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Kelompok 1
Fitria Fadzri
Ibramu Al FurqanNurin Pascarini Jusaim
Sari Nur Rahmawati
JournalPrimary Breast Cancer:ESMO Clinical Recommendations
or
!ia"nosis# treatment and ollow$u%
Stase &edah 'e%anitraan 'lini( RS Mohammad Ridwan
Meura(sa
Periode ) Mei * +, Juli -.+,
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INSIDEN
CaMamma
e
Pen/ebabutama
(ematianter(ait (an(erdi 0ni Ero%a
-..,
!i 0ni Ero%a++.123+..
...
Mortalitas-41.3+.. ...
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!IA5NOSIS
Pal%asi bimanual %a/udara '5& re"ional lo(al
Pemeri(saan 'linis
Mammo"ra6 bilateral 0S5 mammae dan '5&
re"ionalRadiolo"i
Core needle bio%s/ Fine needle bio%s/
PA
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Stage and Risk Assesment
Pre
o%erasi Stadium (linis 7NM# PA
core needle bio%s/#estro"en rese%tor 8ER9#%ro"esteron
rese%tor
8P5R9 dan :ER- rese%tor
;$ra/ thora
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Stage and Risk Assesment
P
ost
O%
erasi
Jumlah tumor dalam=arin"an# diameter
tumor# =enis histolo"isdan "rade tumor
Jumlah total (elen=ar"etah benin" /an"
dibuan"# =umlah %ositi(elen=ar "etah benin"
7in"(atmetastasis %ada(elen=ar "etah
benin"
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Terapi okal!Non"In#asi#e Carsinoma$
'arsinoma Intradu(tal da%at di obati den"an
&CS 8&reast Conser>atin" Sur"er/9
Pada %asien den"an (arsinoma intradu(tal#
u(uran tumor ?+. mm dan batas /an" =elas#
risi(o %ada lo(al e(sisi san"at rendah
sehin""a tera%i radiasi da%at dihilan"(an
7era%i tamo
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Terapi okal!In#asi#e Carsinoma$
'an(er %a/udara in>asi dila(u(an o%erasi&CS atau
Mase(tomi
&iasan/a di(ombinasi(an den"an SN SN& @
!ise(si A(sila# atau !ise(si a(sila'ontraindi(asi &CS tumor
multisenter# tumor
besar 8 B2$ cm9# batas /an" =elas setelahrese(si# (an(er
%a/udara inDamasi# dan
(ein"inan %asienRadiotera%i dian=ur(an %ada %asien den"an
atau lebih %ositi %ada (len=ar a(sila# tumor72$7 inde%enden dari
status nodal
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Indi(asi
Ca mammae stadi%m &A"&B
7u=uan
Mem%er(ecil u(uran tumor sebelum dila(u(anBreast Conserving
Surgery
8Maste(tomi Parsial91
Terapi Primer Sistemik
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S/arat
&io%simelihat histo%atolo"i
men"analisis a(tor %redile(si
Penentuan
Stadium 'linisMen/in"(ir(an adan/ametastasis
Terapi Primer Sistemik
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'ER(stat%s
'ig)ly endocrineresponsi#e
Incompletelyendocrineresponsi#e
Endocrinenon"responsi#e
Ne"ati>
e
E7 E7 C7
Positi>e E7 @ 7rastuzumab @C7
E7 @ 7rastuzumab @C7
7rastuzumab @C7
Terapi Ad*%#an Sistemik
E7 Endocrine thera%/
C7 Chemothera%h/
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Terapi Endokrin
PASIEN PRE$MENOPO0SE
+1 7amoarium
PASIEN POS7$MENOPO0SE
+1 7amo
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Ad=u>ant chemothera%/ di re(omendasi(anuntu( intermediate and
high risk patient
Kemoterapi
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Pasien den"an :ER-$positive
anthracyclines (doxorubicin, idarubicin)
Pasien den"an umur lan=ut dan (ontraindi(asi
=antun" non-anthracycline-containingregimes (CMF)
anita den"an %remeno%ause2 * , bln
in=e(si &is%hos%honatesaat + tahun awal%en"obatan untu(
mence"ah (era%uhan
tulan"1
Kemoterapi
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ama wa(tu /an" dire(omendasi(an %ada
%en""unaan trastuzumab adalah + tahun
7ida( boleh diberi(an bersamaan atau
sesudah %en"obatan den"an anthrac/cline1
'ontra Indi(asi low GEF 8e!t "entricular
#$ection Fraction)
Trast%+%ma,
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7u=uan
0ntu( mendete(si dini adan/a re(urensi lo(al atau
(ontralateral ca mammae1
0ntu( men"e>aluasi %en"obatan /an" te%at danmenin=au
(om%li(asi
0ntu( memberi(an su%%ort secara 6siolo"is
-ollo."%p
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I%silateral 8setelah tinda(an breast conservingsurgery9 dan
(ontralateral mammo"ra6dire(omendasi(an setia% tahunn/a untu(wanita
%remeno%ausal#
+ * - tahun untu( wanita %ostmeno%ausal
-ollo."%p
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/Terima Kasi)0
