Breast-conserving treatment versus mastectomy in T1-2N0 breast cancer: which one is better for Indonesian women?

Background: This study aimed to compare the treatment outcomes between the use of breast-conserving treatment (BCT) and mastectomy for T1-2N0 breast cancer patients.Methods: This study retrospectively reviewed T1-2N0 breast cancer patients who received treatment between January 2001 and December 2010 at Department of Radiotherapy Cipto Mangunkusumo Hospital and Jakarta Breast Center. The endpoints of this study were overall survival (OS), local  recurrence (LR), contra-lateral breast cancer (CBC), distant metastasis (DM), and disease-free survival (DFS).Results: Among the 262 eligible patients, 200 (76.3%) patients underwent BCT while 62 (23.7%) patients underwent mastectomy. There were no differences between BCT and mastectomy groups in 5-Y OS (88.2% vs 86.7%, p = 0,743), LR (7.4% vs 2.7%, p = 0.85), CBC (3.4% vs 5.3%, p = 0.906), DM (17.7% vs 37.7%, p = 0.212), and DFS (78.5% vs 60.7%, p = 0.163). In multivariate analysis, grade 3 was associated with worse OS (HR 2.79; 95% CI 1.08 – 7.21, p = 0.03) and DFS (HR 2.32; 95% CI 1.06 – 5.06). Premenopausal women were associated with decreased risk of DM (HR 0.37; 95% CI 0.17 – 0.80) and DFS (HR 0.38; 95% CI 0.19 – 0.78).Conclusion: BCT and mastectomy showed similar outcome in terms of OS, LR, CBC, DM, and DFS. (Med J Indones. 2012;21:220-4)Keywords: Breast-conserving treatment, mastectomy, outcomes</p

Multicenter Management of Breast Cancer in Indonesia: Ten Years of Experience

&nbsp;In Indonesia, despite the increasing incidence, there is a gap in breast cancer patients profile, tumor characteristics and management as well as the follow up. This study aims to provide the profile and 10-year-experience in managing breast cancer. This was a cohort retrospective study conducted in all patients admitted to Department of Radiotherapy dr. Cipto Mangunkusumo National Hospital and Jakarta Breast Center from 2001 to 2010. Outcomes measured were patients&rsquo; profiles, disease stage at diagnosis, and treatment regimens which were collected from medical records to establish survival analysis and prognostic factors. In total, out of the 1,289 patients admitted during the period, follow-up was conducted in 933 breast cancer patients with a median follow-up of 26 months (0-130 months). The mean age of incidence was less than 50 years old. Most patients were pre-menopausal, not obese, breastfed their children and without a family history of cancer. Most common tumor profiles were invasive ductal (69%) grade II (28%) without lymph node involvement and positive hormone receptors. The survival of patients was higher in early stages. Multimodalities management were used for most patients, but overall compliance was only 46.2%. Five year survival was greater in patients with algorithm-based therapy and with high adherence. Despite the advancement of breast cancer screening and early therapy, more than 50% of breast cancer patients in Indonesia came at a later stage of breast cancer. Multimodalities treatment have become useful in managing breast cancer in various stages. &nbsp; &nbsp; Manajemen Multisenter Kanker Payudara di Indonesia: Pengalaman Sepuluh Tahun &nbsp; Di Indonesia, terdapat kesenjangan dalam tatalaksana pasien kanker payudara yang berdasarkan karakteristik tumor, manajemen yang diberikan serta tindak lanjut. Penelitian ini bertujuan untuk memberikan data profil dan pengalaman 10 tahun dalam mengelola kanker payudara di Indonesia. Penelitian ini merupakan penelitian retrospektif kohort yang dilakukan pada semua pasien kanker payudara di Departemen Radioterapi RSUPN dr. Cipto Mangunkusumo dan Jakarta Breast Centre dari tahun 2001 hingga 2010. Hasil yang diukur adalah profil pasien, tahap diagnosa, regimen terapi yang dikumpulkan dari rekam medis sehingga membentuk sebuah analisis survival dan faktor prognostik. Dari total 1.289 pasien di RSUPNCM pada periode tersebut, tindak lanjut dilakukan pada 933 pasien kanker payudara dengan rata-rata tindak lanjut 26 bulan (0-130 bulan) dengan usia rata-rata pasien kurang dari 50 tahun. Sebagian besar pasien memiliki kriteria premenopause, tidak obesitas, menyusui dan tanpa riwayat keluarga dengan kanker. Profil tumor yang paling umum ditemukan adalah duktal invasif (69%) grade II (28%) tanpa keterlibatan kelenjar getah bening dan reseptor hormon positif. Kelangsungan hidup pasien lebih tinggi pada tahap awal. Manajemen multimodalitas digunakan untuk kebanyakan pasien, tetapi kepatuhan keseluruhan hanya 46,2%. Kelangsungan hidup 5 tahun lebih besar pada pasien dengan terapi berbasis algoritma dan kepatuhan tinggi. Terlepas dari kemajuan skrining kanker payudara dan terapi dini, lebih dari 50% pasien kanker payudara di Indonesia datang dengan stadium lanjut. Tata laksana multimodal bermanfaat pada penanganan kanker payudara dalam berbagai tahap. &nbsp;&nbsp

A clinical study on skin cancer in Indonesian patients

[no abstract available