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The Correlation between Fasting Blood Glucose Level with Infiltrated Axillary Limph Node Rate in Infiltrating Ductal Carcinoma of the Breast Thomas Aribowo; Widyanti Soewoto
Journal of Medicine and Health Vol. 1 No. 6 (2017)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (366.107 KB) | DOI: 10.28932/jmh.v1i6.552

Abstract

Cancer cell have been shown to extensively use glucose for proliferation, even at hypoxia environment. The consumption of glucose in a hypoxia environment induced HIF and VEGF, which play a role in cancer cell infiltration process . The objective of study is to determine the relationship between fasting blood glucose levels with the amount of infiltrated axillary lymph node in patients with infiltrating ductal carcinoma. This is an analytic observational study with cross sectional design. The data obtained were tested with chi-square test (α < 0.05). This study was conducted on 24 infiltrating ductal carcinoma patients. The results showed p value of 0.004, indicating there is a significant correlation between fasting blood glucose levels with the amount of infiltrated axillary lymph nodes. The correlation coefficient ( r) value was 0.505; indicating medium level correlation. As conclusion, there is a significant correlation between fasting blood glucose levels with the amount of infiltrated axillary lymph node in patients with infiltrating ductal carcinoma.Keywords: axillary lymph nodes, breast cancer, fasting blood glucose level, infiltrating ductal carcinoma
Rare Presentations of Male Breast Cancer: A Case Series Highlighting Diagnostic and Therapeutic Challenges Chandra Budi Hartono; Widyanti Soewoto
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 3 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i3.717

Abstract

Male breast cancer (MBC) is a rare disease with a rising incidence, accounting for less than 1% of all breast cancer cases. It typically presents in older men and outcome-based studies in adolescent and young adult (AYA) males are scarce due to its rarity. This case series aims to highlight the diagnostic and therapeutic challenges encountered in two rare presentations of MBC. The first case involved an 18-year-old male who presented with left chest pain and a rapidly growing breast mass. Histopathological analysis revealed invasive ductal carcinoma (IDC) NST grade III with positive margins, staged as cT2N0M0. He also presented with anemia and elevated transaminase enzymes. The second case was a 59-year-old male with a history of mucinous adenocarcinoma of the right breast who presented with the right arm and shoulder pain and a supraclavicular mass. Imaging revealed extensive metastatic disease in the lungs, liver, and bones, and he was diagnosed with cT2N3cM1. Both patients underwent different treatment approaches based on their disease stage and presentation. In conclusion, MBC, especially in AYA patients, presents unique diagnostic and therapeutic challenges due to its rarity and potential for aggressive behavior. These cases underscore the importance of considering MBC in differential diagnoses, even in younger males, and the need for tailored treatment strategies based on the specific clinicopathological features and stage of the disease. Early detection, comprehensive nodal evaluation, and adherence to established treatment guidelines are crucial for improving outcomes in MBC patients. Further research is warranted to better understand the biological characteristics and optimal management of MBC in rare presentations and younger populations.
The Correlation between Fasting Blood Glucose Level with Infiltrated Axillary Limph Node Rate in Infiltrating Ductal Carcinoma of the Breast Thomas Aribowo; Widyanti Soewoto
Journal of Medicine and Health Vol 1 No 6 (2017)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.28932/jmh.v1i6.552

Abstract

Cancer cell have been shown to extensively use glucose for proliferation, even at hypoxia environment. The consumption of glucose in a hypoxia environment induced HIF and VEGF, which play a role in cancer cell infiltration process . The objective of study is to determine the relationship between fasting blood glucose levels with the amount of infiltrated axillary lymph node in patients with infiltrating ductal carcinoma. This is an analytic observational study with cross sectional design. The data obtained were tested with chi-square test (α < 0.05). This study was conducted on 24 infiltrating ductal carcinoma patients. The results showed p value of 0.004, indicating there is a significant correlation between fasting blood glucose levels with the amount of infiltrated axillary lymph nodes. The correlation coefficient ( r) value was 0.505; indicating medium level correlation. As conclusion, there is a significant correlation between fasting blood glucose levels with the amount of infiltrated axillary lymph node in patients with infiltrating ductal carcinoma.Keywords: axillary lymph nodes, breast cancer, fasting blood glucose level, infiltrating ductal carcinoma
Aggressive Multifocal Recurrent Fibrosarcoma in an Elderly Patient: A Case Report Nadhim Askar; Widyanti Soewoto
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 4 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i4.751

Abstract

Fibrosarcoma is an uncommon malignant mesenchymal neoplasm originating from fibroblasts, notorious for its aggressive clinical behavior, high local recurrence rates, and potential for distant metastatic spread. Managing fibrosarcoma in elderly patients presents unique challenges, particularly when characterized by multifocal and recurrent disease. This case report aims to describe an unusual and particularly challenging presentation of aggressive, multifocal recurrent fibrosarcoma in a 65-year-old female patient. A 65-year-old Indonesian female presented with a complex history of multiple recurrent fibrosarcomas. Her oncological journey began with an inguinal mass excised in 2022, diagnosed as Grade I fibrosarcoma, followed by chemotherapy. Despite these interventions, she experienced recurrence at the primary site and developed new masses in the abdomen, flank, gluteal regions, left breast, right supraclavicular area, right antebrachial region, and left femur over the ensuing year. Comprehensive imaging, including whole abdomen MSCT, revealed multiple widespread soft tissue masses with suspicious lymphadenopathy and equivocal liver lesions. Histopathological examination of subsequent biopsies and excised specimens, supported by immunohistochemistry (CD34 positive; S-100, CD-117, Desmin negative), consistently confirmed recurrent fibrosarcoma. The patient underwent multiple extensive wide excision surgeries for various tumor locations, including the left inguinal region, left breast, left flank, bilateral gluteal regions, left antebrachial, and left supraclavicular areas. In conclusion, this case underscores the exceptionally aggressive and relentless nature of multifocal recurrent fibrosarcoma in an elderly individual. Despite an initial low-grade diagnosis and adjuvant chemotherapy, the disease progressed rapidly with widespread recurrences. Aggressive surgical management with wide excision remains the cornerstone of treatment in an attempt to achieve local control. However, the propensity for new lesions highlights the limitations of current therapies for such extensive disease. Vigilant, long-term surveillance and a multidisciplinary approach are paramount. This case also emphasizes the need for further research into the molecular drivers of such aggressive behavior and the development of more effective systemic therapies.
Evaluating Progesterone Level Fluctuations as a Response Indicator to Chemotherapy in Triple Negative Breast Cancer Handito Sarwwotatwadhiko; Widyanti Soewoto; Ida Bagus Budhi Surya
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1334

Abstract

Background: Triple negative breast cancer (TNBC) represents an aggressive subtype with limited targeted therapies and often poorer prognosis. Chemotherapy remains a cornerstone of treatment, yet its systemic effects, including hormonal alterations, are not fully elucidated. The role of progesterone in TNBC progression and its modulation by chemotherapy is particularly complex and warrants investigation. This study aimed to evaluate changes in serum progesterone levels following chemotherapy in TNBC patients. Methods: A prospective cohort study was conducted at Dr. Moewardi General Hospital, Surakarta, involving 30 patients diagnosed with TNBC undergoing chemotherapy. Serum progesterone levels were quantified using the ELISA method before the first chemotherapy cycle and after the sixth cycle. Statistical analysis, primarily the Wilcoxon test, was used to compare pre- and post-chemotherapy levels. Results: The cohort had a mean age of 49.13 ± 8.98 years. Prior to chemotherapy, progesterone levels varied: 53.3% were below normal (<0.5 ng/mL), 23.3% were normal (0.5-5 ng/mL), and 23.3% were above normal (>5 ng/mL). Following six cycles of chemotherapy, a significant decrease in progesterone levels was observed (p=0.020). The proportion of patients with below-normal levels increased to 63.3%. Overall, 10 patients showed decreased levels, 18 remained stable, and 2 showed increased levels. No significant correlation was found between progesterone level changes and baseline patient characteristics like age, menarche, or menopausal status. Conclusion: Systemic chemotherapy significantly impacts progesterone levels in TNBC patients, leading to an overall decrease. Monitoring progesterone fluctuations during treatment may hold potential value for assessing therapeutic response or prognosis, warranting further investigation.
Evaluating Progesterone Level Fluctuations as a Response Indicator to Chemotherapy in Triple Negative Breast Cancer Handito Sarwwotatwadhiko; Widyanti Soewoto; Ida Bagus Budhi Surya
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i7.1334

Abstract

Background: Triple negative breast cancer (TNBC) represents an aggressive subtype with limited targeted therapies and often poorer prognosis. Chemotherapy remains a cornerstone of treatment, yet its systemic effects, including hormonal alterations, are not fully elucidated. The role of progesterone in TNBC progression and its modulation by chemotherapy is particularly complex and warrants investigation. This study aimed to evaluate changes in serum progesterone levels following chemotherapy in TNBC patients. Methods: A prospective cohort study was conducted at Dr. Moewardi General Hospital, Surakarta, involving 30 patients diagnosed with TNBC undergoing chemotherapy. Serum progesterone levels were quantified using the ELISA method before the first chemotherapy cycle and after the sixth cycle. Statistical analysis, primarily the Wilcoxon test, was used to compare pre- and post-chemotherapy levels. Results: The cohort had a mean age of 49.13 ± 8.98 years. Prior to chemotherapy, progesterone levels varied: 53.3% were below normal (<0.5 ng/mL), 23.3% were normal (0.5-5 ng/mL), and 23.3% were above normal (>5 ng/mL). Following six cycles of chemotherapy, a significant decrease in progesterone levels was observed (p=0.020). The proportion of patients with below-normal levels increased to 63.3%. Overall, 10 patients showed decreased levels, 18 remained stable, and 2 showed increased levels. No significant correlation was found between progesterone level changes and baseline patient characteristics like age, menarche, or menopausal status. Conclusion: Systemic chemotherapy significantly impacts progesterone levels in TNBC patients, leading to an overall decrease. Monitoring progesterone fluctuations during treatment may hold potential value for assessing therapeutic response or prognosis, warranting further investigation.
Mandibular Ameloblastoma in a 28-Year-Old Woman Muhammad Apri Rajab; Widyanti Soewoto
Jurnal Kesehatan dan Kedokteran Vol. 4 No. 2 (2025): Juni: Jurnal Kesehatan dan Kedokteran
Publisher : Asosiasi Dosen Muda Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56127/jukeke.v4i2.2083

Abstract

Ameloblastoma is a benign odontogenic tumor originating from enamel-producing epithelial cells, which, despite being benign, can grow aggressively and cause damage to surrounding structures. This case reports a 28-year-old female patient who complained of a lump on the left chin that had developed over the past three years. The lump was hard, painless, and not accompanied by systemic symptoms such as fever or weight loss. Based on clinical and supporting examinations, including MSCT and biopsy, the diagnosis of bilateral mandibular and maxillary ameloblastoma was confirmed. This tumor displayed characteristics of bone destruction and invasion into surrounding tissues, requiring radical treatment. A hemimandibulectomy procedure was chosen as the primary therapy to remove the part of the jaw infected by the tumor, with the aim of reducing the high risk of recurrence. Reconstruction with a mandibular plate was performed to restore chewing function and the patient's facial aesthetic appearance. Long-term monitoring with radiography is required to detect recurrence. Although benign, ameloblastoma can be highly destructive and requires proper treatment to prevent further damage or tumor recurrence
Dynamic Coupling of Systemic and Intratumoral Estradiol in HER2-Positive and Triple-Negative Breast Cancer: A Validation Study of a Non-Invasive Surrogate Nadhim Muhammad Askar; Widyanti Soewoto; Brian Wasita
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1476

Abstract

Background: The role of estradiol in the tumor microenvironment (TME) of estrogen receptor (ER)-negative breast cancers is increasingly recognized. Direct measurement of intratumoral estradiol is invasive, creating a barrier to clinical research. This study aimed to determine if circulating plasma estradiol can serve as a high-fidelity, non-invasive surrogate for intratumoral concentrations in HER2-positive (HER2+) and triple-negative breast cancer (TNBC). Methods: This retrospective, cross-sectional study included 60 women with primary operable HER2+ (n=21) and TNBC (n=39) who underwent mastectomy. Paired pre-operative plasma and post-operative tumor tissue samples were analyzed. Estradiol concentrations were quantified using a validated high-performance liquid chromatography-radioimmunoassay (HPLC-RIA) protocol. Clinicopathological data, including Body Mass Index (BMI), were collected. The primary outcome was the correlation between plasma and intratumoral estradiol, assessed by Spearman's rank correlation. Paired concentrations were compared using the Wilcoxon signed-rank test. Results: Baseline clinicopathological characteristics, including BMI, were well-balanced between the HER2+ and TNBC cohorts. A highly significant, strong positive correlation was found between plasma and intratumoral estradiol concentrations across the entire cohort (Spearman's ρ = 0.78, p < 0.001). This correlation remained robust in subgroup analyses of menopausal status and tumor grade. Interestingly, median intratumoral estradiol levels (30.0 pg/mL; IQR: 10.0-65.0) were significantly lower than paired median plasma levels (132.0 pg/mL; IQR: 40.0-225.0) (p < 0.001). Conclusion: Plasma estradiol demonstrates a strong and direct correlation with intratumoral estradiol in HER2+ and TNBC, validating its use as a reliable, non-invasive surrogate. This provides a crucial tool to explore the pathophysiology of the TME. The finding that intratumoral levels are lower than systemic circulation, yet tightly coupled, suggests a dynamic equilibrium that warrants further investigation into local estradiol metabolism and signaling in ER-negative disease.
Dynamic Coupling of Systemic and Intratumoral Estradiol in HER2-Positive and Triple-Negative Breast Cancer: A Validation Study of a Non-Invasive Surrogate Nadhim Muhammad Askar; Widyanti Soewoto; Brian Wasita
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1476

Abstract

Background: The role of estradiol in the tumor microenvironment (TME) of estrogen receptor (ER)-negative breast cancers is increasingly recognized. Direct measurement of intratumoral estradiol is invasive, creating a barrier to clinical research. This study aimed to determine if circulating plasma estradiol can serve as a high-fidelity, non-invasive surrogate for intratumoral concentrations in HER2-positive (HER2+) and triple-negative breast cancer (TNBC). Methods: This retrospective, cross-sectional study included 60 women with primary operable HER2+ (n=21) and TNBC (n=39) who underwent mastectomy. Paired pre-operative plasma and post-operative tumor tissue samples were analyzed. Estradiol concentrations were quantified using a validated high-performance liquid chromatography-radioimmunoassay (HPLC-RIA) protocol. Clinicopathological data, including Body Mass Index (BMI), were collected. The primary outcome was the correlation between plasma and intratumoral estradiol, assessed by Spearman's rank correlation. Paired concentrations were compared using the Wilcoxon signed-rank test. Results: Baseline clinicopathological characteristics, including BMI, were well-balanced between the HER2+ and TNBC cohorts. A highly significant, strong positive correlation was found between plasma and intratumoral estradiol concentrations across the entire cohort (Spearman's ρ = 0.78, p < 0.001). This correlation remained robust in subgroup analyses of menopausal status and tumor grade. Interestingly, median intratumoral estradiol levels (30.0 pg/mL; IQR: 10.0-65.0) were significantly lower than paired median plasma levels (132.0 pg/mL; IQR: 40.0-225.0) (p < 0.001). Conclusion: Plasma estradiol demonstrates a strong and direct correlation with intratumoral estradiol in HER2+ and TNBC, validating its use as a reliable, non-invasive surrogate. This provides a crucial tool to explore the pathophysiology of the TME. The finding that intratumoral levels are lower than systemic circulation, yet tightly coupled, suggests a dynamic equilibrium that warrants further investigation into local estradiol metabolism and signaling in ER-negative disease.