RELATIONSHIP BETWEEN THE STATUS KLINIKOPATOLOGIS IN BREAST CANCER PATIENTS UNDERGOING MORE LOCAL radical mastectomy pascakemoterapi NEOAJUVAN MODIFICATIONS WITH RESISTANCE ON FIVE YEARS
ABSTRACT: Background: Breast cancer is the most cancer among women in the world. The five years survival rate of breast cancer was highly associated with the clinicopathologic status. The five years survival rate of the locally advanced breast cancer was less than operable breast cancer. Purpose of Study: To find out the correlation between clinicopathologic status in the locally advanced breast cancer patients who underwent modified radical mastectomy after getting neoadjuvant chemotherapy with five years survival rate. Subjects of Study: Our subjects were locally advanced breast cancer patients who underwent modified radical mastectomy after getting neoadjuvant chemotherapy in dr Sardjito General Hospital Yogyakarta during January-December 2008, and met with the inclusive criterias. Methods: This study was a descriptive analytical study with cross sectional design. We used chi-square test in statistical analysis, with p-value<0.05 considered as significant. The significant variable was analyzed using logistic regression and multivariate analysis (multiple logistic regression). Results: There were 62 peoples in population, all of them were women (100%). Among of them, 53.22% (33/62) were still alive. Based of age : group of < 40 y.o. 62.5% (5/8) still alive , group of ≥40 y.o. were 51.58% (28/54). Based of stadium : stadium IIIA were 69.05% (29/42) still alive , stadium IIIB were 20% (4/20) , there is no subject in stadium IIIC (0%). Based of grade : grade I were 66.67% (2/3) still alive , grade II were 50% (21/42) , grade III were 58.82% (10/17). Based of size of tumour : diameter ≤2 cm were 77.78% (7/9) still alive , diameter >2-5 cm were 53.33% (16/30) , diameter >5 cm were 43.48% (10/23). Based of axillary node involved : lymph node (+) 0 were 68.42% (13/19) still alive , lymph node (+) 1-3 were 62.96% (17/27) , lymph node (+) ≥4 were 18.75% (3/16). Based of imunohistochemical subtyping : luminal A were 70% (21/30) still alive, luminal B was only 1 people (100%) still alive , triple negative were 39.13% (9/23) , Her2-neu Overexpresion were 25% (2/8). All of subject were using AC regiment for neoadjuvant chemotherapy (100%). All of histopathologic results were Ductal Infiltrative Carcinoma (100%). Stadium (p-value=0.000), nodal status (pvalue= 0.005) and imunohistochemical subtyping (p-value=0.034) were significant clinicopathologic status. The most significant of the clinicopathologic factor that correlated with the five years survival rate were stadium and nodal status, using multiple logistic regression. Conclussion: Clinicopathologic status that correlated with five years survival rate in breast cancer patients who underwent modified radical mastectomy after getting neoadjuvant chemotherapy significantly were stadium, nodal status and imunohistochemical subtyping. The most significant among clinicopathologic status were stadium and nodal status.
