Longitudinal clinicopathological follow up of breast cancer patients from 1988 to 1996 in Jakarta
Vtl 8, No 2, April. - June 1999
Cliticoltathol.ogicaL of breast cancer patients
t09
Longitudinal clinicopathological follow up of breast cancer patients
from 1988 to 1996 in Jakarta
Didid Tiindarbumi'', Gunawan Tjahjadi#, Muchlis Ramli*, Yoshiyuki Ohnot, Idral Darwis*,
Goi Sakamoto', Santoso Cornain#, Esti Soetrisno#, Joedo Prihartonoo, Endang Sri Roostini#,
Setyawati Budiningsiho, Kenji Wakait, Drupadi S Dillons
Abstrak
Kanke
Penel.ititttt
r payudctrct nrcrupctkan kegartasan 1'ang paling sering clitemukan pada wcurito Intlonesia sesudalt kanker ntulut rahint.
Sejetk
ini dibagi dal.am 2 fase . Pada fase I ( l9B8 s/d 1992) tliteliti 300
kasus ktnker ltayudarcr baru tlan dibantlingktm dengan 600
(1993 s/d 1996) ditel.iti 266 kasus kanker pa\tudara baru dur dibandingkan dengan 452 kontrol. Makalah ini
ctkrut tnernbicarakatz ketahanart dtut lnrapcut hidup 5 tahwt dari 110 penderita kanker payuclara opertbel yang tennontk kelontltok I
dililmt clari segi kl.inikopatologi. Sisa 190 dari jumlah 300 ka.rus yang termasuk kelontpok I itu, tidak diikut sertakan karcna srrlcth berada
daLarn kearltmn Lttniut dart buruk, dan ticlak nrcnmngkinkan wûuk ntentlaltatkan ;tengobatan lengkap. Kasus kanker payutlara operabel
ycLng terntnsuk fase 11, 75 kasus, juga tidttk cliikutsertakan karena masa obsen,asi 5 tahun sel.urulutya baru akan selesai tahun 2001.
DiantcLra I I0 kasus kartker payudara operabel yang dioperasi clari talun 1989, 1992 dan diikuti s/tl I 996, ditenukan 43 (39Vo) penderita
rneninggal cli runah sakit atau runah sendiri, 33 (30Vo) nrtsilt lridttlt taryta atlanya ltenyebaran atau kekunbuhan penyakit dut 34 (3 tVo)
kctslts kon.trol. Padafa-se
II
payudara adalalt: 68,80/o clertgart perincian 87,5Vo dari Stacliurrr I, 61,3Vo clari Stodinn
II
dan 57,8Vo tlari Stadium IIIA.
Abstract
Breast cancer belongs to tlu leading cancer anLong Intlonesitut wonrcn, it ranked .çecond to the crmcer of the Ltterine cervix. A
colLaborative ,;tutly on the eliol.ogy ancl cLinir:opathology of brcast cculcer belween Japan and Indonesia has been cctrried out. This stucly
wct.s started in 1988 utd concluclecl itr 2 botches. Tlrc Jirst wcLs between i,988- I992, w,here 300 cctses utd 600 controls were stutlied, wh.ich
was extenrletl with. the secontl batch from 1992- 1996, for Jurther nutritional analrsis on 226 and 452 controls. This paper will cliscuss
the 5 ttear longitutlinal. cl,itticopatlrclogiccrl.foLlow up obsen,atiort ort ll0 operable cases bel.onging to the 300 l{ batch patients. The
rennining 190 patien.ts wetz lote cases ancl were ltot suitabl.e for this project since nanv of tlrcnt were in a worse conclition. The opercLble
ltctienls (75 ) .from the 2nt baîch (226) were not incl.uded since tlr 5 ):eor survival. anal.ysis wouLd not be done until. the year 2001 . Antong
II0 operable breast cancer adnittetl between 1989 througlt 1992, we./brd 43 (39Eo) lratients died in the hospitctl or al their own hone,
33 (30Vo) palietils orz al.ive u,illnut recurrence and 34 (3lVo) patients are alive, but with recurrence or nxet(Ætatic clisease. Tlte overall
5 year sun,ivttl rate v,as 68.8Vo wirh thefollowirtg detail.s: BT.5Vofrom Stage I,6l.3o/ofrom Stage II cuul 57.8Vofrom Stage IItA.
Keywolds: Btcttst cancer, operabl.e ccses, Iortgittttlindl. stud!-, cLinicopathological., sun,ivtil. an.alysis.
INTRODUCTION
Breast cancer presents an enormous public health
problem in countries with a high as well as low social
socio-economic level.l The morbidity rate and the
*
#
DeportmerTt of SLu'gery, Faculty of Medicine, Unit,ersity
Incloneskt, Jokarta ] 0430, I ntlonesio
of
Deportmenl of Anatontic Patlnl.ogy, Faculty of Medicine,
University of Intlonesia, Jalcarta 10430, Intloneskr
t Depttrtnrcnl of Preventif Medicine, Nctgol,cL Universit,- SchooL
of Metlicirrc, Nagoya 466, Japan
' Department of PathoLogy, Cancer Instittûe, Tokyo 170, Japan
" Department oJ'Contnuutit-v- Merlicine, FacLrl.ty of Mediciue,
U n iv e r s i ty of I rd one s ict, J akar ta 1 03 20, I ndo ne s ia
S Departnent of Nutrition, Faculty of Medicine, University of
I nelottes ia, Jakarta I 0430, I ndonesia
moftality rate remain difficult to control despite of
the therapeutic advances combined modality of surgery, radiotherapy and chemotherapy.
This cancer is fairly coûtmon in Indonesia, varying
from 1)Vo to 7l,5Vo of all the malignant lesions in the
females.2'3 In females it is the second most frequent
tumor after cervical carcinoma with relative frequency (age standardized cancer ratio) of l8,4IVa of
all female malignancies in 1989. The prognosis has
been considered poor with about 50Vo 5-years relative survival and a I5-20Vo overall long-term relative
survival.4-6 It is of interest to study the five year survival oflndonesian breast cancer patients in conjunction with clinical staging, type of operation, histopathological findings and risks factors such as age,
ll0
Med J Indones
Tjinelarbumi et al
menarche, menstrual status, marital status, number
children, and cancer history in the family.
of
For this purpose 2 batches of case control studies
were conducted between 1988-1996 at the Department of Surgery Dr. Cipto Mangunkusumo Teaching
HospitalAvledical School University of Indonesia,
tion of cases was already seen in younger age group
namely at 35-39 yrs. The majority, 64.5Vo were of
stage IIIA and 28.2Vo of stage II and only 7 .37o werc
of stage I.
Table
Nagoya University School of Medicine, Nagoya and
the Cancer Institute, Tokyo, Japan.
MATERIALS AND METHODS
that were admitted between 1993 until 1996 but will
not be included in this paper since the 5 years survival analysis would not be done until the year 2001.
Of the 300 patients belonging to this research project,
only 110 operable patients were subjected to the 5
Table
Cliticoltathol.ogicaL of breast cancer patients
t09
Longitudinal clinicopathological follow up of breast cancer patients
from 1988 to 1996 in Jakarta
Didid Tiindarbumi'', Gunawan Tjahjadi#, Muchlis Ramli*, Yoshiyuki Ohnot, Idral Darwis*,
Goi Sakamoto', Santoso Cornain#, Esti Soetrisno#, Joedo Prihartonoo, Endang Sri Roostini#,
Setyawati Budiningsiho, Kenji Wakait, Drupadi S Dillons
Abstrak
Kanke
Penel.ititttt
r payudctrct nrcrupctkan kegartasan 1'ang paling sering clitemukan pada wcurito Intlonesia sesudalt kanker ntulut rahint.
Sejetk
ini dibagi dal.am 2 fase . Pada fase I ( l9B8 s/d 1992) tliteliti 300
kasus ktnker ltayudarcr baru tlan dibantlingktm dengan 600
(1993 s/d 1996) ditel.iti 266 kasus kanker pa\tudara baru dur dibandingkan dengan 452 kontrol. Makalah ini
ctkrut tnernbicarakatz ketahanart dtut lnrapcut hidup 5 tahwt dari 110 penderita kanker payuclara opertbel yang tennontk kelontltok I
dililmt clari segi kl.inikopatologi. Sisa 190 dari jumlah 300 ka.rus yang termasuk kelontpok I itu, tidak diikut sertakan karcna srrlcth berada
daLarn kearltmn Lttniut dart buruk, dan ticlak nrcnmngkinkan wûuk ntentlaltatkan ;tengobatan lengkap. Kasus kanker payutlara operabel
ycLng terntnsuk fase 11, 75 kasus, juga tidttk cliikutsertakan karena masa obsen,asi 5 tahun sel.urulutya baru akan selesai tahun 2001.
DiantcLra I I0 kasus kartker payudara operabel yang dioperasi clari talun 1989, 1992 dan diikuti s/tl I 996, ditenukan 43 (39Vo) penderita
rneninggal cli runah sakit atau runah sendiri, 33 (30Vo) nrtsilt lridttlt taryta atlanya ltenyebaran atau kekunbuhan penyakit dut 34 (3 tVo)
kctslts kon.trol. Padafa-se
II
payudara adalalt: 68,80/o clertgart perincian 87,5Vo dari Stacliurrr I, 61,3Vo clari Stodinn
II
dan 57,8Vo tlari Stadium IIIA.
Abstract
Breast cancer belongs to tlu leading cancer anLong Intlonesitut wonrcn, it ranked .çecond to the crmcer of the Ltterine cervix. A
colLaborative ,;tutly on the eliol.ogy ancl cLinir:opathology of brcast cculcer belween Japan and Indonesia has been cctrried out. This stucly
wct.s started in 1988 utd concluclecl itr 2 botches. Tlrc Jirst wcLs between i,988- I992, w,here 300 cctses utd 600 controls were stutlied, wh.ich
was extenrletl with. the secontl batch from 1992- 1996, for Jurther nutritional analrsis on 226 and 452 controls. This paper will cliscuss
the 5 ttear longitutlinal. cl,itticopatlrclogiccrl.foLlow up obsen,atiort ort ll0 operable cases bel.onging to the 300 l{ batch patients. The
rennining 190 patien.ts wetz lote cases ancl were ltot suitabl.e for this project since nanv of tlrcnt were in a worse conclition. The opercLble
ltctienls (75 ) .from the 2nt baîch (226) were not incl.uded since tlr 5 ):eor survival. anal.ysis wouLd not be done until. the year 2001 . Antong
II0 operable breast cancer adnittetl between 1989 througlt 1992, we./brd 43 (39Eo) lratients died in the hospitctl or al their own hone,
33 (30Vo) palietils orz al.ive u,illnut recurrence and 34 (3lVo) patients are alive, but with recurrence or nxet(Ætatic clisease. Tlte overall
5 year sun,ivttl rate v,as 68.8Vo wirh thefollowirtg detail.s: BT.5Vofrom Stage I,6l.3o/ofrom Stage II cuul 57.8Vofrom Stage IItA.
Keywolds: Btcttst cancer, operabl.e ccses, Iortgittttlindl. stud!-, cLinicopathological., sun,ivtil. an.alysis.
INTRODUCTION
Breast cancer presents an enormous public health
problem in countries with a high as well as low social
socio-economic level.l The morbidity rate and the
*
#
DeportmerTt of SLu'gery, Faculty of Medicine, Unit,ersity
Incloneskt, Jokarta ] 0430, I ntlonesio
of
Deportmenl of Anatontic Patlnl.ogy, Faculty of Medicine,
University of Intlonesia, Jalcarta 10430, Intloneskr
t Depttrtnrcnl of Preventif Medicine, Nctgol,cL Universit,- SchooL
of Metlicirrc, Nagoya 466, Japan
' Department of PathoLogy, Cancer Instittûe, Tokyo 170, Japan
" Department oJ'Contnuutit-v- Merlicine, FacLrl.ty of Mediciue,
U n iv e r s i ty of I rd one s ict, J akar ta 1 03 20, I ndo ne s ia
S Departnent of Nutrition, Faculty of Medicine, University of
I nelottes ia, Jakarta I 0430, I ndonesia
moftality rate remain difficult to control despite of
the therapeutic advances combined modality of surgery, radiotherapy and chemotherapy.
This cancer is fairly coûtmon in Indonesia, varying
from 1)Vo to 7l,5Vo of all the malignant lesions in the
females.2'3 In females it is the second most frequent
tumor after cervical carcinoma with relative frequency (age standardized cancer ratio) of l8,4IVa of
all female malignancies in 1989. The prognosis has
been considered poor with about 50Vo 5-years relative survival and a I5-20Vo overall long-term relative
survival.4-6 It is of interest to study the five year survival oflndonesian breast cancer patients in conjunction with clinical staging, type of operation, histopathological findings and risks factors such as age,
ll0
Med J Indones
Tjinelarbumi et al
menarche, menstrual status, marital status, number
children, and cancer history in the family.
of
For this purpose 2 batches of case control studies
were conducted between 1988-1996 at the Department of Surgery Dr. Cipto Mangunkusumo Teaching
HospitalAvledical School University of Indonesia,
tion of cases was already seen in younger age group
namely at 35-39 yrs. The majority, 64.5Vo were of
stage IIIA and 28.2Vo of stage II and only 7 .37o werc
of stage I.
Table
Nagoya University School of Medicine, Nagoya and
the Cancer Institute, Tokyo, Japan.
MATERIALS AND METHODS
that were admitted between 1993 until 1996 but will
not be included in this paper since the 5 years survival analysis would not be done until the year 2001.
Of the 300 patients belonging to this research project,
only 110 operable patients were subjected to the 5
Table