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CRITICAL APPRAISAL
PROGNOSIS IN WOMAN WITH INTERVAL BREAST CANCER: POPULATION
BASED OBSERVATIONAL COHORT STUDY
Disusun oleh :
Deniswari Rahayu 1102010065
Indah Kusumo Wardani P. 1102010129
Dosen Pembimbing :
dr. Yulia Suciati, M.Kes
FAKULTAS KEDOKTERAN UNIVERSITAS YARSI
APRIL 2013
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EBM
Nama : Deniswari Rahayu / Indah Kusumo Wardani P.
NIM : 1102010065 / 1102010129
TUGAS EVIDENCE BASED MEDICINE
SkenarioPerempuan berusia 53 tahun datang ke rumah sakit dengan
keluhan pembesaran payudara
kanan dan teraba benjolan. Satu tahun yang lalu pasien pernah
menjalani pemeriksaan
mamogram dan didapatkan hasil normal. Dokter menyarankan untuk
melakukan pemeriksaan
mamogram lanjutan dan diagnosis sementara adalah kanker
payudara. Pasien menanyakan
kemungkinan kesembuhan penyakitnya, apakah pemeriksaan mammogram
sebelumnya telah
mempengaruhi penyakitnya tersebut?
Pertanyaan (foreground question)
Adakah perbedaan prognosis kanker payudara pada pasien yang
telah terpapar radiasi alatradiologi (mamogram) dan yang belum
terpapar radiasi alat radiologi?
PICO
Population : Pasien perempuan dewasa dengan keluhan pembesaran
dan benjolanpada payudara kanan.
Intervention : Menilai perbaikan pembesaran dan benjolan pada
payudara yangtelah terpapar radiasi.
Comparisson : Menilai perbaikan pembesaran dan benjolan pada
payudara yangbelum terpapar radiasi.
Outcome : Paparan radiasi pemeriksaan mamogram tidak dapat
digunakan untukmemprediksi prognosis penyakit.
Pencarian bukti ilmiahAlamat website :
http://www.ncbi.nlm.nih.gov/pubmed/
Kata kunci : interval women breast cancer AND prognosis AND
mammogram
Limitasi : Januari 2007- Januari 2013
Hasil Pencarian : 53
Dipilih artikel berjudul:Prognosis in Women with Interval Breast
Cancer: Population Based Observational Cohort
Study.
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REVIEW JURNAL
Pendahuluan
To compare the prognosis in women with interval breast cancer
(cancer detected after a
normal screening mammogram and before the next scheduled
mammogram) with breast
cancer detected among women not yet invited to mammography
screening (non-screened).
Jenis Penelitian
Population based observational study.
Setting Waktu dan Tempat
Norwegian breast cancer screening programme, implemented in
different counties from 1996
to 2005.
Peserta
7116 women with a diagnosis of breast cancer at age 50 to 72
years; 1816 had interval breast
cancer and 5300 had a diagnosis of breast cancer but had not yet
been invited to screening.
Penilaian Utama
Characteristics of the breast tumours, and survival of the women
using Kaplan Meier curves
and multivariable Cox proportional hazard models.
Hasil
Although interval cancers on average were slightly larger than
the cancers in women not
invited to screening, the histological type or status of
axilliary lymph nodes did not differ
noticeably between the two groups. Among interval cancers, there
were no appreciable trends
in size, nodal status, grade, or hormone receptor positivity
associated with time since the last
normal mammogram as a marker of growth rate. After 10 years of
follow-up, the survival
rates were 79.1% (95% confidence interval 75.4% to 82.3%) among
women with interval
cancers and 76.8% (75.3% to 78.2%) among women in the
non-screened cancer group
(hazard ratio 0.98, 95% confidence interval 0.84 to 1.15;
P=0.53). Analyses stratified by time
since last normal mammogram, age at diagnosis, or screening
round showed similar results.
Kesimpulan
The prognosis of women with interval breast cancers was the same
as that of women with
breast cancers diagnosed without mammography screening.
