KARAKTERISTIK, FREKUENSI, DAN PENGARUH FAKTOR RISIKO TERHADAP STADIUM KLINIS TRIPLE NEGATIVE BREAST CANCER (TNBC) DI RSUP DR SARDJITO YOGYAKARTA

HASNA FIKRIYA, Dr. dr. Ibnu Purwanto, Sp. PD-KHOM; Dr. dr. Usi Sukorini, Sp. PK(K), M.Kes

2020 | Skripsi | S1 KEDOKTERAN

Latar Belakang: Kanker payudara (KPD) merupakan malignansi dengan urutan terbesar ke-2 di dunia dengan prevalensi 1.79 per 1000 penduduk. Kanker payudara dibagi menjadi beberapa subtipe, Triple Negative Breast Cancer (TNBC) adalah salah satu subtipe KPD yang secara klinis negatif untuk ekspresi reseptor estrogen dan progesteron (ER / PR) maupun protein HER2. TNBC hanya menyumbang proporsi 15% kasus di seluruh dunia, namun TNBC bersifat lebih agresif dan lebih cepat mengalami rekurensi serta metastasis ke bagian tubuh lainnya. Tujuan: Mengetahui frekuensi demografi, karakteristik, dan hubungan antara faktor risiko dan stadium klinis pasien TNBC. Metode: Penelitian ini merupakan penelitian deskriptif analitik dengan data catatan medik pasien TNBC di RSUP Dr. Sardjito periode 2014-2018 sebanyak 97 sampel. Analisis statistik dilakukan menggunakan analisis univariat, bivariat dengan uji chi square, dan regresi logistik ordinal menggunakan perangkat lunak SPSS. Hasil: Hasil deskripsi dari 97 pasien TNBC menunjukkan bahwa pasien paling banyak tinggal di perkotaan, paling banyak berada pada stadium III, usia pasien lebih banyak di golongan, memiliki status BMI non obesitas, memiliki pola patologi anatomi karsinoma duktal invasif, tidak mengalami anemia pre kemoterapi, menjalani tipe operasi mastektomi, regimen kemoterapi yang paling banyak diberikan yakni antrasiklin, lebih banyak pasien yang mengalami neutropenia pasca kemoterapi, serta lebih banyak pasien yang tidak mengalama trombositopenia pasca kemoterapi. Hasil pengujian independensi menunjukkan bahwa tidak ada hubungan antara faktor risiko TNBC yang meliputi golongan usia, lingkungan, status BMI pre kemoterapi, dan status anemia pre kemoterapi dengan stadium klinis pasien. Hasil regresi logistik ordinal menunjukkan bahwa tidak terdapat variabel independen yang berpengaruh signifikan terhadap stadium klinis pasien TNBC. Kesimpulan: Usia saat pertama diagnosis, lingkungan tinggal, BMI pre kemoterapi, dan anemia pre kemoterapi tidak berpengaruh secara statistik terhadap stadium klinis pasien TNBC. Kata Kunci: kanker payudara, triple negative breast cancer, frekuensi demografi, karakteristik, factor risiko, stadium klinis

Background: Breast cancer is the 2nd highest malignancy in the world with a prevalence of 1.79 per 1000 population. Breast cancer is divided into several subtypes, Triple Negative Breast Cancer (TNBC) is one of the breast cancer subtypes that is clinically negative for the expression of estrogen and progesterone receptors and HER2 protein. It only accounts for 15% of cases worldwide, but TNBC is more aggressive and it recurs and metastases more quickly. Objective: To determine the demographic frequency, characteristics, and the relationship between risk factors and clinical stage of TNBC patients. Methods: This study is a descriptive analytic study using the medical records of TNBC patients at RSUP Dr. Sardjito Yogyakarta in the 2014-2018 period with 97 samples. Statistical analysis was performed using univariate analysis, bivariate analysis with chi square test, and ordinal logistic regression using SPSS software. Results: The description of 97 TNBC patients shows that most patients live in urban areas, most are in stage III, more in the old group, has a BMI status non-obese, has an anatomical pathology pattern of invasive ductal carcinoma, does not experience anemia pre chemotherapy, underwent a type of mastectomy surgery, most are given anthracycline, more have post-chemotherapy neutropenia, and more patients do not experience post-chemotherapy thrombocytopenia. Independence test showed that there was no relationship between TNBC risk factors including age, environment, pre-chemotherapy BMI status, and pre-chemotherapy anemia status with the patient's clinical stage. The results of ordinal logistic regression showed that there were no independent variables that had a significant effect on the clinical stage of TNBC patients. Conclusion: Age at first diagnosis, living environment, pre-chemotherapy BMI, and pre-chemotherapy anemia did not statistically influence the clinical stage of TNBC patients. Keywords: breast cancer, triple negative breast cancer, demographic frequency, characteristics, risk factors, clinical stage.

Kata Kunci : kanker payudara, triple negative breast cancer, frekuensi demografi, karakteristik, factor risiko, stadium klinis