Primariadewi Rustamadji
Faculty of Medicine Universitas Indonesia/ Cipto Mangunkusumo Hospital, Jakarta

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Lymph Nodes Metastasis is Associated with Higher Body Mass Index in Indonesian Breast Cancer Patients Yournita, Debbie; Rustamadji, Primariadewi
Majalah Patologi Indonesia Vol. 32 No. 3 (2023): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v32i3.560

Abstract

Background Breast cancer is the most prevalent malignancy among women and is the second largest contributor to cancer-related deaths globally. Women with a high body mass index (BMI) are at a greater risk of developing breast cancer and an increased risk of lymph node metastasis. This retrospective study aimed to determine the relationship between BMI and the clinical pathological profile of invasive breast carcinoma (IBC) patients. Method This study was conducted from 2019 to 2022. Data were collected through the archives of the Department of Anatomic Pathology FKUI/RSCM (Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital). Clinical pathological data were collected. The histological type, grade, lymphovascular invasion, and lymph node metastasis of the tumors were re-evaluated. The chi-square hypothesis test was used to determine the relationship between BMI and clinical pathological profile. The results were considered statistically significant with a p <0.05. Result A total of 151 cases of IBC with lymph node dissection from 2019 to 2022 were included in this study, all of which were female, with the majority being >50 years old (55%). The most common tumor size and histological type were T2 (39,7%) and invasive ductal carcinoma NST (74,8%), 49% of cases were grade 3 tumors. Most IBC cases had an obese BMI (49%), 63.1% with lymph node metastasis had an overweight-obese BMI. Statistical analysis was performed between BMI and lymph node metastasis status, and p-value=0.025 was obtained. The relationship between tumor size and lymphovascular invasion with lymph node metastasis was also found to be statistically significant, as indicated by a p-value of 0.000. Conclusion Cases with lymph node metastasis had the highest rate of overweight-obesity, and a significant relationship was found between BMI and lymph node metastasis status. A significant relationship was also found between tumor size and lymphovascular invasion with lymph node metastasis.
Karakteristik Histopatologik dan Imunofenotipik Kanker Payudara di Rumah Sakit Cipto Mangunkusumo Jakarta, Indonesia Rustamadji, Primariadewi; Marisca, Stephanie
Medicinus Vol. 6 No. 3 (2017): June 2017 - September 2017
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v6i3.1147

Abstract

Introduction: Breast cancer can be classified into luminal A, luminal B, Her2+, dan basal-like molecular subtype according to genetic profile and immunophenotype. The aim of this study is to assess histopathologic and immunophenotype characteristics of breast cancer in Cipto Mangunkusumo Hospital Jakarta, Indonesia.Material and methods: This study is a cross-sectional retrospective study. The sample was 2632 breast cancer case in Department of Anatomical Pathology Cipto Mangunkusumo Hospital from the year 2011 until 2015. ER, PR, Her2, Top2 α, and Ki67 immunohistochemical stain was then grouped into luminal A (ER+/PR+/Her2-/Ki67<20%) subtype, luminal B (ER+/PR+/Her2-/Ki67‰¥20%) subtype, Her2+ (ER-/PR-/Her2+) subtype, and basal-like (ER-/PR-/Her2-) subtype. Kendall’s Tau analysis was done to assess association between sample characteristics and molecular subtype, association between top2α positive and molecular subtype.Result: The most prevalent to the less prevalent breast cancer molecular subtype was luminal B (43,9%), Her2+ (14,6%), luminal A (14,0%), and basal-like (11,3%). There was a significant association between the tumor stage and breast cancer subtype (p=0,0001). There is also a significant association between Top2α expression and molecular subtype (p=0,0001).Conclusion: The most prevalent breast cancer molecular subtype was luminal B. There was an association between breast cancer molecular subtype and a higher degree and Top2α expression.
Differential Effects of Anthracycline-based Neoadjuvant Chemotherapy on Stromal and Intratumoral FOXP3+ Tumor-Infiltrating Lymphocytes in Invasive Breast Cancer of No Special Type Rustamadji, Primariadewi; Wiyarta, Elvan; Pramono, Meike; Maulanisa, Sinta Chaira
The Indonesian Biomedical Journal Vol 16, No 2 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i2.2828

Abstract

BACKGROUND: Neoadjuvant chemotherapy (NAC) plays a crucial role in the management of invasive breast cancer with no special type (IBC-NST), with the immune system's response to cancer heavily relying on the dynamics between tumor-infiltrating lymphocytes (TILs) and cancer cells. In this study, the differential effects of anthracycline-based NAC on stromal and intratumoral foxhead box P3 (FOXP3+) TILs expressions were specifically examined.METHODS: In this cross-sectional study, 32 IBC-NST samples were evaluated for pre- and post-NAC FOXP3+ TIL expression as well as the changes of FOXP3+ TIL expression. Comprehensive data collection regarding subjects' age, tumor size, grade, lymphovascular invasion, regional lymph node metastasis, and receptor status were conducted. Immunohistochemistry was utilized to quantify FOXP3+ TILs. The stromal, intratumoral and total FOXP3+ TILs expression were then analyzed.RESULTS: Significant reductions in FOXP3+ TIL expression post-NAC were observed, with stromal FOXP3+ TILs showing a median decrease of 3.6 units in subjetcs aged ≥50 years (p=0.013) and a median decrease of 13.2 units in subjects with tumors ≥5 cm after NAC (p=0.006). In contrast, intratumoral FOXP3+ TILs remained relatively stable, with minor changes. The total FOXP3+ TIL expression, combining stromal and intratumoral components, was significantly decreased with a median of 13.0 units decreased to 5.3 units (p<0.001).CONCLUSION: This study highlights the significant reduction in stromal FOXP3+ TIL expression after NAC treatment in IBC-NST subjects, in contrast to the relatively stable intratumoral FOXP3+ TILs. Understanding these differences may guide future therapeutic strategies and improve treatment outcomes for IBC-NST.KEYWORDS: biomarkers, chemotherapy, FOXP3, prognostic, response, lymphocyte 
Hubungan Profil Klinikopatologik dengan Rekurensi Karsinoma Payudara Invasif di Departemen Patologi Anatomik FKUI/RSCM Anggreani, Ineke; Rustamadji, Primariadewi
Majalah Patologi Indonesia Vol. 31 No. 2 (2022): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Anatomik Indonesia (PDSPA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55816/mpi.v31i2.506

Abstract

ABSTRACTBackgroundBreast cancer is the most common malignancy and the leading cause of death in women. Invasive breast carcinoma is a breastmalignancy originating from the glandular epithelium of the breast. Approximately 40% of invasive breast carcinomas had recur.There are several factors that influence the occurrence of recurrence, such as age, tumor size, lymphovascular invasion, incisionmargins, hormonal status and therapy. This study aims to determine the clinicopathological profile associated with recurrence 5years after therapy for invasive breast carcinoma.MethodsThis study is a retrospective study with data collection carried out through the archives of the Department of Anatomical Pathology,Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo General Hospital within a period of 2 years (2014-2015). Theclinicopathological data was searched for up to 5 years of therapy.ResultsFrom the 54 cases of invasive breast carcinoma in this study, all were women with mean age 48.3 years. A total of 18 cases(33.3%) experienced recurrence, especially in patients aged ≤50 years, tumor mass size more than 2 cm and luminal B moleculartype. Tumor margin is difficult to evaluate because many review cases do not submit the tumor margin section. Therapy received bypatients was in accordance with standard procedures’ hospital, both neoadjuvant and adjuvant chemotherapy. From the statisticalanalysis, there was no significant relation between all profiles that studied with recurrence. It is because the comparison of numberof recurrent and non-recurrent cases is not equal.ConclusionOne third of advanced invasive breast carcinomas treated with neoadjuvant and showing a partial response have recurrence,whereas no complete response has recurrence. Tumor size, histologic grade, molecular type and adherence to routine follow-uptreatment influenced the recurrence within 5 years of treatment.