Background: Anthracycline is the first-choice chemotherapy for the treatment of breast cancer, particularly in elderly patients. However, several studies reported adverse events in the treatment of using anthracyclines. This study aims to identify adverse events. It is also to find out more about how independent variables are related to adverse events. Method: An observational retrospective study of elderly patients (≥ 60 years old) was conducted in a tertiary cancer hospital in Jakarta. Data were collected from January 2018 to December 2020. We used an oncology-specific trigger tool to identify adverse events during anthracycline-based regimens. Independent variables were evaluated in univariate analysis: age, weight loss, marital status, total cumulative dose, polypharmacy, types of anthracyclines, and metastatic status. Bivariate and multivariate analyses were conducted to find out the relationship between the independent variables and adverse events. Results: In total, 107 subject records were collected and reviewed. Triggers were identified 122 times in 86 medical records. Blood transfusion, the most common trigger, was found in 35% of subjects. We found the number of triggers and adverse events more commonly identified in the first and second cycles of chemotherapy. The prevalence of adverse events is detected in 80% of subjects. Of these 86 subjects, 74% were detected in doxorubicin and 26% were detected in epirubicin. All the adverse events were categorized as The National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) harm category E. Conclusion: Trigger tools specific for cancer patients can be used to identify adverse events. Blood transfusion was the common trigger to detect adverse events in our study. Adverse events with category E were identified in all the subjects. Neutropenia and anemia were the most common adverse events in all cycles of chemotherapy. Weight loss was the independent variable related to adverse events in elderly breast cancer patients (p <0.003).

Background: Breast cancer has had the highest mortality and morbidity globally in recent years. Breast cancer in young women presents with biological characteristics of more aggressive cancer, generally detected at advanced stage and a poorer prognosis. This study aimed to determine the characteristics of the incidence of breast cancer in young female patients at Dr. Mohammad Hoesin General Hospital Palembang in 2019–2020. Methods: This study is descriptive observational study conducted in October–November 2021. After having ethical approval from the Institutional Review Committee, research data were obtained from the medical records of young female patients diagnosed with breast cancer from January 1, 2019 to December 31, 2020. Samples were collected by using total sampling with the patient’s young age limit of fewer than 40 years. Results: The incidence of breast cancer was 20.9% (169 patients). The number of samples in this study was 120. Sociodemographic characteristics include the age range of 35–39 years around 63.3% (76 people), the highest education level of senior high school around 35% (42 people), not working around 73.3% (88 people), and living in the Palembang City area around 47.5% (57 people). Clinicopathological characteristics include the stage at the first diagnosis of stage IIIB about 46.7% (56 people), luminal B clinical subtype about 60% (72 people), and most histopathological type of invasive carcinoma of no special type about 88.3% (106 people). Conclusions: The incidence of breast cancer in young women is less than in older women but has worse cancer characteristics

Introduction: Free tissue transfer performed in patients with hematologic malignancies has several considerable challenges. Studies that report the challenges and outcomes related to these patients have been rather limited. This study presents the outcome of free tissue transfer as the reconstructive option for patients with hematologic malignancies. This study reports our experience regarding the perioperative evaluation, management, and outcomes of five patients with hematological malignancies that underwent free tissue transfer at Dharmais Cancer Hospital-National Cancer Center, Jakarta, Indonesia. Case Presentation: Five patients with hematologic malignancies, aged 26 to 60 years, who underwent free tissue transfer at Dharmais Cancer Hospital-National Cancer Center, Jakarta, Indonesia from January 2017 to February 2020 were included. The outcomes such as flap survival, complications, and mortality were reviewed. There were three patients with NonHodgkin lymphoma (NHL), one patient with peripheral T-cell lymphoma, and one patient with acute myeloid leukemia (AML). All patients received free tissue transfer with flap modalities such as radial free forearm flap and anterolateral thigh. One patient had a postoperative complication of vein compromise and was treated with negative pressure wound therapy (NPWT), which resulted in partial flap necrosis. Dehiscence was also found in one patient, and the patient underwent reoperation. Then, a myocutaneous trapezius flap was applied. There was no total flap loss, no donor site morbidity, and no mortality. Conclusions: This study has shown that free tissue transfer was a reliable reconstructive option for patients with hematologic malignancies. Flap survival and minimal complications can be achieved by optimizing the patient’s condition preoperatively, performing the meticulous nontraumatic surgical technique, closely monitoring potential post-operative complications, and implementing a multidisciplinary approach with the hematooncologists.

Background: Kidney cancer is one of the most prevalent cancers in urology. The higher prevalence of risk factors, as well as better diagnostic modalities, has led to a reported increase worldwide. The study aims to describe the profile and management pattern of kidney cancer patients at a tertiary referral center over seven years. Methods: A descriptive study was conducted to assess the profile and management of kidney patients in the national cancer center (NCC) - Dharmais Hospital Jakarta between January 2013 and December 2020. The variables collected included age, gender, stage (AJCC staging), histopathological result, and management, using the total sampling method. Results: A total of 53 kidney cancer cases were documented in NCC - Dharmais Hospital Jakarta from 2013 to 2020. Overall, males are more prevalent than females, with a sex ratio of 2.3:1. The most frequent age group was 51–65 years. The most common histological subtype was a clear cell in the renal cell carcinoma (RCC) subtype and sarcoma in the non-RCC subtype. Noticeably, end-stage (stage IV) was found in more than half of patients (65.6%), with no patient found in stage I. Radical nephrectomy was preferable to cytoreductive nephrectomy. Conclusions: : An increasing trend of kidney cancer incidence was found between 2013 and 2020 with most patients diagnosed with stage IV.

Background: There is a growing trend for those with a terminal illnesses to be cared for by their families at home. Globally, there is a growing governmental policy to engage caregivers, families, and communities in the healthcare delivery system. Family caregivers (FCG) have taken responsibility for the day-to-day care of their ill loved ones at home. A cancer diagnosis is a major event for the person diagnosed and also for his or her family and caregivers. The caregiving activity has a significant impact on FCG’s quality of life (QOL). This study aimed to analyze the best predictor of FCG’s QOL of female cancer patients in a community setting. Methods: This cross-sectional study involved five Public Health Centers (PHCs) among 63 PHCs in Surabaya (7.94%), Indonesia, which were selected by one-stage cluster random sampling. There were 60 FCGs of female cancer patients who participated in this study (n = 60). The Caregiver Quality of Life – Cancer (CQOLC) was a valid and reliable instrument that was used to collect the data. Linear regression and one-way ANOVA tests were used in data analysis (α < .05). Ethical clearance was issued. Results: Most respondents were middle-aged married men with sufficient educational background and still actively working with sufficient income. Their QOL was mostly at a moderate level (Mean ± SD = 62.57 ± 16.23). Burden (p < 0.000), disruptiveness (p = 0.001), and financial concern (p < 0.000) were significantly different between the low, moderate, and high FCG’s QOL. The best predictor of FCG’s QOL of female cancer patients in a community setting was disruptiveness (R2 = 0.622; p < 0.000) compared to burden (R2 = 0.531; p < 0.000) and financial concern (R2 = 0.184; p = 0.001), especially when other family members have not shown interest in caregiving (R2 = 0.539; p < 0.000). Conclusions: FCG’s QOL of female cancer patients in a community setting is at a moderate level. Disruptiveness, burden, and financial concern could predict FCG’s QOL significantly. The other family members’ disinterest in caregiving which belongs to the disruptiveness domain is the best predictor of FCG’s QOL of female cancer patients in a community setting, which accounted for 53.9% variance of QOL in this population

Introduction: Multiple primaries have been reported in patients with breast cancer in the range of 4.1% to 16.4%. This report followed the standard Surgical Case Report (SCARE) and discussed two histologically distinct breast cancer malignancies. This paper also explored the risk factor, pathogenesis, treatment, and prognosis of multiple primary malignancies in the same organs, especially in the breasts. Case Presentation: The patient was a 45-year-old woman with a lump in the left and right breasts for five years. The patient claimed that the lump was enlarged and painless. The tumor size of the left breast was 3 x 2 x 3 cm, the right breast was 4 x 2 x 4 cm, and the patient had no enlargement of lymph nodes. The patient underwent a biopsy examination of the left breast showing invasive ductal carcinoma NST (No Special Type) 3rd grade with LV1 (+). The biopsy examination of the right breast showed malignant phyllodes tumor. Thus, the patient must undergo chemotherapy and mastectomy as definitive therapy. The patient has already completed the treatment and is currently under evaluation. Conclusion: This report looked for the rare case of double primary malignancies in the breasts. It highlighted double primary cancers starting to increase these days but in a particular way because it happens in the same organ, the breasts. However, medical literature rarely presented a synchronous malignancy case, prompting the publishing of this case. With improved cancer treatment and more prolonged survival, the number of patients with double cancers is increasing.

Introduction: Chemotherapy has been shown to reduce breast cancer (BC) mortality significantly. However, several types of chemotherapy drugs affect the reproductive system. As BC has become increasingly prevalent, many young women are diagnosed during their reproductive years. As a result, overcoming chemotherapy-related infertility is becoming increasingly important. Hence, in-vitro fertilization (IVF) with embryo cryopreservation before chemotherapy is considered a way to preserve future reproductive potential. For this reason, this paper aims to report the cases of safe pregnancy in BC survivors through pre-chemotherapy IVF followed by embryo cryopreservation. Case Presentation: Two women, aged 35 and 29, respectively, were treated for BC by surgery, chemotherapy, and tamoxifen. They performed in-vitro fertilization (IVF) with embryo cryopreservation before chemotherapy. Their pregnancy was completed without complications, and they gave birth to healthy babies. Their last oncological visit also showed no signs of cancer recurrence, showing disease-free intervals of seven and eight years, respectively. Conclusions: Pre-chemotherapy IVF followed by embryo cryopreservation can be an alternative to treat infertility in BC survivors of reproductive age who are receiving chemotherapy.

Introduction: Breast Fibromatosis is a rare benign stromal tumor that accounts for 0.2% of all breast tumors. The clinical presentation and imaging features may mimic a malignant tumor. We reported a case of breast fibromatosis mimicking breast cancer. Case Presentation: A 22-years-old woman with a palpable breast lump was present and being examined. The ultrasound and mammography features suggested malignancy. Magnetic Resonance Imaging (MRI) and Multislice Computerized Tomography (MSCT) evaluation showed invasion of a tumor to muscle without intrathoracic involvement. A core biopsy was performed with the pathologic conclusion suspected as a phyllodes tumor with a differential diagnosis as mammary fibromatosis. The pathology result of intraoperative examination favor for fibromatosis. A wide excision procedure with a free margin could be achieved. The histopathological examination revealed spindle cells tumor infiltrating into muscle tissue. The result of immunohistochemistry examination excluded metaplastic carcinoma and Phyllodes tumor. Therefore, it confirmed a diagnosis of breast fibromatosis. Conclusions: Breast fibromatosis is a rare benign tumor of the breast that can mimic malignancy. This entity should be considered as one of the differential diagnoses in a patient with a breast lump. A pre-operative tissue diagnostic is mandatory to prevent radical treatment for this nonmalignant case.

Background: Tumor-infiltrating lymphocytes (TILs), mainly CD4+ and CD8 + T cells, have been extensively described in anti-tumor immunity, and knowledge of CD4+ and CD8+ T lymphocytes’ interplay in mediating the control of tumor growth exists. We use the role of TILs in predicting the prognosis of cervical cancer patients and develop the discovery of new immunotherapy strategies that specifically target TILs. Methods: A systematic review of studies carried out a histopathological and immunohistochemical examination of TILs and an immunotherapy treatment. Results: 10 articles were selected for a systematic review. Expression of TILs was associated with the progression of NIS to cervical cancer. CD4+ and CD8+ TILs can determine the stage and prognosis of cervical cancer. TILs immunotherapy is effective for all cervical cancer patients. Combination chemotherapy with anti-TILs immunotherapy and combination therapy for PD-1 and TILs was found to have a better potential for cervical cancer therapy. Conclusions: TILs can be a prognostic biomarker and a marker to predict cervical cancer.

Background: There is still a limited number of studies related to overall survival in breast cancer patients in Indonesia. This study determines the overall survival and the factor which can affect the survival of stage III breast cancer patients. Methods: This study was a retrospective study. Patients first diagnosed with stage III breast cancer from January 1 to August 31, 2018, at DR. Mohammad Hoesin General Hospital Palembang had been studied. The primary outcome of this study was overall survival. The sociodemographic, clinicopathology, and treatment factors were analyzed to identify the independent variables associated with overall survival using Kaplan-Meier and Cox proportional hazard regression. Results: In this study, 78 samples were included. The 3-year overall survival for stage III breast cancer was 71%. In the bivariate analysis, several factors including older age (> 40) (HR = 2.795, 95% CI 1.223–6.387), higher stages for IIIB (HR = 7.155, 95% CI 0.960–53.334), and IIIC (HR = (HR = 33.450, 95% CI 3.013-371.354), history of not undergoing surgical intervention (HR = 3.999, 95% CI 1.684–9.495), and adjuvant chemotherapy (HR = 2.768, 95% CI 1.211–6.327) have been associated significantly to lower overall survival. Multivariate analysis showed IIIC breast cancer stage as an independent factor and had a significantly increased probability of mortality (HR = 14.677, 95% CI 1.268–169.948). Conclusions: The stage at diagnosis was the only significant predictor for the survival outcome, indicating that early diagnosis may need more attention.