Perbedaan Kadar Profil Lipid Sewaktu pada Subtipe Kanker Payudara

Abstract

Pendahuluan :Kanker payudara menyebabkan kematian wanita nomor satu didunia hingga saat ini. Data dari American Cancer Society (2015) diperkirakan 231.840 kasus baru kanker payudara dan 40.290 kematian yang diakibatkan oleh kanker payudara. Dalam pengembangan ilmu kedokteran onkologi, didapati bahwa kanker payudara bukanlah penyakit yang sifatnya tunggal, melainkan beberapa penyakit yang memiliki sifat dan respon yang berbeda dengan modalitas terapi yang ada. Penyakit ini disebut sebagai subtipe pada kanker payudara. Dari beberapa studi epidemiologi telah dibuktikan adanya hubungan antara peningkatan konsumsi lemak dengan peningkatan risiko kanker payudara. Atas dasar latar belakang diatas, peneliti tertarik untuk melihat perbedaan kadar profil lipid sewaktu pada subtipe kanker payudara. Metode Penelitian : Penelitian ini merupakan penelitian analitik observasional dengan desain penelitian cross sectional yang dilakukan di Divisi Bedah Onkologi Departemen Ilmu Bedah RSUP H. Adam Malik Medan. Sampel penelitian adalah 151 penderita kanker payudara sejak Oktober 2018 hingga Februari 2019 yang memenuhi kriteria inklusi dan eksklusi. Pada sampel kemudian dilakukan pemeriksaan subtipe kanker dan kadar profil lipid. Hubungan antar variabel didapat dengan menggunakan uji Chi square pada program SPSS ver. 20. Hasil Penelitian : Subtipe kanker payudara di RSUP H Adam Malik Medan sejak Oktober 2018 hingga Februari 2019 dijumpai subtipe Luminal A sejumlah 81 (53,6%), Luminal B sejumlah 16 (10,6%), HER2 overexpression sejumlah 13 (8,6%), serta TNBC sejumlah 41 (27,2%). Dijumpai penderita kanker payudara memiliki profil lipid tidak normal sebanyak 75 (49,7%) orang dan profil lipid normal sebanyak 76 (50,3%) orang. Hasil uji Chi-Square untuk menilai perbedaan kadar profil lipid sewaktu pada subtipe kanker payudara tidak signifikan, dengan p-value 0,733. Juga dinilai hubungan kadar masing-masing profil lipid sewaktu dengan masing-masing subtipe kanker payudara, dan hanya dijumpai hubungan yang signifikan antara subtipe TNBC dengan kadar kolesterol total (p-value 0,002). Simpulan : Tidak terdapat perbedaan kadar profil lipid sewaktu pada subtipe kanker payudara (p-value 0,733).

Background and Aim : Breast cancer is the leading cause of cancer death among woman. Changes in lipid metabolism have been reported in many types of cancer. Lipids have been involved in the regulation of proliferation, differentiation, apoptosis, inflammation, autophagia, motility and membrane homeostasis. The purpose of this study is to determine the differences levels of lipid profiles in subtypes of breast cancer. Methods: We include all breast cancer patients who treated at polyclinics and patient wards of Oncology Surgical Science Department of general hospital of H. Adam Malik Medan since October 2018 to February 2019. Data such as age, age at the onset of menarche, menopausal status, body mass index (bmi), parity status, family history of breast cancer, previous history of breast cancer, histopathological findings, tumour grade, stage of cancer, genetic subtypes, lipid profile were collected. Results: From 151 patients, The median age of this study was 51.0 (18-82) years. The mean age at the menarche onset was 12.61 (±1.291) years. Patients who were already menopause that represented approximately 78.8% of the total study population. Forty three (28,5%) patients have BMI of 25.0-29.9. Most of the subjects had one to two children around the study period accounting for 53 (35.1%) and 75 (49.7%) patients, respectively. A total of 127 (84%) subjects did not report any history of breast cancer occurred in their family members. The results showed that approximately 90% of the subjects had undergone at least one operative management for breast cancer. Majority of the samples were categorized as IDC histologic subtypes with 114 (75.5%) patients, poorly differentiated cancer with 87 (57.6%) patients, diagnosed with stage III and IV breast cancer which 104 (68.8%) patients, have Luminal A cancer with 81 (53.6%) patients. From the analysis, the only significant finding was for the difference in total cholesterol levels among those with TNBC (p-value of 0.002). Conclusions: There was no difference found in the level of lipid profile as in breast cancer subtype. There is a difference in tumor patient TNBC subtype with normal total cholesterol value and abnormal total cholesterol value.