EVIDENCE BASED MEDICINE Prognostic Factors In Young Japanese Women With Breast Cancer: Prognostic Value Of Age At Diagnosis

DISUSUN OLEH : Muhammad jaka satria 11020091

BLO! !EDO!"E#AN !ELUA#$A !ELOM%O! B2 "ut&r : dr' Nu(u() Ai(ur #ahmah* S+%A

,A!UL"AS !EDO!"E#AN UNIVE#SI"AS -A#SI .A!A#"A 201/

EVIDENCE BASED MEDICINE
Artik01 %r&)(&sis Sk0(ari& N ! Y "erumur #$ tahun %atang &e %o&ter %engan &eluhan ter%apat rasa n eri %an "en'olan %i %a%a se"elah &iri ang %i rasa&ann a selama "e"erapa "ulan tera&hir! setelah %i la&u&an pemeri&saan fisi& %an la"! %o&ter men%iagnosis &an&er pa u%ara stage () *etapi &e&ha+atiran pasien "ertam"ah parah &eti&a pasien mem"aca salah satu arti&el %i internet ang men ata&an "ah+a +anita pre menopause ang "erumur ,#- tahun memili&i resi&o relaps %an per&em"angan pen a&it serta prognosis ang le"ih "uru& %i"an%ing&an +anita ang le"ih tua) %0rta(2aa(: Apa&ah prognosis +anita %engan &an&er pa u%ara "erumur ,#- tahun le"ih "uru& %aripa%a +anita "erumur #-.#/ tahun0 %ICO : Patient : Wanita pen%erita &an&er pa u%ara

Inter1ention : Pasien ,#- tahun Comparison : Pasien #-.#/ tahun Outcome : Prognosis le"ih "ai&

%0(3aria( Bukti I1miah Alamat +e"site : http:22high+ire)stanfor%)e%u 3ata &unci 4imitasi : Prognosic AND oung AND age AND "reast cancer AND sur1i1al : Januari $5(5 6 Desem"er $5($

Dipilih arti&el : Prognostic Factors in Young Japanese Women +ith Breast Cancer: Prognostic Value of Age at Diagnosis Dimuat %alam : http:22'cm)asm)org 4imitasi : Januari $5(5. %esem"er $5($

7asil Pencarian : (/8 arti&el

C#I"ICAL A%%#AISAL : A#"I!EL %#O$NOSIS

Prognostic Factors in Young Japanese Women +ith Breast Cancer: Prognostic Value of Age at Diagnosis

1' VALIDI"-

()( A+akah ada sam+01 +asi0( 2a() r0+r0s0(tati40 da( did05i(isika( s03ara j01as +ada titik 2a() sama 6simi1ar +&i(t7 da1am +0rja1a(a( +0(2akit 63&urs0 &5 th0 dis0as078 From the database of the National Cancer Center Hospital, Tokyo, Japan, we identied consecutive patients who were dia nosed with breast cancer before the a e of !" years and underwent sur ery between January #$$" and %ecember &""!' (nly patients with sta e ) * ))) disease who underwent denitive sur ery were included' +atients who had under, one preoperative ad-uvant therapy or had e.cisional biopsy in a local clinic were also e.cluded because it is difcult to determine patholo ical factors in/uencin pro noses0 9 %ati0(t a(d m0th&d * +ara)ra+h 1 (ut of a total of 1$!! patients who underwent sur ery at the National Cancer Center Hospital, Tokyo, Japan, between January #$$" and %ecember &""!, &!& patients were eli ible for this study' (f which $$ 2!#'"34 were a ed ,15 years at dia nosis, and #!1 25$'"34 were a ed between 15 and 1$ years0 9 #0su1t* +ara)ra+h 1

()$ A+akah follow-up 10()ka+ da( 3uku+ 1ama: sufficiently long and complete8

+atients were followed up every 1 * 6 months durin the rst 5 years and every 6 * #& months from 5 to #" years0 *%ati0(t a(d m0th&d *%ara)ra+h ;

The follow,up duration was calculated as the len th of time between the date of dia nosis and the date of death or last contact0, %ati0(t a(d m0th&d 6statisti3a1 m0th&d7 %ara)ra+h ;

()# A+akah di)u(aka( 3rit0ria outcome 2a() &<20kti5 da( tidak <0r<ias8

multivariate analyses indicated that positive a.illary lymph nodes 2 pN# * pN14 and triple, ne ative status were the independent factors associated with poor %F7 and (70 * #0su1t* +ara)ra+h =

()9 A+akah ada +0(20suaia(:adjustment t0rhada+ 5akt&r +r&)(&stik 2a() +0(ti()8

The complete medical records of patients enrolled in the study were reviewed' )nformation derived from the database and medical records included clinical and histolo ical vari, ables such as a e8 family history8 pT 2 primary tumor4 and pN 2re ional lymph node4 status8 histolo ical type8 histolo i, cal rade8 peritumoral vessel invasion 2+9)4 :includin lym, phatic vessel invasion 2;9)4 and blood vessel invasion 2<9)4=8 >?, + ? and H>?&8 tumor subtype stratied by hormone receptor 2H?4 and H>?& status8 operative pro, cedure8 radiation therapy8 ad-uvant systemic therapy 2che, motherapy and endocrine therapy40, %ati0(t a(d m0th&d *%ara)ra+h 2

II'IM%O#"ANCE 2'1 Ba)aima(a )am<ara( &ut3&m0 m0(urut >aktu 8 %urin a median follow,up of @" months 2ran e 5 * #@6 months4, @6 patients 215'534 e.perienced %F7 events :second primary breast cancer 1'A38 locore ional relapse A'!38 distant relapse &!'!3 2non,visceral @'A38 visceral #5'A34= and 5# patients 2&#'#34 died0 , #0su1t* +ara)ra+h 2 2'2 S0<0ra+a t0+at +0rkiraa( +r&)(&sis8

No si nicant difference was found in %F7 and (7 between patients a ed , 15 years and those a ed 15 * 1$ years 2Fi ' #4' Be did not also nd a si nicant difference in freCuency of occurrence of various %F7 events between the two a e roups0 , #0su1t* +ara)ra+h 2

Per&iraan prognosis ti%a& tepat &arena! %iper&ira&an hasiln a pasien ang %i%iagnosis &an&er pa u%ara pa%a umur #-tahun memili&i resi&o relaps %an prognosis ang le"ih "uru&! tetapi menurut penelitian ini! ti%a& a%a per"e%aan prognosis 'i&a %ilihat %ari factor umur ter%iagnosis n a pen a&it)

III'A%%LICABILI"1' A+akah +asi0( da1am +0(01itia( i(i s0ru+a d0()a( +asi0( kita 8

Da karena pasien merupakan penderita kanker payudara di bawah umur !" tahun'

2' A+akah sim+u1a( kita t0rhada+ hasi1 studi <0rma(5aat a+a<i1a disam+aika( k0+ada +asi0( da1am +r&)(&sis s03ara k0s01uruha(8

Da, karena simpulan studi yan menyatakan dia nosis kanker payudara pada umur tertentu tidak berpen aruh dalam factor pro nosis'