Beruflich Dokumente
Kultur Dokumente
in
Breast Cancer
Denni Joko Purwanto
Surgical Onkology, Dept
Dharmais Cancer Hospital/National Cancer Center
Goals of Therapy
•Many patients in Breast cancer will recur not with
local or regional disease, but with metastatic
disease
I 13 5.35%
II 77 31.69%
III 81 33.33%
IV 51 20.99%
NA 21 8.64%
Multimodality therapy
including surgery
Prevent complications
improve progression free survival.
Patient Selection for Surgery
Careful assessment of the patients
• Medical condition
• Extent and biology of the cancer
• Feasibility and risks of complete resection is
necessary
Work Up Diagnostic
• Laboratory
• CT scan / MRI ,
• Bone scan,
• PET Scan (if necessary)
FACTORS WHEN CONSIDERING
RESECTION OF STAGE IV DISEASE
Patient age
Co morbidities
Ability to tolerate resection
Likelihood of complete resection
Single organ versus multiple organ disease
Solitary versus multiple lesions
Disease-free interval
Options for systemic therapy
Resection of Specific Metastatic Sites
Lung Metastases
Liver Metastases
Brain Metastases
Bone Metastases
Group IV Incomplete - - 18 - 25
Liver Metastases
•Rare to find isolated liver disease (5% to 12% of
stage IV patients)
Unresectable primary
cryotherapy
radiofrequency ablation (RFA /HAIFFU)
Brain Metastases
Poor prognosis, with a median survival (untreated) of only 1 to 2
months
Taxotere, Carboplatin, (6 x)
Trastuzumab (1 year)
Bilateral Mastektomy
Skin Graft Coverage Chest Wall
One Year After Surgery