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Tantangan dalam mengobati kanker payudara stadium lanjut tipe Luminal B HER2 negatif dengan krisis viseral

  • Elvidawati ,
  • Khairiyah Darojat ,
  • Lia Sasmithae ,
  • Trinugroho Heri Fadjari ,


Abstract

Introduction: Breast cancer is the most prevalent form of malignancy in women, with over two million new cases yearly. The complex instance of advanced breast cancer with visceral crisis occurs when cancer has spread to vital organs such as the liver, lungs, and brain. This case report aims to teach us how to prevent visceral crisis, which will increase mortality, particularly in advanced breast cancer.

Case presentation: A 50-year-old woman who presented with complaints of shortness of breath was diagnosed with advanced breast cancer and visceral crisis. On examination, there were indications of hypervolemia, including a rightward displaced trachea and diminished vocal fremitus. The anatomical pathology results revealed a grade II invasive breast carcinoma. (Luminal B HER2 negative). X-rays of the chest reveal bilateral pleural effusion. The lumbosacral X-ray and abdominal ultrasonography both revealed liver metastases. Before intra-thoracic metastases and visceral crisis, the patient received hormonal therapy (tamoxifen). When intra-thoracic metastases and visceral problems occurred, the treatment was substituted with capecitabine for 3 months. However, capecitabine was discontinued because the cancer spread to the bones and liver. Patients were administered chemotherapy using docetaxel following NCCN and ESMO guidelines. The patient perished during chemotherapy with docetaxel due to complications from the disease and adverse effects.

Conclusion: Patients with advanced breast cancer who are not appropriately treated run a high risk of developing visceral crisis complications. Therefore, it is crucial that clinicians provide education about routine examinations and adhere to established evaluation procedures in order to prevent these complications.

 

Latar Belakang: Kanker payudara adalah jenis keganasan yang paling umum terjadi pada wanita dengan lebih dari dua juta kasus per tahun. Kanker payudara stadium lanjut dengan krisis viseral merupakan kasus yang kompleks, dimana kanker menyebar ke organ vital seperti hati, paru-paru dan otak. Tujuan diangkatnya laporan kasus ini adalah menjadi pembelajaran bagi kita bagaimana upaya untuk mencegah kondisi krisis viseral terutama pada kanker payudara stadium lanjut yang akan meningkatkan mortalitas.

Presentasi kasus: Seorang perempuan berusia 50 tahun datang dengan keluhan sesak nafas, pasien terdiagnosa kanker payudara stadium lanjut dengan krisis viseral. Pada pemeriksaan didapatkan adanya tanda-tanda hipervolemia, trakea terdorong ke kanan, penurunan fremitus vokal. Hasil patologi anatomi didapatkan gambaran invasive carcinoma mammae grade II. (Luminal B HER2 negative). Gambaran rontgen thorax menunjukkan adanya efusi pleura bilateral. Hasil rontgen lumbosakral didapatkan metastasis ke tulang dan pada ultrasonografi abdomen didapatkan metastasis hati. Sebelumnya pasien mendapatkan terapi hormonal (tamoxifen), dan pada saat terjadi metastasis intra thoracal serta krisis viseral terapi diganti dengan capecitabine selama 3 bulan namun terjadi progresifitas berupa penyebaran ke tulang dan hati, selanjutnya capecitabine dihentikan. Pasien diberikan kemoterapi berupa docetaxel sesuai guidelines pada NCCN dan ESMO. Selama masa kemoterapi menggunakan docetaxel akhirnya pasien meninggal dunia akibat komplikasi penyakit dan efek samping.

Kesimpulan: Pasien yang menderita kanker payudara stadium lanjut dapat mengalami komplikasi krisis viseral yang berisiko tinggi jika tidak ditangani dengan tepat. Oleh karena itu, laporan kasus ini sangat penting bagi klinisi untuk memberikan edukasi tentang pemeriksaan rutin dan mematuhi prosedur evaluasi yang ditetapkan guna mencegah terjadinya komplikasi tersebut.

Keywords: her2 negatif kanker payudara krisis visceral luminal b

References

  1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer Statistics, 2021. CA: A Cancer Journal for Clinicians. 2021;71(1):7–33.
  2. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians. 2021;71(3):209–49.
  3. Sutnick AI, Gunawan S. Cancer in Indonesia. JAMA: The Journal of the American Medical Association. 1982;247(22):3087–8.
  4. Population I, Population M, Sum P. International Agency for Research on Cancer. WHO chronicle. 1969;23(7):323–6.
  5. Robertson JFR, Di Leo A, Johnston S, Chia S, Bliss JM, Paridaens RJ, et al. Meta-analyses of visceral versus non-visceral metastatic hormone receptor-positive breast cancer treated by endocrine monotherapies. npj Breast Cancer. 2021;7(1):1–12.
  6. Cardoso F, Paluch-Shimon S, Senkus E, Curigliano G, Aapro MS, André F, et al. 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5). Annals of Oncology. 2020;31(12):1623–49.
  7. Liedtke C, Kolberg HC. Systemic Therapy of Advanced/Metastatic Breast Cancer - Current Evidence and Future Concepts. Breast Care. 2016;11(4):275–81.
  8. Thomssen C, Lüftner Di, Untch M, Haidinger R, Würstlein R, Harbeck N, et al. International Consensus Conference for Advanced Breast Cancer, Lisbon 2019: ABC5 Consensus - Assessment by a German Group of Experts. Breast Care. 2020;15(1):82–95.
  9. Yang R, Lu G, Lv Z, Jia L, Cui J. Different treatment regimens in breast cancer visceral crisis: A retrospective cohort study. Frontiers in Oncology. 2022;12(October):1–11.
  10. Jahan S, Al-saigul AM, Abdelgadir MH. Breast Cancer Breast Cancer. Journal of the Royal Society of Medicine. 2016;70(8):515–7.
  11. Gennari A, André F, Barrios CH, Cortés J, de Azambuja E, DeMichele A, et al. ESMO Clinical Practice Guideline for the diagnosis, staging and treatment of patients with metastatic breast cancer ☆. Annals of Oncology. 2021;32(12):1475–95.
  12. Jafari SH, Jahanmir A, Bahramvand Y, Tahmasebi S, Dallaki M, Nasrollahi E. Association of Estrogen Receptor, Progesterone Receptor, and Human Epidermal Growth Factor Receptor 2 Expression with Breast Cancer Metastasis in Iran. Iranian Journal of Medical Sciences. 2022;47(1):40–7.
  13. Kim J, Lee Y, Yoo T, Kim J, Hyun J, Park I, et al. Organ-Specific Recurrence or Metastatic Pattern of Breast Cancer according to Biological Subtypes and Clinical Characteristics. Journal of Breast Disease. 2019;7(1):30–7.
  14. Franzoi MA, Saúde-Conde R, Ferreira SC, Eiger D, Awada A, de Azambuja E. Clinical outcomes of platinum-based chemotherapy in patients with advanced breast cancer: An 11-year single institutional experience. Breast. 2021;57:86–94.
  15. Gradishar WJ, Anderson BO, Abraham J, Rebecca Aft AD et al. NCCN 2022.pdf. Vol. 20, Journal of the National Comprehensive Cancer Network. 2022.
  16. Benvenuti C, Gaudio M, Jacobs F, Saltalamacchia G, Sanctis R De, Torrisi R, et al. Visceral Crisis. biomedicine. 2023;11(1083):1–11.
  17. Vu T, Ellard S, Speers CH, Taylor SCM, de Lemos ML, Hu F, et al. Survival outcome and cost-effectiveness with docetaxel and paclitaxel in patients with metastatic breast cancer: A population-based evaluation. Annals of Oncology. 2008;19(3):461–4.
  18. Jones SE, Erban J, Overmoyer B, Budd GT, Hutchins L, Lower E, et al. Randomized phase III study of docetaxel compared with paclitaxel in metastatic breast cancer. Journal of Clinical Oncology. 2005;23(24):5542–51.
  19. Fallon M, Giusti R, Aielli F, Hoskin P, Rolke R, Sharma M, et al. Management of cancer pain in adult patients: ESMO Clinical Practice Guidelines. Annals of Oncology. 2018;29(July):iv166–91.
  20. Sbitti Y, Slimani K, Debbagh A, Mokhlis A, Kadiri H, Laraqui A, et al. Visceral Crisis Means Short Survival Among Patients With Luminal A Metastatic Breast Cancer: A Retrospective Cohort Study. World Journal of Oncology. 2017;8(4):105–9.

How to Cite

Elvidawati, Darojat, K. ., Sasmithae, L. ., & Fadjari, T. H. . (2023). Tantangan dalam mengobati kanker payudara stadium lanjut tipe Luminal B HER2 negatif dengan krisis viseral . Intisari Sains Medis, 14(1), 429–433. https://doi.org/10.15562/ism.v14i1.1715
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Elvidawati
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Khairiyah Darojat
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Lia Sasmithae
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Trinugroho Heri Fadjari
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