BackgroundBreast cancer diagnosed at a young age is often associated with aggressive biology, advanced stage, and unfavorable prognosis. The median age of breast cancer diagnosis in Indonesia is younger (48 vs. 68 years-old in Europe) with a relatively higher proportion of patients younger than 40 years old. Although prognosis and outcome of young breast cancer are well studied in developed nations, research evaluating biological characteristics, delivered treatment, and clinical outcomes is very limited in Indonesia.MethodsWe analyzed all breast cancer patients who underwent surgery at Dr. Sardjito Hospital, Indonesia, in 2012–2017. Details of pathology profiles, treatment administrated, and outcomes, as well as reproductive factors among patients younger than 40 years old, were collected and analyzed. Kaplan-Meier curve was used to assess conditional survival based on baseline characteristics.ResultsFrom the total of 1259 breast cancer patients (median age 51 years), 144 (11.4%) were younger than 40 years old (median age 37 years). Of these young patients, 19 (13.2%) were bilateral and 92 (64%) were diagnosed in advanced stages (stages IIIA-C and IV). Median tumor diameter was 5.5 cm and nodal infiltration was present in 73%. Distant metastasis was found in 16% at the time of diagnosis. Moderate and poor differentiation of tumor were 20.8 and 78.5%, respectively, and lymphovascular invasion was found in 90.3%. Around 40% were hormone receptor-positive, 30.6% human epidermal growth factor receptor 2 positive, and 38.2% triple negative. Patients underwent radical surgery in 121 cases (84%) and breast conserving surgery in 7 cases (4.9%). Adjuvant chemotherapy was administrated in 68% and hormonal therapy in 34%. Progression-free survival was significantly shorter in patients with advanced stage, skin and chest wall involvement (T4), positive lymph node infiltration, positive hormonal receptor, and triple negative subtype (log-rank Mantel-Cox tests, p < 0.05).ConclusionWe found a high frequency of young breast cancer with biologically more aggressive tumors, late diagnosis, frequent relapse, and poor prognosis. Further actions to improve clinical management and meet psychosocial needs in young breast cancer patients are warranted.

Latar Belakang : Eicosapentaenoic acid (EPA) mempunyai efek sebegai imunomodulator dan meningkatkan status gizi terutama dalam kaitannya dengan tumor kakeksia pada penderita dengan keganasan, Tujuan penelitian ini adalah mengetahui pengaruh pemberian eicosapentaenoic acid (EPA) terhadap jumlah sel T CD8+ pasien duktus invasif kanker payudara yang menjalani kemoterapi. Metode : Penelitian eksperimental pada pasien wanita dengan karsinoma duktus invasif payudara stadium IIIB yang menjalani kemoterapi Cyclophosphamide Adriamycin Fluorouracyl (CAF) siklus I dibagi menjadi 2 kelompok : tanpa pemberian EPA (kontrol) dan diberikan EPA 225 gr/hari selama 21 hari (perlakuan). Jumlah sel T CD8+ dalam darah perifer pasien diukur sebelum dan sesudah 21 hari setelah terapi. Hasil : Empatpuluh pasien mendapat kemoterapi CAF siklus I, terdiri dari 20 orang kelompok perlakuan dan 20 orang kelompok kontrol. Jumlah sel T CD8+ setelah terapi pada kelompok perlakuan lebih tinggi secara bermakna 1131,7sel/µl (483 – 3506) dibanding kelompok kontrol 631,8 sel/µl (227 – 1616) ( p< 0,05) dan diperoleh selisih jumlah sel T CD8+ yang berbeda bermakna sebelum dan 21 hari setelah kemoterapi pertama pada kedua kelompok penelitian ( p<0,001). Kesimpulan : Suplementasi EPA meningkatkanjJumlah sel T CD8+ dalam darah perifer pasien karsinoma duktus invasif payudara stadium III B yang dilakukan kemoterapi. Kata kunci : karsinoma duktus invasif payudara, Eicosapentaenoic acid (EPA), kemoterapi, CD8+

Background. Corona Virus Disease-19 (COVID-19) is an infectious disease caused by the SARS-CoV2 virus. The increasing number of COVID-19 cases have caused anxiety problems in several countries. Breast cancer patients already have anxiety about their own disease. During the COVID-19 pandemic, this anxiety might be increased due to the fear of getting infected both in the environment where they live or in the hospital. Methods. This is a descriptive observative study, on females with history of cancer in the Wijayakusuma group, Dr. Kariadi Hospital, Semarang, Central Java during February – March 2021. Data collected using questionnaire based on Generalized Anxiety Disorder 7-item (GAD-7) that the question was modified for evaluating anxiety about COVID-19 pandemic in breast cancer patients. Data analyzed using SPSS 23rd version Results. In this study, the breast cancer patient who not anxious were 19.1%, slightly anxious 35.5%, moderate anxious 23.6%, and severe anxious 21.8%. 74,5% patients feel they must wash their hands more often. 60,9% were worried about possibility of contracting COVID-19 of their members, 49,1% afraid of COVID-19, 50,9% were not afraid about COVID-19, 44,5% feel uncomfortable when think about COVID-19, and 40,9% Feel that COVID-19 is life-threatening. Conclusion. There was increase of anxiety level. There was a behavioral change in patients where patients wash their hands more often due to the COVID-19 pandemic.

Pendahuluan : Seperti tumor padat lainnya kanker payudara dapat tumbuh dan bermetastasis bila memperoleh oksigen dan nutrisi yang cukup. Tanpa adanya suplai darah yang menyediakan oksigen dan nutrisi maka tumor akan diam atau bahkan mati. Suplai darah bisa terjadi apabila sel tumor mampu membentuk pembuluh darah baru, yang disebut angiogenesis, yang merupakan faktor terpenting agar sel kanker itu dapat tumbuh dan melakukan metastasis. Metode : Penelitian ini menggunakan studi prospektif cross sectional dengan melakukan kultur jaringan kanker payudara sebanyak 14 kasus. Eksplan diambil dari spesimen hasil operasi dan ditanam dalam medium kultur 3 dimensi yang telah diberi endhotelial cell line. Aktifitas angiogenesis dinilai secara semikuantitatif invitro. Pengamatan aktifitas angiogenesis dilakukan setiap 24 jam dengan menilai migrasi sel endotel selama 96 jam. Pengamatan didokumentasikan dengan memakai skoring 0-4. Hasil : Berdasarkan evaluasi terhadap 14 kasus yang dilakukan kultur, didapatkan korelasi antara skor angiogenesis dengan TNM (tumor lymnode metastase), grading, dan tipe histopatologi. Kanker dengan grade III, tipe scirous mempunyai nilai skoring (+4), tanpa memandang TNM. Diskusi : Angiogenesis dapat terjadi melalui beberapa cara yaitu melaui proses tunas atau bukan tunas. Pembentukan angiogenesis meliputi pembentukan jaringan kapiler baru yang merupakan awal pembuluh darah, sedangkan yang bukan melalui tunas angiogenesis meliputi proses menjadi besar, pemisahan, dan penggabungan calon pembuluh darah. Proses bukan tunas memerlukan proliferasi sel endotel untuk membentuk dinding pembuluh darah. Pada penelitian ini tidak ada korelasi antara umur, status menopaus, dan status masa tumor dengan derajat angiogenesis. Hanya pada tipe histopatologi dan yang mempunyai korelasi dengan derajat angiogenesis dengan korelasi koefisien p=0,019 (