewardi Surakarta. Penelitian prospektif analitik korelasi dengan cross sectional.</p><p><strong>Kesimpulan:</strong> Tidak terdapat hubungan antara reseptor estrogen dengan grading histopatologi pada pasien kanker payudara di RSUD dr. Moewardi Surakarta Jawa Tengah (p=0,901).Tidak terdapat hubungan antara reseptor progesteron dengan grading histopatologi pada pasien kanker payudara di RSUD dr. Moewardi Surakarta Jawa Tengah ( p=0,512).Tidak terdapat hubungan antara ekspresi Her-2/neu dengan grading Histopatologi pada pasien kanker payudara di RSUD dr. Moewardi Surakarta Jawa Tengah ( p=0,629).</p><p> </p><p>Introduction: Breast cancer is a malignancy in women who have a high percentage and mortality rate both in the world and Indonesia. Breast cancer has receptors for the hormones estrogen, progesterone, and Her-2 protein which play a role in the process of cancer cells. Where the existence of ER, PR and Her-2 / Neu and Histopathology Grading greatly affect the management and prognosis in patients with breast carcinoma.</p><p>Objective: To determine the relationship between Estrogen Receptor, Progesterone Receptor and Her-2 / neu expression with histopathological grading in women with breast cancer.</p><p>Material &amp; Methods: There were 73 breast cancer patients who were treated at the Polyclinic and treated in the ward and taking samples in the sub-section of Surgical Oncology Hospital Dr. Moewardi Surakarta between April to December 2018. Immunohistochemistry and Histopathology Examination in the Anatomy Pathology section of RSUD dr. Moewardi Surakarta. Prospective analytic correlation research with cross sectional study.</p><p>Conclusion: There is no relationship between estrogen receptors with histopathological grade in breast cancer patients at dr. Moewardi Surakarta, Central Java (p = 0,901). There was no relationship between progesterone receptors and histopathological grade in breast cancer patients at dr. Moewardi Surakarta, Central Java (p = 0.512). There was no relationship between Her-2 / neu expression and histopathological grading in breast cancer patients at dr. Moewardi Surakarta, Central Java (p = 0.629)</p>

Introduction Fibroadenoma is the most common benign tumor found in young women. Transformation for Fibroadenoma to borderline phyllodes tumor is rare. Phyllodes tumor tends to recur locally due to the aggressive nature of the phyllodes tumor tissue, which tends to become malignant when recurrence occurs. Presentation of case We report an 18-year-old woman with a lump in the right breast for one year, a mass in the upper lateral quadrant measuring 20x15x10cm; the lump felt mobile, supple, cystic. 2 years earlier, lumpectomy surgery with anatomical pathology of fibroadenoma mammae with 6 cm. A biopsy was performed, the result was a borderline phyllodes tumor. Neoadjuvant chemotherapy was performed with tumor reduction >50%, followed by wide excision surgery with tumor-free margins. The first one-year evaluation showed no signs of recurrence, and no signs of distant metastases were found. Conclusion Our patient had a juvenile relapse FA which progressively changed to borderline tumor phyllodes borderline. We report this case to the need for continuous follow-up for fibroadenoma cases and the possibility of recurrence and becoming malignant.

Background: Breast cancer remains a global health issue, including in Indonesia, which has a relatively high incidence of breast cancer. Several theories have proved the role of estrogen in breast cancer carcinogenesis, but there is yet to be a preventive measure against breast cancer. Chemotherapy is one of the therapeutic modalities for breast cancer that disturbs ovarian function in producing estrogen due to damaged ovarian granulosa cells. Chemotherapy becomes an alternative option to decreasing circulating estradiol levels through interventions in ovarian functions, either by surgery, such as oophorectomy, or medications that disturb the ovarian functions. This study aimed to observe the estradiol levels in breast cancer patients before and after chemotherapy. Methods:This was a prospective cohort study. We observed the estradiol levels before and after adjuvant chemotherapy in breast cancer patients. Subjects' characteristics are presented in mean ± standard deviation, distribution frequency, and percentage. Subjects' characteristics based on chemotherapy were tested using an independent ttest, Mann-Whitney U, and Chi-square/Fisher exact test. Effects of chemotherapy on estrogen levels were tested using the Wilcoxon rank test and Kruskal-Wallis test.Results: A total of 194 research subjects were included. There were changes in estradiol levels before and after therapy. The decrease of estradiol levels in patients who did not receive chemotherapy was -6.9% (P > 0.05). Patients who received anthracycline cyclophosphamide (AC) regimen, paclitaxel and anthracycline (TA) regimen, paclitaxel, anthracycline and trastuzumab (TA + H) regimen, and platinum regimen experienced a significant decrease in estradiol levels (-21.4% (P < 0.05), -20.2% (P < 0.001), -31.7% (P < 0.01), and -23.7% (P < 0.05), respectively). Among chemotherapy groups, the estradiol levels before and after chemotherapy did not have significant differences (P = 0.937 and P = 0.730, respectively). Conclusion:There are no significant differences in estradiol levels between chemotherapy and hormonal therapy groups. Patients in both groups have decreased estradiol levels after therapy, although patients in hormonal therapy do not experience as much decrease as those in chemotherapy.

Research Background: This study aimed to scrutinize the chemotherapy’s effect on estradiol levels in patients with triple-negative breast cancer (TNBC) at low-resource country. Methods: This prospective analytic observational cohort study involved patients with TNBC who had undergone surgery and had never received chemotherapy or hormonal therapy before. Patients were checked for estradiol levels before and after chemotherapy. This study was conducted at the Surgical Oncology Department of Regional Public Hospital Dr. Moewardi, Surakarta Indonesia, from April 2020 to March 2021. Descriptive data were presented in a frequency table based on age, menopausal status, parity status, breastfeeding status, hormonal contraception, hormonal contraception duration, family history, stage, and histological grade. Differences in estradiol changes before and after chemotherapy (mean+sd) were then reported. Results: From a total of 23 patients, 21 patients (91.3%) experienced a decrease in estradiol levels, while two patients (8.7%) underwent an increase in serum estradiol levels after chemotherapy. The mean decrease was 11.57 pg/ml. The two samples that experienced an increase in estradiol levels had a mean increase of 16.5 pg/ml. There was a significant difference between estradiol levels before and after undergoing chemotherapy, with p-value=0.001. Conclusions: In this research, chemotherapy reduced estradiol levels in TNBC patients. Statistically significant reductions in estradiol levels were based on the disease stage.