LIMA BESAR TUMOR

GANAS DI INDONESIA

1. MULUT RAHIM (SERVIKS)

2. PAYUDARA
3. KULIT
4. KELENJAR GETAH BENING
5. NASOFARING
PAP’S SMEAR
 GEJALA KLINIK:

LESI PRA KANKER DAN STADIUM

AWAL TIDAK KHAS :

 KEPUTIHAN
 PERDARAHAN PASCA SENGGAMA
 KELUAR CAIRAN BERBAU BUSUK
PADA KEADAAN LANJUT :

 MENOMETRORHAGIA
 NYERI PANGGUL/LUMBO SACRAL
 BADAN PUCAT DAN KURUS
 EDEMA TUNGKAI
 HEMATURIA
 MELENA
 GEJALA-GEJALA METASTASE

KEMATIAN
 PAP’SMEAR
PEMERIKSAAN SITOLOGI SEL-
SEL SERVIK :

 EKTOSERVIK
 ENDOSERVIK
TUJUAN TES PAP

DETEKSI DINI :
 INFEKSI VIRUS
 LESI PRAKANKER
 KELAINAN LAIN
LESI PRA KANKER
CIN I : DISPLASIA RINGAN

CIN II : DISPLASIA SEDANG

CIN III: DISPLASIA BERAT

 ALAT-ALAT :
 FORMULIR
 SPATULA :~ AYRE
~ CYTOBRUSH
 OBJEK GLAS
 SPEKULUM COCOR BEBEK
 TABUNG FIKSASI
 CAIRAN FIKSASI ( ALK 95% )
 KOTAK PENGIRIMAN
CARA PENGAMBILAN
OS DITIDURKAN
MASUKKAN SPEKULUM
PENGAMBILAN MATERI
OLESKAN PADA OBJEK GLAS
FIKSASI ( MIN.30 MENIT )
KERINGKAN – KIRIM KE LAB
 SISTEM PELAPORAN

 PAP
 DESKRIPTIP
 BETHESDA
PAYUDARA
INFLAMMATIONS
 ACUTE MASTITIS  bacterial infection of the
breast  abscess
– Post partum lactating or involuting breast.
– From : - Fissure at Nipple
- Eczema
- Other skin diseases
 COMEDOMASTITIS DUCT ECTASIA=
Plasma Cell Mastitis.
– Presence of dilated large and intermediate ducts
of the breast contain pasty, inspissated material 
periductal inflammation and fibrosis.
– Micros : dilated ducts, contain acelluler debris &
macrophages, periductal inflammation, foreign
body granulomas (+).
 Traumatic fat necrosis is an uncommon
 mostly trauma to the breast 
hemorrhage  necrosis of adipocytes +
inflamm cell phagocytes lipid debris
(limfosit + giant cell).

 GALACTOCELE
Cystic dilatation of terminal ducts during
lactation.
 FIBROCYSTIC CHANGE
 = Mammary dysplasia fibrocystic disease.
 Hormonal imbalance.
 Short menstruation cycle(21-24days)
 Estrogen >>  Hyperestrism.
 50% breast surgery cases in reproductive period.
 Premenstrual pain+lumpy breast, batas tidak
jelas
 Stromal and terminal ducts epithelial
proliferation.
FIBROADENOMA
MAMMAE
 Benign neoplasm of the breast and is composed of
epithelial and stromal elements that originate from
the terminal duct lobular unit.
 Ages : 20-35 years.
 Sign : round, rubbery tumor, soliter / multiple,
sharply demarcated, freely moveable, upper lateral
quadrant >>
 Macros : encapsulated, gray white.
 Micros : proliferation of glands and fibrous stroma;
the ducts may be either simple and round or elongate
and branching and are dispersed within fibrous
stroma, which varies from loose and myxomatous to
hyalinized collagen.
CARCINOMA O/T BREAST

 EPIDEMIOLOGY  the most common

malignancy of women after cervix cancer.
 PATHOGENESIS :

- Genetic Factor  history of breast ca in

first line degree relatives
(mother,sister,daughter).
Pemeriksaan IHC Payudara

 Rutin : ER,PR, HER2

 Ki67, P53, CD 20 dll.

PATHOGENESIS
 Mutations of p53 tumor suppressor gene; BRCA 1
gene (breast ca 1) located at chromosome 17 (17q21)
and BRCA 2 gene located on chromosome 13q12.
 Hormonal status  early menarch, late menopause
and older age at first term pregnancy  increased
risk.
 Environmental influences  high fat intake.
 Radiation.
 Fibrocystic change.
 Previous cancer o/t breast.
Ca. mammae