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All Journal Medical Journal of Indonesia The Indonesian Biomedical Journal Eksakta : Berkala Ilmiah Bidang MIPA The New Ropanasuri Journal of Surgery Journal of Applied Science, Engineering, Technology, and Education Jurnal Ilmu Bedah Indonesia Narra J Indonesian Journal of Cancer Jurnal ARSI : Administrasi Rumah Sakit Indonesia Biomedika Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Sonar Panigoro
Department Of Surgery, Faculty Of Medicine, Universitas Indonesia, Jakarta
Agriculture, Biological Sciences & Forestry Astronomy Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Civil Engineering, Building, Construction & Architecture Computer Science & IT Decision Sciences, Operations Research & Management Electrical & Electronics Engineering Energy Engineering Environmental Science Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Materials Science & Nanotechnology Mathematics Mechanical Engineering Medicine & Pharmacology Public Health Social Sciences Other

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Relationship Between C-Reactive Protein-Albumin Ratio and Metastasis in Breast Cancer Hazmi, Mohammad Zul; Panigoro, Sonar Soni; Yulian, Erwin Danil; Nugroho, Nyityasmono Tri; Agustina, Amilya
Indonesian Journal of Cancer Vol 19, No 1 (2025): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i1.1224

Abstract

Background: Breast cancer is a type of malignancy with the highest number of cases in the world and Indonesia. The C-reactive protein-albumin ratio (RCA) is a simple, feasible, and objective breast cancer serum marker representing inflammatory and nutritional status. There are not many studies regarding the relationship between RCA and breast cancer metastasis, especially in the advanced-stage case population in Indonesia.Method: Study with a cross-sectional design in 180 breast cancer patients stage III and IV at Cipto Mangunkusumo Hospital, who were diagnosed in 2018 until 2023. Comparative analysis of the RCA values between the groups with and without metastasis was carried out using the Chisquare test. All statistical test results are considered significant if the p-value is 0.05.Results: A receiver-operating characteristic curve (ROC) is a graphical analytical technique used to assess the effectiveness of a binary diagnostic classification method. The ROC area under the curve (AUC) value was 0.713 (IC 95%; 0.638–0.789) and significance 0.001, with the RCA cut-off value was 0.515 with sensitivity 74.4% and specificity 67.8%. The high RCA proportion was 53.3%. There is a significant relationship (p-value 0,001) between RCA level and the risk of metastasis in breast cancer patients. Liver and lung metastases of breast cancer are the most frequent locations. Conclusion: The CRP-albumin ratio has a significant relationship with the incidence of metastasis in breast cancer
Strategy for Diagnosing Breast Cancer in Indonesia during the COVID-19 Pandemic: Switching to Ultrasound-Guided Percutaneous Core Needle Biopsy Sobri, Farida Briani; Bachtiar, Adang; Panigoro, Sonar Soni; Rahmaania, Juwita Cresti; Yuswar, Patria Wardana; Krisnuhoni, Ening; Tandiari, Nelly
Kesmas Vol. 16, No. 3
Publisher : UI Scholars Hub

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Abstract

In this era of COVID-19, suspected breast cancer patients experience delay in diagnosis due to the fear of contracting the virus and reduction of non-COVID-19 health services. Furthermore, it may lead to potential increase in the incidence of advanced cancers in the future. Ultrasound-guided (US-guided) percutaneous core needle biopsy (CNB) is a great option for the diagnosis of cancer but it is poorly utilized. This study aimed to prove that the US-guided CNBis accurate when performed in a local setting and a potential solution for diagnosing breast cancer patients in this pandemic. In addition, it was a single health center cross-sectional study, and the participants were all breast cancer patients that had US-guided CNB from 2013-2019. The pathology results from US-guided CNB were compared to specimens from post-CNB surgeries. The data were collected from medical records and the immunohistochemistry (IHC) examinations were carried out for malignancy. There were 163 patients who were included in this study, 86 had malignancies and 77 had benign tumor reported in their CNB results. The US-guided CNB had 100% sensitivity and specificity compared to surgery. With its lower cost, time usage, and patient exposure to the hospital environment, US-guided CNB should replace open surgery biopsy for diagnosing suspicious breast cancers during the pandemic in Indonesia.
The Bioinformatics Application in Detecting Germline and Somatic Variants towards Breast Cancer using Next Generation Sequencing Retnomawarti, Rizka; Panigoro, Sonar Soni; Paramita, Rafika Indah
Journal of Applied Science, Engineering, Technology, and Education Vol. 5 No. 1 (2023)
Publisher : PT Mattawang Mediatama Solution

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35877/454RI.asci1608

Abstract

Breast cancer is the type of cancer with the most and the highest cases causing mortality in Indonesia, so an effective treatment is required to reduce the incidence and mortality rate due to cancer breasts. Most breast cancer patients are diagnosed at an advanced stage so the treatment used are limited and the risk of death becomes higher. Along with the development of human genome sequencing technology, the genetic examination of breast cancer is considered as an examination that can be used for early prevention and treatment management personally. Based on the target variants detected, the genetic examination of breast cancer can be divided into two, namely the examination of germline variants and somatic variants. Germline variant examination is intended to predict the risk of breast cancer which can be used as an early preventive measure, while somatic variant examination is intended for cancer diagnosis and management therapy. NGS technology is able to detect both types of variants in a number of genes associated with breast cancer in several samples effectively and quickly. However, the data generated from NGS technology is very large and complex, so the role of bioinformatics is required in analyzing and interpreting data. By utilizing bioinformatics pipelines and tools, analysis of germline variants and somatic variants in breast cancer can be carried out accurately so that the results of genetic examinations can be used as a step to treat breast cancer.
Mutation of BRCA1/2 Gene in Premenopausal Triple-Negative Breast Cancer Patients in West Sumatera Harahap, Wirsma Arif; Khambri, Daan; Panigoro, Sonar Soni; Hafiz, Muhammad Zaki Abdul
Indonesian Journal of Cancer Vol 19, No 1 (2025): March
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i1.1255

Abstract

Background: The BRCA1/2 mutation rate was found to be higher in triple-negative breast cancer (TNBC) patients depending on young age, and the presence of a family history of breast cancer and ovarian cancer. Research on BRCA1/2 germline mutations that focused on premenopausal TNBC patients in Indonesia has never been carried out. The objective of this research is to determine the BRCA1/2 germline gene mutation status in premenopausal TNBC patients in West Sumatra.Methods: This is a descriptive study conducted at the Surgical Oncology Division of DR. M. Djamil Hospital, Padang from April to July 2023. This study included patients aged 50 years who were diagnosed with the TNBC subtype at Dr. M. Djamil Hospital, Padang from January 2016 to July 2023. Secondary data was collected through the patient’s medical records to observe the TNBC patient’s characteristics. A blood test of TNBC patients was carried out to determine germline mutation of BRCA1/2.Results: 22 patients with TNBC participated in the study. In this study, 4/22 (18.2%) had BRCA2 pathogenic mutations and no BRCA1 pathogenic mutation was found. All patients with BRCA2 pathogenic mutation have the same mutation characteristics, i.e exon 3, genetic variation (c.262_263delCT), amino acids (p.Leu88AlafsTer12), and type of mutation (Frameshift Deletion). Conclusions: TNBC patients in West Sumatra have BRCA2 pathogenic mutations with the same characteristics as the mutations
Inter- and intra-rater reliability of modified near-infrared camera to assess superficial lymphatic system in breast cancer-related lymphedema Brahma, Bayu; Yusuf, Prasandhya Astagiri; Priambodo, Purnomo Sidi; Harimurti, Kuntjoro; Haryono, Samuel Johny; Harlim; Suryadi; Paskahenru, Mahesa; Lesmana, Rika; Manangka, Rumuat Semuel Wullul; Taher, Akmal; Panigoro, Sonar Soni
Medical Journal of Indonesia Vol. 35 No. 1 (2026): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.258234

Abstract

BACKGROUND Near-infrared (NIR) fluorescence imaging is one of the most useful diagnostic methods for breast cancer-related lymphedema (BCRL). It utilizes indocyanine green (ICG) lymphography, which requires a commercial camera that is not widely available. This study aimed to qualitatively assess the reliability of the modified NIR camera in diagnosing BCRL. METHODS This prospective cross-sectional study was conducted between December 2023 and December 2024 in breast cancer (BC) patients with BCRL. A commercial mirrorless digital camera was modified by incorporating an excitation light source and spectral filters to enable NIR imaging. To evaluate the camera reliability, intra- and inter-observer agreements were assessed using Kappa analysis. Three independent observers evaluated dermal backflow patterns of lymphatic flow: linear, splash, stardust, and diffuse patterns. RESULTS 60 BC patients with BCRL resulting in 280 images were included. The mean (standard deviation) age was 54.7 (10.1) years and body mass index were 27.1 (4.5) kg/m². Most patients had stage IIA BC (40%) and stage IV ICG lymphography (38%). Intra-observer analysis showed observers 1 and 2 of had a Kappa of 1.00 (95% confidence interval [CI]: 1.00–1.00), while observer 3 had Kappa of 0.99 (95% CI: 0.97–1.00). Inter-observer analysis between observers 1 and 2 showed Kappa 1.00 (95% CI: 1.00–1.00), while observers 1–3 and 2–3 had Kappa of 0.99 (95% CI: 0.97–1.00). Observer 3 misinterpreted 3 linear as splash patterns. CONCLUSIONS This study showed a high inter- and intra-observer agreements making it reliable for BCRL diagnosis.
The Potential of Liquid for Breast Cancer: A Review Panigoro, Sonar Soni; Yuella, Clarissa Kezia, -
The New Ropanasuri Journal of Surgery Vol. 7, No. 2
Publisher : UI Scholars Hub

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Abstract

Introduction. Tissue biopsy is the current gold standard for cancer diagnosis, targeted treatment, and prognosis. However, biopsy is an invasive procedure that could result in postoperative bleeding, pain, and infection. Such limitations may now be resolved by the clinical technique known as liquid biopsy, which enables a better representation of disease status.Method. This literature review was conducted through online databases (PubMed, Ascopubs, EuroPMC) using the following keywords: "liquid biopsy", "ctDNA", "CTC", "breast cancer", "pathogenesis of breast cancer", "tumor microenvironment”, “ctdna detection technologies”, "early diagnosis", "targeted therapy" ,"monitoring disease progression”, and "prognosis”. The literature search was conducted using the PRISMA format (Figure 1). The appraised articles were further evaluated using the Joanna Briggs Institute (JBI).Discussion. Liquid biopsy, also known as blood-based analysis of circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA), has become more significant in breast cancer in recent years. There are several techniques for CTC and ctDNA detection that are continuously developing. PCR-based techniques are the initial approaches used to identify ctDNA, however targeted deep sequencing is now superior. Instead of tumor biopsy, liquid biopsy might be beneficial for breast cancer diagnosis, therapy, and prognosis based on the clinical trials. However, more clinical trial studies are still needed.Conclusion. The advancement of technology has made genetic alteration detection via liquid biopsy feasible to detect genetic alterations that are very important not only for early detection of breast cancer, but also targeted therapy and disease monitoring. Numerous studies have shown the potential of liquid biopsy as an alternative to tumor biopsy.
Locoregional Management in Breast Cancer with BRCA1/2 Mutation: Evidence Based Case Report Karisyah, Adlina; Panigoro, Sonar S
The New Ropanasuri Journal of Surgery Vol. 10, No. 1
Publisher : UI Scholars Hub

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Abstract

Introduction. Breast cancer is still one of the top health issues worldwide. Hereditary predisposition is linked with morbidity and mortality of breast cancer patients. BRCA 1/2 genetic mutation, one of mutations in breast cancer that has been extensively observed, has tremendous effects on the carrier. Studies showed that patients with BRCA1/2 mutation are often associated with poor pathological characteristics. Further research isyet to identify the effect of the mutation with prognosis including locoregional recurrences. This study aims to understand the risk of locoregional recurrences on the patients with breast cancer and BRCA 1/2 genetic mutation who had BCT or mastectomy. Method. Comprehensive literature search conducted based on clinical-questions-related keywords from various sites i.e., Cochrane, PubMed, EBSCOhost, ProQuest, and ScienceDirect. Three articles were selected considering the exclusions and inclusions criteria. Later the articles were critically appraised based on validity, importance, and applicability. Results. Two of the three articles showed no statistical difference on the locoregional recurrence on the patients with the breast cancer and the BRCA1/2 genetic mutation who had BCT and mastectomy. The locoregional recurrence was 0 – 8.1% in patients underwent BCT. Whilst the patient underwent mastectomy had 3.5 – 22.2% locoregional recurrence with p value < 0.05. Conclusion. BCT can be considered as a locoregional treatment in breast cancer with BRCA 1/2 genetic mutation as it is equally effective as mastectomy because both had negligible differences in locoregional recurrences.
THE ROLE OF EPIGENOME-WIDE ASSOCIATION STUDIES (EWAS) IN IDENTIFYING EPIGENETIC BIOMARKERS FOR BREAST CANCER: A NARRATIVE REVIE Karunia Karunia; Rafika Indah Paramita; Sonar Soni Panigoro
Biomedika Vol 18, No 1 (2026): Biomedika February 2026
Publisher : Universitas Muhammadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/biomedika.v18i1.13599

Abstract

Breast cancer remains the most common malignancy among women worldwide and a leading cause of cancer-related mortality. Advances in epigenetics, particularly through the Epigenome-Wide Association Study (EWAS) approach, have provided new opportunities to identify epigenetic biomarkers for early detection, risk assessment, and therapeutic monitoring. This narrative review aims to describe the role of EWAS in identifying DNA methylation biomarkers relevant to breast cancer and to highlight current methodological challenges. Literature was retrieved from PubMed, ScienceDirect, and Google Scholar using the keywords “EWAS,” “breast cancer,” “DNA methylation,” and “epigenetic biomarker,” focusing on studies published between 2015 and 2025. Findings indicate that EWAS can reveal methylation patterns associated with cancer risk, prognosis, and potential for noninvasive detection, with alterations detectable even before clinical onset. Several candidate biomarkers identified include methylation changes in genes such as BRCA1, RASSF1A, CDH1, and APC, as well as specific CpG sites associated with hormonal exposure and lifestyle-related risk factors. Despite technological advances in microarray platforms and bioinformatics, many studies still face issues such as cross-sectional design, cellular heterogeneity, and limited replication. These challenges highlight the need for standardized analytical pipelines, larger longitudinal cohorts, and multi-omics integration to improve the reliability and clinical applicability of EWAS findings. Nevertheless, with growing standardization and integration of multi-omics data, EWAS holds significant promise for advancing precision medicine toward more predictive and preventive breast cancer care
Co-Authors Abidin Widjanarko Adang Bachtiar Afifi, Rahmi Agustina, Amilya Akmal Taher Anak Agung Istri Sri Wiadnyani Arif Kurniawan Aryo Tedjo Averdi Roezin Billy, Christy Amanda Brahma, Bayu Budiningsih, Setyawati Cipto, Herman Cornain, Santoso Daan Khambri Darmiati, Sawitri Darwito Denni Joko Purwanto Dewi Wulandari Diani Kartini Djajadiman Gatot ELFIRA ANWAR Endang Windiastuti Ening Krisnuhoni Ening Krisnuhono EVLINA SUZANNA Fadilah Fadilah, Fadilah Farida Briani Sobri Ferry Sandra GRACE SHALMONT Hafiz, Muhammad Zaki Abdul Hamzah, Mochtar HARJATI - Harlim Haryana, Sofia M Haryono, Samuel Johny Hazmi, Mohammad Zul Herqutanto Herqutanto I Made Nasar Ichihashi, Masamitsu Iik Wilarso Irwan Ramli Joedo Prihartono Jusman, Sri W Juwita Cresti Rahmaania Kanoko, Mpu Karisyah, Adlina Karunia Karunia Kuntjoro Harimurti Kurnia, Ahmad Lenny Sari Lenny Sari Manangka, Rumuat Semuel Wullul Maulanisa, Sinta C. Mochtar Hamzah Muchlis Ramli Muchlis Ramli Mukhtar, Arman Munakata, Nobuo Murdani Abdullah Nelly Tandiari Noorwati Sutandyo Nugroho, Nyityasmono Tri Nurul Akbar ohno, Yoshiyuki Paramita, Rafika I. Paramita, Rafika Indah Paskahenru, Mahesa Patria Wardana Yuswar Poetiray, Evert PRADNYA SRI RAHAYU Prasandhya Astagiri Yusuf Prihartono, Joedo Primariadewi Rustamadji Primariadewi Rustamadji Purnomo Sidi Priambodo R. R. Mangunkusumo Rafika Indah Paramita Rafika Indah Paramita Rahmaania, Juwita Cresti Ramadhan Karsono Ramadhan Karsono Ramadhan Ramadhan Ratnaningayu, Nindhyana Diwaratri Retnomawarti, Rizka Rianto Setiabudy Rika Lesmana, Rika Rizka Andalusia Santoso Cornain Septelia I. Wanandi Sigit Pribadi Sobri, Farida Briani Sri M.S. Utami Sukartini, Ninik Supono, Arif Suryadi Tandiari, Nelly TIARLAN SIRAIT Tjarta, Achmad Ueda, Masato Wibisana, I GNG. Wilfried H. Sibuea Wirsma Arif Harahap Yuella, Clarissa Kezia, - Yulian, Erwin D. Yuswar, Patria Wardana