AKURASI PEMERIKSAAN KLINIS, ULTRASONOGRAFI PAYUDARA DAN SITOLOGI BIOPSI ASPIRASI DALAM MENEGAKKAN DIAGNOSIS KEGANASAN PAYUDARA STADIUM DINI (THE ACCURACY OF CLINICAL FEATURES, BREAST ULTRASOUND AND FINE NEEDLE ASPIRATION CYTOLOGY FOR DIAGNOSIS EARLY STAGE BREAST CANCER

Abstract

Background : The mortality rate of women breast cancer have been reported to increase. Usually patients diagnosed in advance stage and the prognosis became poor. Histopathological diagnostic such as frozen section or fine needle aspiration were done to determine surgical treatment. Triple test consisting of clinical features, mammography and fine needle aspiration, have a high diagnostic accuracy. Unfortunately mammography and frozen section are rare facilities in rural health services. The aim of this research is to evaluate the accuracy of clinical features, breast ultrasound and fine needle aspiration as an alternative combination treatment test for definitive treatment. Methods : The design of this research is diagnostic test. Ninety six breast cancer patiens admitted in the sub department of Oncology Dr Kariadi Hospital were examined. Clinical features, breast ultrasound and fine needle aspiration cytology were done before surgical treatment. The accuracy diagnostic of clinical features, breast ultrasound and fine needle aspiration were analized and compare with the accuracy of frozen section diagnosis. Result : Combination of clinical features,breast ultrasound and fine needle aspiration shows sensitivity 94%, specificity 95%, positive predictive value 96%, negative predictive value 93%, accuracy 94%.On the other hand the frozen section diagnostic shows sensitivity 94,7%, specificity 100%, positive predictive value 100%, negative predictive value 92,8% and accuracy 96,8% . Conclusion : The combination of clinical features, breast ultrasound and fine needle aspiration has a slightly lower accuracy.compaired with frozen section diagnosis Latar belakang : Keganasan payudara merupakan penyebab kematian tertinggi akibat kanker pada wanita yang makin meningkat. Penderita biasanya datang dalam keadaan stadium lanjut sehingga mempengaruhi prognosis. Diagnosis pasti ditentukan oleh hasil pemeriksaan histopatologi seperti potong beku dan sitologi biopsi aspirasi. Hasil pemeriksaan potong beku menentukan tindakan definitif. Triple test terdiri dad pemeriksaan klinik, mammografi dan sitologi biopsi aspirasi yang meiliki akurasi diagnostik tinggi. Sayangnya mammografi dan potong beku jarang tersedia daerah. Tujuan penelitian ini untuk mengetahui kombinasi pemeriksaan klinis, ultrasonografi payudara dan sitologi biopsi aspirasi sebagai suatu kombinasi pemeriksaan alternatif untuk terapi definitif. Metode : Desain penelitian ini merupakan penelitian uji diagnostik. Sembilan puluh enam pasien keganasan payudara datang ke bagian bedah onkologi RS Dr Kariadi Semarang dan dilakukan pemeriksaan. Dilakukan pemeriksaan klinis, ultrasonografi payudara dan sitologi biopsi aspirasi sebelum tindakan bedah. Dilakukan analisa akurasi diagnostik pemeriksaan klinis, ultrasonografi payudara, sitologi biopsi aspirasi dan dibandingkan dengan akurasi diagnostik potong beku . Hasil : Kombinasi pemeriksaan klinis, ultrasonografi payudara dan sitologi biopsi aspirasi menunjukkan sensitifitas 94%, spesifisitas 95%, nilai prediksi positif 96%, nilai prediksi negatif 93%, akurasi diagnostik 94%. Sedangkan uji diagnostik potong beku sensitifitas 94,7%, spesifisitas 100%, nilai prediksi positif 100%, nilai prediksi negatif 92,8% . Kesimpulan : Kombinasi pemeriksaan Minis, ultrasonografi payudara dan sitologi biopsi aspirasi mempunyai akurasi sedikit lebih rendah dibandingkan dengan pemeriksaan potong beku.