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Azis Aimaduddin AI
PPDS BEDAH
FK UNS
RS DR MOEWARDI
Definisi
didiagnosis selama kehamilan, atau dalam
satu tahun setelah melahirkan
Epidemiologi
1
/ 3000 kehamilan
Median umur 33 ( 23 - 47 y)
- Painless mass
- Nipple discharge
- Inflammatory breast
Invasive lobular
ca
Inflammatory breast ca
Invasive ductal ca
Middleton LP , et al. Breast carcinoma in pregnant women.Assissment of
clinicopathologic & immunohistochemical features
Grade
keterlambatan diagnostik
Rata-rata keterlambatan 8,2 bulan (2-15
bulan)
Stadium lanjut '2,5 kali lipat'
Moore HCF, Foster Jr Rs. Breast cancer and pregnancy, Semin oncol
FNAB
Core biopsi - Cost efektif
Sensitifity 60-70 %
USG sensitivity 93 %
Mammogram:
- 0.004 Gy
- sensitivity 70%
Staging Thoraks ro , USG
Nicklas A, Baker M. Imaging strategies in pregnant caner patients. Semin
oncol 2000;27:623-32
Manajemen
Tidak
Trimester I
(Std
I,II)Continuing pregnancy
Mastectomy + Axilary staging adjuvant
kemoterapi 2nd trimester Adjuvant
radiasi post partum adjuvant endokrin
terapi post partum
(Std
III,IV)Discus termination
adjuvant kemoterapi 2nd trimester
Adjuvant radiasi post partum adjuvant
endokrin terapi post partum
Trimester II
(Std
I,II)Mastektomy/BCS + Axilary
staging adjuvant kemoterapi Adjuvant
radiasi post partum adjuvant endokrin
terapi post partum
(Std
Trimester III
(Std
I,II)Mastectomy/BCS + Axilary
staging adjuvant kemoterapi Adjuvant
radiasi post partum adjuvant endokrin
terapi post partum
Std