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Distributions of Breast Cancer Primary Tumor Locations in Indonesian Patients Putri, Helenia; Kristina, Maria A.; Widjaja, Devita; Baskoro, Bernard A.; Kristiani, Erna; Muljadi, Rusli
Medicinus Vol 11, No 2 (2022): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v9i3.6970

Introduction: Overseas studies have shown various distributions of breast cancer primary tumor locations based on stages and histopathologic types. Based on them, breast cancer was consistently reported to be found on theleft breast more than the right. Breast cancer laterality was estimated to be one of the determinant factors in prognosis. In Indonesia, there are only a few studies on the laterality of breast cancer, as well as the characteristics that accompany it. The aim of this study is to know the distributions of primary breast cancer tumor locations in Indonesian patients.Material and Methods: A cross-sectional design study was done and the data was collected from Siloam Hospital Lippo Village radiology and pathology anatomy department within the 2014-2018 period. The results were presented using descriptive statistics.Results: A total of 74 breast cancer patients from various ages and stages were enrolled in this study. Based on the histopathological types, 84.2% patients left breast tumors and 72.2% patients with right breast tumors had invasive ductal carcinoma of no special type. Based on quadrants, 50% tumors on the left breast are in the superolateral quadrant, followed by 31.6% in superomedial, 13.2% in inferomedial, and the rest in inferolateral. Conclusion: Most tumors are located in the superolateral quadrant and the most histopathological types are non-specific invasive carcinomas.

Distributions of Breast Cancer Primary Tumor Locations in Indonesian Patients Putri, Helenia; Kristina, Maria A.; Widjaja, Devita; Baskoro, Bernard A.; Kristiani, Erna; Muljadi, Rusli
Medicinus Vol. 11 No. 2 (2022): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v9i3.6970

Introduction: Overseas studies have shown various distributions of breast cancer primary tumor locations based on stages and histopathologic types. Based on them, breast cancer was consistently reported to be found on theleft breast more than the right. Breast cancer laterality was estimated to be one of the determinant factors in prognosis. In Indonesia, there are only a few studies on the laterality of breast cancer, as well as the characteristics that accompany it. The aim of this study is to know the distributions of primary breast cancer tumor locations in Indonesian patients.Material and Methods: A cross-sectional design study was done and the data was collected from Siloam Hospital Lippo Village radiology and pathology anatomy department within the 2014-2018 period. The results were presented using descriptive statistics.Results: A total of 74 breast cancer patients from various ages and stages were enrolled in this study. Based on the histopathological types, 84.2% patients left breast tumors and 72.2% patients with right breast tumors had invasive ductal carcinoma of no special type. Based on quadrants, 50% tumors on the left breast are in the superolateral quadrant, followed by 31.6% in superomedial, 13.2% in inferomedial, and the rest in inferolateral. Conclusion: Most tumors are located in the superolateral quadrant and the most histopathological types are non-specific invasive carcinomas.

Prognostic factors of brain metastases affecting survival: an Indonesian cohort Koesbandono, Koesbandono; Muljadi, Rusli; Sutanto, Ratna; Hendriansyah, Lutfi; Kristiani, Erna; Faustina, Carissa; Christanti, Jessica
Universa Medicina Vol. 44 No. 3 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.298-309

BackgroundBrain metastases (BMs) most frequently originate from primary tumors of the lung and breast, and significantly impact cancer patient prognosis. Metastases can be detected synchronously along with the primary tumor or metachronously, following treatment of localized disease. The objective of this study was to identify key prognostic factors influencing survival in synchronous metastases (SM) and metachronous metastases (MM), focusing on metastatic duration, tumor volume response, and gamma knife radiosurgery. MethodsA retrospective cohort study was conducted involving 100 patients with brain metastases (48 synchronous, 52 metachronous). Age, gender, primary tumor, gamma knife status, metastasis location, peritumoral index group, volume reduction, metastatic duration, metastasis characteristics, and intensity pattern based on MRI. A Cox proportional hazards regression was used to analyze the data. Based on the Cox regression coefficients, a prognostic index was constructed. ResultsCalculated HR comprised MM (HR=0.49;95% CI :0.24–0.97], gamma knife treatment (HR = 0.15;95% CI: 0.07–0.29], and volume response (HR=0.40;95% CI: 0.16–0.99), all indicating a significantly reduced mortality risk. A prognostic index was calculated for all patients; those with scores ≤–1.513 were classified as low risk. Kaplan-Meier analysis showed that the low-risk group had a significantly longer mean survival period (75.52 months) compared to the high-risk group (31.43 months) (p<0.001). ConclusionMetachronous presentation, gamma knife therapy, and greater tumor volume reduction independently predict better survival. The developed prognostic index provides a clinically useful tool for personalized risk assessment and treatment planning in patients with brain metastases.

Bronchoscopic Balloon Dilatation for Tuberculosis-related Bronchial Stenosis: A Rare Case Wahyuni, Titis Dewi; Alatas, Mohamad Fahmi; Widysanto, Allen; Siahaan, Sylvia Sagita; Muljadi, Rusli; Carolline, Chaifung
Respiratory Science Vol. 4 No. 2 (2024): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v4i2.125

Background: Bronchial stenosis is known as a complication of endobronchial tuberculosis (EBTB). The incidence of stenosis affects quality of life. A minimally invasive therapeutic strategy, bronchoscopic balloon dilatation (BBD), can be chosen to manage the disease. Case: A 29-year-old woman suffered from bronchial stenosis, which appeared after completing treatment for tuberculosis (TB). She was diagnosed with TB around the middle of her pregnancy. She received anti-tuberculosis treatment for six months. Two years later, she complained of a persistent cough for two weeks prior to hospitalization. A complete stenosis of the left main bronchus with atelectatic on the left lung was seen on a chest CT scan. The result was confirmed with a bronchoscopy procedure. There were no mycobacteria or other suspicious organisms found in bronchial washings. Bronchoscopic balloon dilatation action was successful. Discussion: Endobronchial tuberculosis is a tuberculous infection that affects the tracheobronchial tree. It can be treated with minimally invasive procedures like bronchoscopy or surgical interventions. If the stenosis is mild or moderate, several procedures such as balloon dilatation, stents, laser photoresection, argon plasma coagulation, and cryotherapy are often performed. Bronchoscopy balloon dilatation nowadays has become a more preferred treatment option for tracheal and bronchial stenosis because it may be areliable and effective method. Conclusion: The BDD procedure in this patient showed good results. This procedure is fast, easy, safe, minimally invasive, and the symptoms resolve quickly. It can be concluded that BBD is a safe and effective therapy for TB-related bronchial stenosis, but the long-term effects of the procedure remain to be monitored.

Diagnostic Accuracy of Coronary Artery Calcium Scoring in Detecting Significant Coronary Artery Stenosis Compared with Invasive Coronary Angiography Erico, Adelbertus; Muljadi, Rusli; Yuniarti, Mira; Pardede, Ingrid Maria; Kurniawan, Andree; Jorizal, Patricia
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10757

Background: Coronary artery disease (CAD) remains a leading cause of mortality, emphasizing the importance of early non-invasive diagnostic strategies. This study evaluated the diagnostic accuracy of coronary artery calcium scoring (CACS) in detecting significant coronary stenosis, using invasive angiography as the reference standard. Methods: Sixty-three patients who underwent both CACS and quantitative coronary angiography were retrospectively analyzed. The mean total CACS was 684.1 ± 1030.8, and significant stenosis (≥70%) was most prevalent in the left anterior descending artery (92.1%). Result: Spearman’s analysis revealed positive correlations between CACS and angiographic stenosis in the right coronary artery (ρ = 0.338, p = 0.007), left anterior descending artery (ρ = 0.492, p = 0.001), and left circumflex artery (ρ = 0.314, p = 0.012). Receiver operating characteristic (ROC) analysis demonstrated moderate-to-good diagnostic performance, with area under the curve (AUC) values of 0.699 for RCA, 0.769 for LAD, and 0.690 for LCX. Conclusions: These findings indicate that CACS can serve as a reliable, low-cost, and non-invasive modality for preliminary screening and risk stratification of CAD, particularly in identifying patients who may benefit from invasive coronary angiography.

Association Between Gender, Coronary Artery Dominance and Severity of Coronary Artery Stenosis on Computed Tomography Angiography Kurniawan, Yohanes Chandra; Muljadi, Rusli; Koesbandono; Lukito, Antonia Anna; Lugito, Nata Pratama Hardjo; Yuniarti, Mira
Medicinus Vol. 15 No. 2 (2026): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i2.10780

Background: Coronary artery disease (CAD) is one of the leading causes of death worldwide. Several preliminary studies suggest that certain dominance patterns may be associated with the distribution and severity of stenosis, influencing the risk of cardiac complications and interventional strategies. However, the relationship of gender specific between coronary artery dominance patterns and the severity of stenosis remains poorly understood. This study designed to evaluate the relationship between gender specific, coronary artery dominance, and severity of coronary artery stenosis, number of stenosis vessels, stenosis location, and calcium score on CCTA examination. Methods: A retrospective cross-sectional study with consecutive non-probability sampling was conducted over a one-year period with 1115 patients who underwent CCTA were analysed using the Chi-square test, Fisher’s exact test, and T-test according to the type of data. Result: The result showed a strong association was found between non-right dominant coronary artery (non-RDCA) in females and significant coronary stenosis (p=0.009), with the most strongly associated location being the LCX (p=0.017). Conclusions: These findings suggest the presence of gender- and dominance-specific patterns in coronary artery disease (CAD), warranting further investigation using prospective study designs and larger sample sizes.

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