THE SENSITIVITY AND SPECIFICITY OF FINE NEEDLE ASPIRATION BIOPSY (FNAB) ON BREAST LUMP DIAGNOSIS IN DR. SARDJITO GENERAL HOSPITAL YOGYAKARTA 2012-2014

HIFDZA FAZA FELISHA, dr. Ery Kus Dwianingsih, Ph.D; dr. Hanggoro Tri Rinonce, Sp.PA, Ph.D

2016 | Skripsi | S1 PENDIDIKAN DOKTER

LATAR BELAKANG. Tumor payudara merupakan keluhan paling sering ditemukan pada wanita terutama dalam usia reproduktifnya. Tumor payudara kebanyakan disebabkan oleh tumor jinak, tetapi 10-20% tumor disebabkan oleh tumor ganas. Sejak 2008, terjadi kenaikan insidensi kanker payudara di dunia mencapai 20% sedangkan kenaikan angka mortalitasnya mencapai 14%. Jika kanker payudara dapat dideteksi dan diobati lebih awal, kemungkinan untuk dapat sembuh akan meningkat dan dapat menurunkan angka kematian. Informasi yang lengkap dan akurat mengenai alat diagnostic yang efektif, terpercaya, dan tidak infasif dalam mendiagnosis kanker payudara, salah satunya Aspirasi Jarum Halus (AJH) sangat penting diketahui. Sayangnya, data mengenai sensitivitas dan spesifisitas AJH di Yogyakarta terbatas. Oleh karena itu, penelitian ini ditujukan untuk mengkonfirmasi sensitifitas dan spesifisitas metode AJH dalam mendiagnosis tumor payudara di RSUP DR. Sardjito Yogyakarta. METODE. Penelitian ini dilakukan di Departemen Patologi Anatomi RSUP Dr. Sardjito Yogyakarta. Dari Januari tahun 2012 hingga Desember tahun 2014 ditemukan 145 pasien tumor payudara. Penelitian ini menggunakan metode penelitian cross sectional deskriptif. Hasil penelitian dianalisa menggunakan Statistic Package for Social Science (SPSS) menggunakan kurva ROC dan uji diagnostik. HASIL. Ditemukan 41/145 penderita tumor jinak dan 104/145 penderita tumor ganas. Akurasi, sensitivitas dan spesifisitas dari AJH dalam mendiagnosis tumor payudara adalah 89.66%, 85.58% dan 100%. Akurasi, sensitivitas dan spesifisitas dari AJH dalam menentukan diagnosis patologis adalah 66.16%, 82.5%, dan 70.3%. Akurasi, sensitivitas dan spesifisitas dari AJH dalam mendiagnosis karsinoma duktal adalah 83.58%, 85.51%, dan 81.54%. Akurasi, sensitivitas dan spesifisitas dari AJH dalam mendiagnosis karsinoma lobular adalah 89.55%, 16.67%, 96.72%. Akurasi, sensitivitas dan spesifisitas dari AJH dalam mendiagnosis lesi fibrokistik adalah 85.82%, 26.67%, dan 93.28%. Akurasi, sensitivitas dan spesifisitas dari AJH dalam mendiagnosis fibroadenoma adalah 94.03%, 90% dan 94.35%. KESIMPULAN. AJH dapat digunakan sebagai alat diagnosis alternatif. Dalam mendiagnosis tumor payudara AJH memiliki beberapa kelebihan seperti: cepat, murah (ekonomis), efektif, terpercaya dan tidak invasive.

BACKGROUND. Breast lump is a very common complaint in the women, especially during reproductive year. Breast lump is often caused by benign (non-cancerous) conditions, yet 10-20% of breast lump are cancerous. Since 2008, breast cancer worldwide incidence has increased more than 20% and its mortality has increased 14%. If breast cancer can be detected and managed earlier, the chance of being cured will be higher and it will reduce the mortality. The accurate and plentiful data of what diagnostic tools that effective, affordable, and less invasive is extremely important, one of them is Fine Needle Aspiration Biopsy (FNAB). Meanwhile, FNAB's sensitivity and specificity in Yogyakarta data is limited. Therefore, this study has been conducted to confirm the sensitivity and specificity of FNAB on breast lump diagnosis in Dr. Sardjito General Hospital. METHODS. This study was performed in Anatomical Pathology Department in Dr. Sardjito General Hospital Yogyakarta. There were 145 breast lump patients from January 2012 until December 2014. This study used descriptive non-experimental study with retrospective cross sectional design. The data were analyze using Statistic Package for Social Science (SPSS) using ROC Curve and Diagnostic Test. RESULTS. There were 41/145 benign and 104/145 malignant lesions. The accuracy, sensitivity and specificity of FNAB was 89.66%, 85.58%, 100% in determine benign or malignant breast lump. The accuracy, sensitivity, and specificity of FNAB was 66.16%, 82.5%, 70.3% in determine the pathological diagnosis of breast lump. The accuracy, sensitivity and specificity of FNAB was 83.58%, 85.51%, 81.54% in diagnose ductal carcinoma. The accuracy, sensitivity and specificity of FNAB was 89.55%, 16.67%, 96.72% in diagnose lobular carcinoma. The accuracy, sensitivity and specificity of FNAB was 85.82%, 26.67%, 93.28% in diagnose fibrocystic changes. The accuracy, sensitivity and specificity of FNAB was 94.03 %, 90%, 94.35% in diagnose fibroadenoma. CONCLUSIONS. FNAB can be used as an alternative diagnostic tool. It provides rapid, cheaper (economical), effective, valuable, and less invasive diagnostic tools on breast lump diagnosis.

Kata Kunci : breast lump, sensitivity, specificity, FNAB, tumor payudara, sensitivitas, spesifisitas, AJH