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Hubungan Profil Klinikopatologik dengan Rekurensi Karsinoma Payudara Invasif di Departemen Patologi Anatomik FKUI/RSCM Ineke Anggreani; Primariadewi Rustamadji
Majalah Patologi Indonesia Vol 31 No 2 (2022): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (384.851 KB) | DOI: 10.55816/mpi.v31i2.506

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ABSTRACTBackgroundBreast cancer is the most common malignancy and the leading cause of death in women. Invasive breast carcinoma is a breastmalignancy originating from the glandular epithelium of the breast. Approximately 40% of invasive breast carcinomas had recur.There are several factors that influence the occurrence of recurrence, such as age, tumor size, lymphovascular invasion, incisionmargins, hormonal status and therapy. This study aims to determine the clinicopathological profile associated with recurrence 5years after therapy for invasive breast carcinoma.MethodsThis study is a retrospective study with data collection carried out through the archives of the Department of Anatomical Pathology,Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital within a period of 2 years (2014-2015). Theclinicopathological data was searched for up to 5 years of therapy.ResultsFrom the 54 cases of invasive breast carcinoma in this study, all were women with mean age 48.3 years. A total of 18 cases(33.3%) experienced recurrence, especially in patients aged ≤50 years, tumor mass size more than 2 cm and luminal B moleculartype. Tumor margin is difficult to evaluate because many review cases do not submit the tumor margin section. Therapy received bypatients was in accordance with standard procedures’ hospital, both neoadjuvant and adjuvant chemotherapy. From the statisticalanalysis, there was no significant relation between all profiles that studied with recurrence. It is because the comparison of numberof recurrent and non-recurrent cases is not equal.ConclusionOne third of advanced invasive breast carcinomas treated with neoadjuvant and showing a partial response have recurrence,whereas no complete response has recurrence. Tumor size, histologic grade, molecular type and adherence to routine follow-uptreatment influenced the recurrence within 5 years of treatment.
E-cadherin and NM23HI as metastasis predictors for various degrees of histological malignancy in invasive ductal carcinoma Rustamadji, Primariadewi; Tjarta, Ahmad; Cornain, Santoso; Ramli, Muchlis; Soetrisno, Esti
Medical Journal of Indonesia Vol 20, No 4 (2011): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1660.907 KB) | DOI: 10.13181/mji.v20i4.459

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Background: This study aims to analyze whether the expressions of E-cadherin and NM23HI can be used as predictors of ductal carcinoma metastasis in various degrees of  malignancies.Methods: Paraffin blocks were obtained from 97 patients with invasive breast ductal carcinoma with malignancy grade 1, 2 and 3 who came to several hospitals in Jakarta and Bandung from 2000 to 2006. Histopathological examinations of hematoxylin eosin slides of primary and secondary tumors were done to  diagnose the degree of histological malignancy and metastasis status. Further, immunohistochemistry staining of E-cadherin, NM23HI and cytokeratin were done followed by scoring according to the number of positive cells and staining intensity. The  associations of E-cadherin and NM23H1 expression with the presence of metastasis and grade of histological malignancy were analyzed.Results: Subjects were 29-75 years old (mean: 48.19 years), with most subjects aged 40–45 years old, with malignancy grade 1, 2 and 3 of 18.56%, 45.36% and 36.1% respectively. There was a significant association between E-cadherin and NM23HI expression in primary tumors. The possibility of invasion and metastasis inhibition by positive E-cadherin and NM23HI was 14 and 11 times respectively compared to those with negative E-cadherin and/ or NM23HI expression. The ROC curve showed that E-cadherin (r= 0.755) and NM23HI (r= 0.827) expressions were strongly associated, sensitive and specific as metastasis markers. However, E-cadherin and NM23HI expression didnot show significant association with histological degree of invasive ductal carcinoma.Conclusion: E-cadherin and NM23HI expressions can be used as invasion and metastasis markers, but cannot be used as  markers for the degree of histological malignancy of invasive ductal carcinoma. (Med J Indones 2011; 20:263-70)Keywords: Breast cancer, E-cadherin, NM23HI
Analisis Peran p53 pada Astrositoma Difus dan Astrositosis: Studi Diagnostik Eka Susanto; Esti DS Soetrisno; Nurjati C Siregar; Ening Krisnuhoni; Primariadewi Rustamadji
Majalah Patologi Indonesia Vol 26 No 1 (2017): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (583.169 KB)

Abstract

Latar belakang Astrositoma difus (WHO grade II) merupakan tumor astrositik yang paling sering ditemukan di FKUI/ RSCM. Tumor ini merupakan tumor invasif, potensial agresif, dan dapat bertransformasi menjadi astrositoma derajat tinggi. Pada praktik sehari-hari, diagnosis astrositoma difus kadang-kadang sulit ditegakkan hanya dengan gambaran histopatologik. Hal ini terutama disebabkan karena astrositoma difus sukar dibedakan dengan astrositosis, apalagi bila ukuran spesimen biopsi sangat kecil. Beberapa penelitian menunjukkan bahwa mutasi gen TP53 sering ditemukan pada astrositoma difus. Penelitian ini dilakukan untuk menganalisis pulasan imunohistokimia p53 dalam membedakan astrositoma difus (WHO grade II) dengan astrositosis. Metode Studi diagnostik dilakukan pada 20 kasus astrositoma difus dan 20 kasus lesi astrositosis dengan baku emas pemeriksaan histopatologi. Penilaian histopatologi dan ekspresi p53 dinilai secara tersamar. Pulasan imunohistokimia dinyatakan dalam skor, yaitu positif bila inti astrosit terwarnai coklat tua. Hasil penilaian ekspresi pulasan p53 dimasukkan ke dalam Tabel 2x2 untuk dihitung nilai diagnostiknya. Hasil Protein p53 terekspresi kuat pada 13 kasus astrositoma difus dan 1 kasus astrositosis karena peradangan. Dengan demikian didapatkan sensitivitas 65% dan spesifisitas 95%. Terdapat 2 kasus astrositosis yang positif kuat pada endotel dan makrofag. Ekspresi lemah dan sedang tidak terbatas pada astrositoma difus, namun dijumpai pula pada kasus astrositosis. Kesimpulan Pada penelitian ini di dapatkan spesifisitas yang cukup tinggi, namun sensitivitas masih rendah. Ekspresi p53 tidak terbatas pada astrosit neoplastik, tapi juga dijumpai pada astrosit reaktif dan sel selain astrosit. Oleh karena itu diperlukan kehati-hatian dalam interpretasi ekspresi p53. Kata kunci: astrositoma difus, astrositosis, imunohistokimia, p53.
Triple Diagnostic Accuracy on Early Stage Breast Cancer at dr. Cipto Mangunkusumo and Persahabatan General Hospital Kartini, Diani; Megatia, Ika; Darmiati, Sawitri; Rustamadji, Primariadewi; Budiningsih, Setyawati
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Introduction. Breast cancer is the most common cancer in Indonesia with incidence rate 40.3 per 100.000 women and mortality rate 16.6 per 100.000women. On early stage, the decision for operative procedure (i.e. mastectomy) requires intraoperative frozen section to assess malignancy; which is mostly unavailable in secondary hospitals. The triple diagnostic (TD) test consists of physical examination, breast ultrasonography and fine needle aspiration biopsy is an accurate and simple preoperative diagnostic method that may solve the problem. The study aimed to find out conformance of the triple diagnostic to histopathology findings in those with breast lump where the malignancy was suspected. Method. A study of diagnostic accuracy conducted enrolling subjects with suspected malignant breast lump managed in dr Cipto Mangunkusumo General Hospital (RSCM) and Persahabatan Hospital (RSP) in period of February 2016 to August 2017 who met the criteria: those underwent preoperative triple diagnostic, intraoperative frozen section and histopathology examination. The conformance of TD and frozen section were compared to histopathology findings. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were the focuses of the study. Results. There were 33 subjects enrolled (prevalence of 4.3%), mean age of 49.6 years ± 10.9, were above 40 years (78.8%). Tumor size of 2–5 cm found in 63.6% subjects, and the most histopathology finding was invasive carcinoma (84.8%). Frozen section showed sensitivity of 96.8%, specificity of 100%, PPV of 100%, NPV of 66.7% and accuracy of 97.0%. TD showed sensitivity of 77.4%, specificity of 100%, PPV of 100%), NPV of 22.2% and accuracy of 78.8% (p = 0.016). Conclusion. Triple diagnostic reaches up to 78% accuracy on early stage breast cancer may be used secondary hospital in Indonesia whenever frozen section is unavailable.
Hubungan Subtipe Molekular pada Karsinoma Payudara Invasif dengan Grade, Invasi Limfovaskular dan Metastasis KGB di Departemen Patologi Anatomik FKUI/RSCM Tahun 2019 Kristina Anna Bethania; Primariadewi Rustamadji
Majalah Patologi Indonesia Vol 31 No 1 (2022): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (564.762 KB) | DOI: 10.55816/mpi.v31i1.493

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BackgroundBreast cancer is classified into molecular subtypes: luminal A, luminal B, HER2 enriched and triple negative breast cancer based onits immunohistochemical profile. This study aims to assess the relationship between histologic grade, lymphovascular invasion andlymph node metastasis with molecular subtypes in invasive breast carcinoma at Cipto Mangunkusumo Hospital from January 1,2019 to December 31, 2019.MethodsA descriptive, cross-sectional study was conducted in Anatomical Pathology Department, FKUI/RSCM over a period of January toDecember 2019. A total of 652 histologic specimens with a diagnosis of invasive breast carcinoma which were immunostained withER, PR, HER2, and Ki67 were reviewed, then grouped into the appropriate molecular subtypes. A Chi-square test was performed toassess the association between histologic grade, lymphovascular invasion and regional lymph node metastases with molecularsubtypes.The p-value <0.05 was statistically significant.ResultsThe molecular subtypes of breast cancer, from the highest to the least number, were luminal A (40.2%), luminal B (37.7%), TNBC(13.6%), and HER2 enriched (8.6%). There was a significant association between grade and molecular subtypes of breast cancer.(p=<0.001). There was a significant association between lymph node metastasis and molecular subtypes of breast cancer(p=0.038).ConclusionThe most common molecular subtype of invasive breast cancer found was Luminal A. There was a significant association betweenlymph node grade and metastasis and the molecular subtype of breast cancer.
The Role of Melatonin in Improving Hypoxia in Malignant Tumor: A Mini-Review Kartini, Diani; Taher, Akmal; Panigoro, Sonar S.; Setiabudy, Rianto; Jusman, Sri W; Haryana, Sofia M; Abdullah, Murdani; Rustamadji, Primariadewi
The New Ropanasuri Journal of Surgery
Publisher : UI Scholars Hub

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Abstract

Karakteristik Histopatologik dan Imunofenotipik Kanker Payudara di Rumah Sakit Cipto Mangunkusumo Jakarta, Indonesia Primariadewi Rustamadji; Stephanie Marisca
Medicinus Vol 6, No 3 (2017): June 2017 - September 2017
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v6i3.1147

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Introduction: Breast cancer can be classified into luminal A, luminal B, Her2+, dan basal-like molecular subtype according to genetic profile and immunophenotype. The aim of this study is to assess histopathologic and immunophenotype characteristics of breast cancer in Cipto Mangunkusumo Hospital Jakarta, Indonesia.Material and methods: This study is a cross-sectional retrospective study. The sample was 2632 breast cancer case in Department of Anatomical Pathology Cipto Mangunkusumo Hospital from the year 2011 until 2015. ER, PR, Her2, Top2 α, and Ki67 immunohistochemical stain was then grouped into luminal A (ER+/PR+/Her2-/Ki67<20%) subtype, luminal B (ER+/PR+/Her2-/Ki67≥20%) subtype, Her2+ (ER-/PR-/Her2+) subtype, and basal-like (ER-/PR-/Her2-) subtype. Kendall’s Tau analysis was done to assess association between sample characteristics and molecular subtype, association between top2α positive and molecular subtype.Result: The most prevalent to the less prevalent breast cancer molecular subtype was luminal B (43,9%), Her2+ (14,6%), luminal A (14,0%), and basal-like (11,3%). There was a significant association between the tumor stage and breast cancer subtype (p=0,0001). There is also a significant association between Top2α expression and molecular subtype (p=0,0001).Conclusion: The most prevalent breast cancer molecular subtype was luminal B. There was an association between breast cancer molecular subtype and a higher degree and Top2α expression.
Ekspresi HER-2 pada Adenokarsinoma Gaster dan Hubungannya dengan Tipe Histopatologik dan Derajat Diferensiasi Diah Setiawati; Diah Rini Handjari; Primariadewi Rustamadji
Majalah Patologi Indonesia Vol 23 No 1 (2014): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

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Background Gastric carcinoma is the most common malignant tumor in upper gastrointestinal. According to epidemiologic data, gastric adenocarcinoma intestinal type and diffuse type showed different carcinogenesis. Recently, targeting therapy for adenocarcinoma has established. The aim of the study to know the relationship between HER-2 expression and histopathologic type according to Lauren’s classification and grading of gastric adenocarcinoma. Methods This study has done in Department of Anatomical Pathology Faculty of Medicine University of Indonesia/Cipto Mangunkusumo National Hospital, Jakarta. HER-2 expression is analyzed to see the relationship with histopathologic type and differentiation of gastric adenocarcinoma. The specimens were from resection and biopsy (2007-2011). Histopathologic type evaluated with Hematoxylin Meyer’s staining. HER-2 expression evaluated with immunostaining with HER-2 antibody. Results We found 55 cases from 2007 until 2011 (76.4% men and 23.6% women). The mean age is 50.55 years (the range of age 29-73 years). HER-2 expression 3+,2+ and 1+ are 14.5%, 34.5%, and 25.5% sampling. 25% sample did not show HER-2 expression. We found overexpression HER-2 (3+) in 8 cases (14.5%) of adenocarcinoma gastric intestinal type. Conclusion There is a significant relation between HER-2 expression with histopathologic type (p=0.021). There is no significant relation between HER-2 with grading (p=0.253). Key words: grading, gastric adenocarcinoma, HER-2.
The Role of Curcumin on Apoptosis through The RASSF1A and Bax Pathways in Breast Cancer Nunung Ainur Rahmah; Harliansyah Harliansyah; Fransiscus D. Suyatna; Mpu Kanoko; Primariadewi Rustamadji; Joedo Prihartono; Samuel Johny Haryono; Bethy Suryawati Hernowo
Indonesian Journal of Cancer Chemoprevention Vol 11, No 2 (2020)
Publisher : Indonesian Society for Cancer Chemoprevention

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14499/indonesianjcanchemoprev11iss2pp67-74

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Curcumin has been reported with an in vitro the cytotoxic effect on several human cancer cells. However, reports on the mode of action and detail mechanism of curcumin in breast cancer disease are limited. Hence, curcumin’s effect on the human breast cancer cell line MCF-7 and MDA-MB-468 was investigated. The MCF-7 and MDA-MB-468 breast cancer cells line were given curcumin in several doses. The anti-proliferation activity of curcumin was determined using the MTS cell viability test and caspase-3 activity was used to detect apoptosis using flowcytometry. The expression of Ras-association domain family 1 isoform A (RASSF1A) and Bax protein in cells was evaluated by ELISA analysis. Kruskal-Wallis followed by the Mann-Whitney test and the Spearman correlation tests were used to asses correlation among RASSF1A, Bax, and caspase-3. Cytotoxicity of curcumin on MCF-7 was lower than that of MDA-MB-468 (75.73 μg/mL and 380.79 μg/mL). The concentration of curcumin at 80 μg/mL induced apoptosis mainly through the intrinsic pathway by caspase-3 activation. Curcumin also showed an anti-proliferative activity as shown by the increase of RASSF1A and Bax protein. Curcumin mediates anti-proliferative and apoptotic effect through the activation of RASSF1A and Bax. Our research data adds information about the role of curcumin in epigenetic events through RASSF1A protein.Keywords: Bax, caspase-3, curcumin, MCF-7, MDA-MB-468, RASSF1A
Unilateral Usual Ductal Hyperplasia in A 22 Years Old Male Patient: A Case Report Kelvin Setiawan; Bramastha Aires Rosadi; Terry Renata Lawanto; Primariadewi Rustamadji
JBN (Jurnal Bedah Nasional) Vol 3 No 2 (2019): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (334.447 KB) | DOI: 10.24843/JBN.2019.v03.i02.p03

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Background: Benign breast disease have been broadly classified into non-proliferative lesions, proliferative lesions without atypia and hyperplasia with atypia. Proliferative disease, such as usual ductal hyperplasia, is associated with a 1.5 to 2 fold increased risk of developing invasive carcinoma. We reported a case of usual ductal hyperplasia in a young male. Case: A 22-year-old male complained of discomfort and enlargement of unilateral breast. Physical examination at that time revealed a palpable mass in the lateral upper quadrant of the patient’s left breast, three centimeters from nipple areola complex. The examination of axilla didn’t reveal any lymph node enlargement on both sides. His vital signs were normal without any abnormalities found on examination. Ultrasonography examination demonstrated fibroglandular tissue in the left breast with the volume of 11.13 cm3, consist of 4.8 cm length, 2.9 cm width and 0.8 cm depth. Excisional tumor biopsy was done on his left breast. Usual duct cell hyperplasia was present in microscopic examination with chronic inflammatory cells spreading around the fibrotic stromal cell. Physical examination, radiologic examination, and biopsy were all performed in this patient. Although the accuracy of the triple test is high, benign concordant results do not obviate further surveillance of a palpable mass. We advised our patient to routinely follow-up his condition every 6 months for 1 to 2 years, especially if there any changes found on his breasts. Conclusion: Any guidelines and further studies regarding patient’s follow-up examination after biopsy for male breasts tumor are needed in order of better understanding about this disease.