Scribd Logo
Upload

Welcome to Scribd!

  • 159 views

    Ca Mammae

    Uploaded by

    Anonymous F0eeZBMK
    Breast cancer is a common type of cancer in women. Early detection through self-examination (SADARI) and screening can help diagnose breast cancer early when it is more treatable. SADARI involves visually inspecting, feeling, and squeezing the nipples to check for any abnormalities. Breast cancer stages range from localized early-stage cancers to more advanced metastatic cancers. Treatment options depend on the cancer stage but may involve surgery, radiation, chemotherapy, hormone therapy, and targeted molecular therapies. Long term follow up after treatment is important to monitor for recurrence.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd

    Ca Mammae

    Uploaded by

    Anonymous F0eeZBMK
    159 views43 pages
    Breast cancer is a common type of cancer in women. Early detection through self-examination (SADARI) and screening can help diagnose breast cancer early when it is more treatable. SADARI involves visually inspecting, feeling, and squeezing the nipples to check for any abnormalities. Breast cancer stages range from localized early-stage cancers to more advanced metastatic cancers. Treatment options depend on the cancer stage but may involve surgery, radiation, chemotherapy, hormone therapy, and targeted molecular therapies. Long term follow up after treatment is important to monitor for recurrence.

    Original Description:

    ca mamae

    Copyright

    © © All Rights Reserved

    Available Formats

    PPT, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Breast cancer is a common type of cancer in women. Early detection through self-examination (SADARI) and screening can help diagnose breast cancer early when it is more treatable. SADARI involves visually inspecting, feeling, and squeezing the nipples to check for any abnormalities. Breast cancer stages range from localized early-stage cancers to more advanced metastatic cancers. Treatment options depend on the cancer stage but may involve surgery, radiation, chemotherapy, hormone therapy, and targeted molecular therapies. Long term follow up after treatment is important to monitor for recurrence.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    159 views43 pages

    Ca Mammae

    Uploaded by

    Anonymous F0eeZBMK
    Breast cancer is a common type of cancer in women. Early detection through self-examination (SADARI) and screening can help diagnose breast cancer early when it is more treatable. SADARI involves visually inspecting, feeling, and squeezing the nipples to check for any abnormalities. Breast cancer stages range from localized early-stage cancers to more advanced metastatic cancers. Treatment options depend on the cancer stage but may involve surgery, radiation, chemotherapy, hormone therapy, and targeted molecular therapies. Long term follow up after treatment is important to monitor for recurrence.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 43

    Breast Cancer

    dr.Donny Valensius Susanto


    RSMH PALEMBANG
    DEPARTEMEN BEDAH
    Sub Devisi Bedah Onkologi
    Epidemiologi kanker

    The burden of cancer in Asia. Pfizer facts. 2008.


    Negara yang sedang berkembang

    Perkiraan Kasus Baru Perkiraan Kematian

    Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin. 2011;61:69-90
    Stage distribusi of breast cancer arround the world

    Centre Is To T1 T2 T3 T4

    UK 10 % 2% 36 % 44 % 8% 0%
    Australia 0% 0% 52 % 36% 12 % 0%

    Hungaria 9% 0% 56 % 32% 6% 2%

    Turkey 0% 4% 26 % 48% 14 % 8%
    Mexico 0% 1% 14 % 35% 20 % 30 %
    Oman 0% 0% 10 % 45% 14 % 31 %
    Pakistan 0% 0% 4% 68% 24 % 4%

    Bangladesh 0% 0% 6% 32 % 53 % 9%
    Kenya 0% 0% 0% 0% 76 % 34 %
    Brazil - - 20 % 48 % 26 % 6%
    Uganda 3% - - 5% 35 % 59 %

    EBCC 9. 21 maret 2014 International prevention Reseach Intitutr


    Reaksi saat didiagnosis kanker ?
    Apakah Kanker Payudara dapat dicegah ?

    Bagaimana DX Kanker payudara stadium awal ?


    Cancer treatment

    Natural History

    Localised disease
    CURABLE
    Harapan Hidup Pasiesn KPD

    Stadium 5 Years 5-Y r S urvival R ate (% )


    (%)
    100
    I 100
    80
    IIA 92
    60
    IIB 81
    40
    IIIA 67 20
    IIIB 54 0
    IV 20 I IIA IIB IIIA IIIB IV

    American Cancer Society


    Status Tumor Terakhir
    Signs and Symptoms

    Most common:
    lump or
    thickening in
    breast. Often
    painless

    Discharge Redness or pitting


    or of skin over the
    bleeding breast, like the
    skin of an orange
    Change in size
    or contours of Change in color
    breast or appearance
    of areola
    Klasifikasi Histopatologi
    WHO Histological classification of breast tumor
    Japanese Breast Cancer Society (1984) Histological classification of breast
    tumor Non invasive ductal
    Non invasive carsinoma,
    carcinoma Lobular Carsinoma in situ

    Invasive carcinoma Special Types


    • Mucinous carcinoma
    • Medullary carcinoma Paget’s
    Invasive Ductal disease
    • Invasive lobular carcinoma
    Carsinoma
    • Adenoid cystic carcinoma
    • Papillobular
    • Squamous cell carcinoma
    • Solid-tubula
    • Spindel cell carcinoma
    • Scirrhous
    • Apocrine carcinoma
    • Carcinoma with cartilaginous
    and or osseous metaplasia
    • Tubular carcinoma
    • Secretory carcinoma
    • Others
    Gradasi Histopatologi
    Kecuali tipe medulare, seluruh kasus kanker payudara harus dibuat gradasi
    histologis.
    The Nottingham combined histologic grade (Elston-Ellis  modifikasi Bloom
    - Richardson)
    Gx Grading tidak dapat
    dinilai
    G1 Low grade
    G2 Intermediate grade
    G3 High grade
    Pembentukan tubulus
    Plemorfisme dari nukleus
    Jumlah mitosis
    Prosedur
    PROSEDUR Diagnostik
    DIAGNOSTIK
    1. Pemeriksaan Klinis (Anamnesis, pemeriksaan
    fisik)
    2. Pemeriksan radiodiagnostik
    3. Fine needle aspiration biopsy
    4. Histopatologi (Gold Standard)
    5. Laboratorium
    Screening
    1. SADARI
    Wanita usia subur, tiap minggu setelah hari
    pertama menstruasi terakhir
    2. Pemeriksaan fisik
    Oleh dokter secara lege artis
    3. Mammografi
    -Wanita usia 35 – 50 tahun : setiap 2 tahun
    -Wanita usia > 50 tahun setiap 1 tahun
    Modalitas Terapi
    1. Pembedahan (BCS, simple / radical / modified
    radical mastectomy)
    2. Radiasi (primer , adjuvan, paliatif)
    3. Kemoterapi (kombinasi)
    4. Hormonal terapi (abblative, additive, optional)
    5. Molecular targeting therapy (biology therapy)
    Modalitas Terapi : Pembedahan
    Indikasi : Kanker payudara stadium awal
    Tipe :
    • Mastectomy radical
    • Modified Radical Mastectomy
    • Simple mastectomy
    • BCS
    Modalitas Terapi : Kemoterapi
    Merupakan terapi kombinasi

    Tipe :
    • Neoadjuvant (sebelum pembedahan)
    • Adjuvant (sesudah pembedahan)
    • Therapeutic chemotherapy  tujuan paliatif
    • Paliatif
    Modalitas Terapi : Kemoterapi

    Dosis dan Jenis Kemoterapi

    Adjuvant : 6 siklus
    Neoadjuvant : 3 siklus
    Terapeutik : s.d metastasis hilang atau terjadi
    intosikasi
    Paliatif : jangka panjang dengan tujuan paliatif
    Modalitas Terapi : Hormonal

    Indikasi : reseptor hormonal positif (ER dan PR).


    Sifat terapi hormonal :
    Additive (tambahan)
    Ablative (menghilangkan sumber hormon tertentu)

    Pilihan:
    • Tamoxifen
    • Aromatase inhibitor (Letrozole, anastrozole dan
    exemestan)
    Terapi
    Pembedahan : BCS , simple
    Stadium mastectomy
    0
    Adjuvan : Radioterapi, kemoterapi,
    hormonal

    Locally Neoadjuvant chemotherapy , hormonal


    advanced pada ER/PR +
    breast cancer Pembedahan : MRM
    (IIIa, III b, III c)
    Adjuvan : Radioterapi, kemoterapi,
    hormonal
    Pembedahan (Paliatif) pada tumor
    Metastatic primer maupun lokoregional (apabila
    breast cancer diperlukan)
    (IV)
    Kemoterapi
    Hormonal pada ER/PR +
    Follow up

     Rekurensi (>50%) biasanya terjadi 2 tahun pasca


    pembedahan, namun bisa sampai 20 tahun pasca
    bedah

     Interval kontrol sebagai berikut:


    Tahun 1 dan 2 Tiap 2 bulan Tujuan :
    Mendeteksi
    Tahun 3 s.d 5 Tiap 3 bulan rekurensi dini
    Tahun > 5 Tiap 6 bulan
    Follow up
    • SADARI setiap bulan

    • Pemeriksaan fisik oleh dokter

    • Imaging 
    • Mamografi, Ro thorax, USG liver tiap 6 bulan selama 3
    tahun pertama
    • Bone scan tiap 2 tahun kecuali jika ada indikasi

    • Tumor marker CA 15-3 tiap 2-3 bulan (monitoring


    rekurensi)
    Pendekatan Skunder

    Menemukan kanker payudara dalam


    stadium dini/awal dengan cara :

    1. SADARI ( periksa payudara sendiri)


    2. PEMERIKSAAN FISIK (oleh dokter)
    3. MAMOGRAFI (wanita usia diatas 40
    tahun)
    Pendekatan Tertier

    • Pengobatan sebaik dan setepat mungkin


    sehingga tidak terjadi kekambuhan yang
    akan menyebabkan kesulitan dalam
    pengobatan berikutnya.
    Apakah Yang Dimaksud “ Sadari” ?

    - SADARI (Periksa Payudara Sendiri)


    - Waktu pemeriksaan
    “ SADARI meliputi ”

    1. MELIHAT
    2. MERABA
    3. PIJIT PUTING SUSU
    PEMERIKSAAN MELIHAT
    PERABAAN
    Pemijatan
    Kesimpulan
    1. Kanker payudara paling sering dijumpai pada
    wanita.
    2. Kanker payudara yang terdiagnosa sudah
    berada pada stadium lanjut.
    3. Kanker payudara berhubungan dengan faktor
    resiko.
    4. Kanker payudara terdiagnosa dini 5- yr Survival
    rate tinggi.
    T4

    Retraksi Nipple
    Ulkus

    Peau De Orange

    You might also like