Displaying publications 1 - 20 of 157 in total

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  1. Tourkmani AM, Alharbi TJ, Bin Rsheed AM, AlRasheed AN, AlBattal SM, Abdelhay O, et al.
    Diabetes Metab Syndr, 2018 08 02;13(1):161-165.
    PMID: 30641690 DOI: 10.1016/j.dsx.2018.07.012
    AIMS: To examine the impact of Ramadan Focused Education Program (RFEP) on medications adjustment in type 2 diabetes patients in Ramadan.

    METHODS: This is a controlled, intervention based study. It was run on three phases: before, during, and after Ramadan on 262 type 2 diabetes patients. The intervention group (n = 140) received RFEP on medications doses & timing adjustment before and after Ramadan, while the control group (n = 122) received standard care.

    RESULTS: The dose of insulin glargine was reduced from 42.51 ± 22.16 at the baseline to 40.11 ± 18.51-units during Ramadan (p = 0.002) in the intervention group while it remained the same in the control group before Ramadan and during Ramadan (38.51 ± 18.63 and 38.14 ± 18.46, P = 0.428, respectively). The hypoglycemia score was 14.2 ± (8.5) pre-Ramadan in the intervention and reduced to 6.36 ± 6.17 during Ramadan (p 

  2. Kamarudin SAA, Ahmad F, Hasan N, Hisham SN, Yusof SN, Abu Hassan A, et al.
    Data Brief, 2024 Feb;52:109974.
    PMID: 38229927 DOI: 10.1016/j.dib.2023.109974
    In Malaysia, rice mutant varieties that are genetically altered to confer resistance against blast disease have been substantially developed through mutational breeding program. However, due to the limited accessible information on the mutant lines, mutant gene variants corresponding to the disease resistance and other useful agronomic traits are yet to be exploited. Here, we conducted whole genome re-sequencing of blast resistance with kernel elongation traits in mutant line, Mahsuri Mutant (87,639,446 bp raw reads), and its parental line, Mahsuri (85,156,783 bp raw reads) using Illumina Novaseq 6000 sequencing platform with 30x sequencing coverage. The generated genome sequences are aimed to facilitate the discovery of causal mutation and single nucleotide polymorphisms (SNPs) related to the intended traits. The identified SNPs can be further employed to develop allele-specific SNP molecular markers to locate the mutant gene regions. The NGS data obtained (FASTQ format) of the parental and mutant lines have been deposited in the National Center for Biotechnology Information (NCBI) database under sequence read archive (SRA) xwith accession numbers SRR24388814 (Mahsuri) and SRR22952097 (Mahsuri Mutant) respectively.
  3. Mohd Azmi AF, Ahmad H, Mohd Nor N, Goh YM, Zamri-Saad M, Abu Bakar MZ, et al.
    Animals (Basel), 2021 Jul 07;11(7).
    PMID: 34359160 DOI: 10.3390/ani11072033
    With the increase in the global buffalo herd, the use of supplementation in the ruminant feeding has become an important area for many researchers who are looking for an isocaloric and isonitrogenous diet to improve production parameters. In order to improve the performance of the Asian water buffalo, the optimal balance of all nutrients, including energy and protein, are important as macronutrients. Dietary supplementation is one of the alternatives to enhance the essential nutrient content in the buffalo diet and to improve the rumen metabolism of the animal. Researchers have found that supplementation of concentrate and rumen bypass fat could change growth performance and carcass traits without causing any adverse effects on the buffalo growth. Some studies showed that dry matter intake, body condition score and some blood parameters and hormones related to growth responded positively to concentrate and rumen bypass fat supplementation. In addition, changes of feeding management by adding the supplement to the ruminant basal diet helped to increase the profit of the local farmers due to the increased performance and productivity of the animals. Nevertheless, the effects of dietary supplementation on the performance of ruminants are inconsistent. Thus, its long-term effects on the health and productivity of buffaloes still need to be further investigated.
  4. Lim J, Onozawa M, Saad M, Ong TA, A-CaP (Asian Prostate Cancer) Study, J-CaP (Japan Prostate Cancer Study Group), et al.
    Cancer Sci, 2021 Jun;112(6):2071-2080.
    PMID: 33738901 DOI: 10.1111/cas.14889
    The number of newly diagnosed prostate cancer cases varies across Asia, with higher mortality-to-incidence ratio reported in developing nations. Androgen deprivation therapy (ADT), alone or in combination, remains the mainstay of first-line treatment for advanced prostate cancer. Key findings of extensive research and randomized controlled trials have shaped current clinical practice and influenced clinical guideline recommendations. We describe here the recent trend of ADT in newly diagnosed prostate cancer for Asia focusing on Japan (high-income country) and Malaysia (middle-income country) based on the Asian Prostate Cancer (A-CaP) Study. The combination of radiotherapy and ADT or ADT alone was common in patients with intermediate-to-high risk localized and locally advanced disease. For metastatic prostate cancer, maximum androgen blockade (gonadotrophin-releasing hormone [GnRH] agonist/antagonist plus antiandrogen) was prevalent among the Japanese patients while primary ADT alone with GnRH agonist/antagonist was widely practiced in the Malaysian cohort. Upfront combined therapy (ADT plus docetaxel or androgen receptor pathway inhibitor) has significantly improved the outcomes of patients with metastatic castration-naïve prostate cancer. Its application, however, remains low in our cohorts due to patients' financial capacity and national health insurance coverage. Early detection remains the cornerstone in prostate cancer control to improve treatment outcome and patient survival.
  5. Muna KA, Mokhtar A, Saad MA, Ahmed AA, Akbar JB
    MyJurnal
    Introduction: Leptin is an adipokine that has strong correlation with the body mass index (BMI). Gestational diabetes mellitus (GDM) is a common medical complication associated with pregnancy. Leptin may lose its correlation with the body mass index (BMI) during diabetes due to hormonal rearrangement. Diet control is the first line management in GDM. Leptin reported to increase in pregnancy and further increases in diabetic patients during GDM screening. There is paucity in the reports concerning Leptin levels in GDM patients on diet control. The present study was aimed to evaluate the changes in maternal leptin in pregnancy complicated by GDM on diet control compared to the normal pregnancy in the 3rd trimesters by comparing the means and to find the correlation of Leptin with the body mass index in both groups.
    Methods: The study included 2 groups: normal pregnancy (n = 40) and pregnancy with GDM under diet control (n = 60) both groups are at 38-40 weeks of gestation. Leptin concentration in serum was measured in both groups and statistically tested using student t test. The BMI were measured and correlated with the Leptin level in test groups.
    Results: the results indicated that Leptin will nearly triple in the third trimester (38±30 ng/ml) of pregnancy compared to the standard normal non-pregnant. Leptin level was significantly lower in diabetic women on diet control (28±16 ng/ ml) when compared with the non-diabetics (38±30 ng/ml). The hormone has no correlation with the age of the patients but have a positive correlation with the body mass index before and during pregnancy in both groups.
    Conclusion: Leptin is increasing in pregnancy as part of the physiological changes. Dieting can decrease Leptin level in diabetics’ pregnant women. Diet can restore the hormonal dysregulation of Leptin. Assessment of Leptin level might be used as an indicator for good diet control during pregnancy.
    Study site: Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang, Malaysia
  6. Tourkmani AM, Abdelhay O, Alharbi TJ, Bin Rsheed AM, Azmi Hassali M, Alrasheedy AA, et al.
    Int J Clin Pract, 2021 Mar;75(3):e13817.
    PMID: 33159361 DOI: 10.1111/ijcp.13817
    BACKGROUND: Ramadan fasting is regarded as a form of worship amongst Muslims. However, patients with a high risk of diabetic complications are advised to avoid fasting, as the practice is associated with significant impacts on several health factors for type 2 diabetic patients, including glycaemic control. Thus, a lack of focused education before Ramadan may result in negative health outcomes.

    AIM: To evaluate the impact of a Ramadan-focused diabetes education programme on hypoglycaemic risk and other clinical and metabolic parameters.

    METHODS: A systematic literature search was performed using Scopus, PubMed, Embase, and Google Scholar to identify relevant studies meeting the inclusion criteria from inception. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and guidelines were followed when performing the search and identification of appropriate studies.

    RESULTS: Seventeen studies were included in this systemic review; five of them met the criteria to compile for a meta-analysis. The included studies were with various study designs, including randomised controlled trials, quasi-experimental and non-randomised studies. Overall, the results revealed a significant reduction of hypoglycemia risk (81% reduction) for fasting patients in intervention groups who received Ramadan-focused education compared with patients receiving conventional care (OR 0.19, 95% CI: 0.08-0.46). Moreover, HbA1c significantly improved amongst patients who received a Ramadan-focused diabetes education intervention, compared with those receiving conventional care.

    CONCLUSION: Ramadan-focused diabetes education had a significant impact on hypoglycemia and glycaemic control, with no significant effect on body weight, blood lipids or blood pressure.

  7. Chin YK, Ina-Salwany MY, Zamri-Saad M, Amal MNA, Mohamad A, Lee JY, et al.
    Dis Aquat Organ, 2020 Jan 16;137(3):167-173.
    PMID: 31942862 DOI: 10.3354/dao03435
    Skin abrasions often occur in farmed fish following handling by labourers, injury by farm facilities, cannibalism and ectoparasites. Vibrio spp. are opportunistic pathogens that can invade host fish through damaged tissues and cause outbreaks of vibriosis. This study describes the effect of skin abrasions on the infectivity of V. harveyi using Asian seabass Lates calcarifer (Bloch, 1790) fingerlings as a case example and compares bacterial load and fish survival following immersion challenge with different doses. In total, 315 fish (6.67 ± 1.8 g) were divided into 3 treatments: skin abrasion followed by immersion infection, immersion infection only and an uninfected, uninjured control. Fish in the infection treatments were divided into 3 subgroups and exposed in triplicate to a 7 d immersion challenge with 106, 107 and 108 CFU ml-1 of live V. harveyi. No mortalities were observed in the control and immersion infection groups. However, fish in the skin abrasion treatment group that were infected with 108 CFU ml-1 of live V. harveyi showed signs of progressing disease throughout the experiment, which resulted in mortalities. Significantly higher bacterial loads (p < 0.05) were recorded in the intestine, liver and gills of the fish in this group. Fish in the skin abrasion treatment that were exposed to 107 and 108 CFU ml-1 of V. harveyi showed 100% mortality by Days 5 and 4, respectively. These findings confirm that skin injuries increase the susceptibility of seabass fingerlings to V. harveyi infection.
  8. Peter ID, Haron AW, Jesse FFA, Ajat M, Han MHW, Fitri WN, et al.
    Vet World, 2018 Nov;11(10):1466-1472.
    PMID: 30532503 DOI: 10.14202/vetworld.2018.1466-1472
    Conventionally, plasma or milk progesterone evaluations are used to determine the reproductive status of female animals. Collection of such samples is often associated with difficulties of animal handling and restraint. Measurable quantities of progesterone metabolites are found in feces of animals. Their concentrations are known to be well correlated to plasma progesterone levels and are, therefore, used as non-invasive samples for assessing reproductive function in a wide range of animal species. Although the analysis of fecal progesterone metabolites has been widely accepted in many laboratories, several factors are known to affect the results from this valuable analytical technique. Some of these factors include storage/transportation media for fecal samples, type of solvent that is used for extraction of progesterone metabolites from feces, and the type and sensitivity of an assaying technique employed. Although fecal progesterone metabolites analysis is associated with some difficulties, it can effectively be used to monitor reproductive function in a wide range of animal species. This review aims to highlight the usefulness of fecal progesterone metabolite analysis as a non-invasive technique in monitoring reproductive function in animals. The article mainly focuses on the many opportunities and challenges associated with this analytical technique.
  9. Saad M, Chong FLT, Bustam AZ, Ho GF, Malik RA, Ishak WZW, et al.
    Indian J Cancer, 2019 1 4;55(2):157-161.
    PMID: 30604728 DOI: 10.4103/ijc.IJC_581_17
    BACKGROUND: Scalp cooling has been shown in several studies to be an effective method in preventing chemotherapy-induced alopecia (CIA). Data on the use of scalp cooling in Asian countries are limited, and evidence for its use and efficacy among our patients are not available.

    OBJECTIVE: The aim of this study was to assess the effectiveness and tolerability of scalp cooling among breast cancer patients in our study population.

    METHODS: Consecutive breast cancer patients receiving FE75C, FE100C, FE100C-D, docetaxel75 or docetaxel, and cyclophosphamide (TC) at our treatment center were recruited and allocated to the treatment (scalp cooling, DigniCapTM system) or control group in this prospective nonrandomized controlled study. The assessment of alopecia was carried out using the World Health Organization grading system and clinical photographs.

    RESULTS: Seventy patients were recruited, but only 25 completed the study and were evaluable for analysis. Five of 12 patients (42%) in the scalp cooling group managed to preserve hair. Two of three patients who received FE75C and TC regimens had minimal hair loss. All patients treated with FE100C had severe hair loss. Half of all patients who received scalp cooling throughout chemotherapy rated the treatment as reasonably well tolerated. The most common reason for discontinuing scalp cooling was intolerance to its side effects.

    CONCLUSION: Scalp cooling is potentially effective in reducing CIA caused by docetaxel, TC, and FE75C chemotherapy regimen. However, it was not well tolerated by our study population. The dropout rate was high, and this needs to be taken into consideration when pursuing further trials in a similar setting.

  10. Duraisamy IS, Saad M, Alip A
    Aging Med (Milton), 2018 Sep;1(2):133-140.
    PMID: 31942490 DOI: 10.1002/agm2.12023
    INTRODUCTION: This study was conducted to compare pain response between single and multiple fraction palliative radiotherapy and to describe prognostic factors affecting treatment response in University of Malaya Medical Centre (UMMC).

    METHODS: The case records of 162 patients with uncomplicated painful bone metastases treated with palliative radiotherapy from 2006 to 2014 were analyzed. Treatment outcomes were pain score response, analgesic score response, response according to International Consensus Endpoints (complete response and overall response) at 4, 12, and 24 weeks, retreatment rate, symptomatic skeletal events (SSEs), and prognostic factors.

    RESULTS: At 24 weeks, pain score response for single and multiple fraction group was 82.3% and 88.5%, analgesic score response was 54.8% and 61.5%, and overall response according to International Consensus Endpoint was 61.3% and 67.7%, respectively. There was no statistically significant difference in treatment response between the 2 treatment groups for all endpoints. ECOG (<2 vs ≥2: aOR 3.405, 95% CI 1.708-6.790, P = .001) and primary breast and prostate (breast vs others: aOR 5.231, 95% CI 1.973-13.869, P = .001; prostate vs others: aOR 5.522, 95% CI 1.493-20.420, P = .01) were significant variables on multivariate analysis.

    CONCLUSION: Single fraction radiotherapy is as effective as multiple fraction radiotherapy for the palliation of uncomplicated bone metastases.

  11. Tourkmani AM, Alharbi TJ, Rsheed AMB, AlRasheed AN, AlBattal SM, Abdelhay O, et al.
    Diabetes Metab Syndr, 2018 Sep;12(5):791-794.
    PMID: 29678605 DOI: 10.1016/j.dsx.2018.04.004
    Hypoglycemia is an essential issue for diabetic patients and considered a limiting factor in the glycemic management. Heterogeneity of the diseases in Type 2 Diabetes Mellitus can affect the frequency of hypoglycemia, especially when the patient has cardiovascular diseases. There are several factors that lead to hypoglycemia including sulfonylurea therapy, insulin therapy, delaying or missing a meal, physical exercise, or alcohol consumption. Long-term studies reported that repeated hypoglycemia could increase the risk of cardiovascular diseases. During Ramadan fasting, diabetic patients have high incidence of hypoglycemia. Therefore, focused education about hypoglycemia in routine life of diabetic patients and during fasting in Ramadan is important to reduce the complications.
  12. Azzam-Sayuti M, Ina-Salwany MY, Zamri-Saad M, Annas S, Yusof MT, Monir MS, et al.
    Biology (Basel), 2021 Nov 17;10(11).
    PMID: 34827185 DOI: 10.3390/biology10111192
    The genus Aeromonas has been recognised as an important pathogenic species in aquaculture that causes motile Aeromonas septicaemia (MAS) or less severe, chronic infections. This study compares the pathogenicity of the different Aeromonas spp. that were previously isolated from freshwater fish with signs of MAS. A total of 124 isolates of Aeromonas spp. were initially screened for the ability to grow on M9 agar with myo-inositol as a sole carbon source, which is a discriminatory phenotype for the hypervirulent A. hydrophila (vAh) pathotype. Subsequently, LD50 of six selected Aeromonas spp. were determined by intraperitoneal injection of bacterial suspension containing 103, 105, and 107 CFU/mL of the respective Aeromonas sp. to red hybrid tilapias. The kidneys, livers and spleens of infected moribund fish were examined for histopathological changes. The screening revealed that only A. dhakensis 1P11S3 was able to grow using myo-inositol as a sole carbon source, and no vAh strains were identified. The LD50-240h of A. dhakensis 1P11S3 was 107 CFU/mL, while the non-myo-inositol utilizing A. dhakensis 4PS2 and A. hydrophila 8TK3 was lower at 105 CFU/mL. Similarly, tilapia challenged with the myo-inositol A. dhakensis 1P11S3 showed significantly (p < 0.05) less severe signs, gross and histopathological lesions, and a lower mortality rate than the non-myo-inositol A. dhakensis 4PS2 and A. hydrophila 8TK3. These findings suggested that myo-inositol utilizing A. dhakensis 1P11S3 was not a hypervirulent Aeromonas sp. under current experimental disease challenge conditions, and that diverse Aeromonas spp. are of concern in aquaculture farmed freshwater fish. Therefore, future study is warranted on genomic level to further elucidate the influence of myo-inositol utilizing ability on the pathogenesis of Aeromonas spp., since this ability correlates with hypervirulence in A. hydrophila strains.
  13. Fadilah A, Zuki AB, Loqman MY, Zamri-Saad M, Norimah Y, Asnah H
    Med J Malaysia, 2004 May;59 Suppl B:178-9.
    PMID: 15468876
    The study was carried out to evaluate macroscopically the ability of coral to repair a large size bone defect. A total 12 adult, male sheep were used in the study. The large bone defect (2.5cm x 0.5cm x 0.5cm) was created surgically on the left proximal femur and replaced by a block of coral (Porites sp.). Radiographs were obtained immediately after surgery and at 2, 4, 8 and 12 weeks post-implantation. Ultrasonographic examinations were carried out every 2 weeks after implantation up to 12 weeks using ultrasound machine (TOSHIBA Capasee II) connected with 7MHz frequency transducer. The sheep were euthanased at 2, 4, 8, and 12 weeks post-implantation and the bone examined grossly. Both ultrasonographs and radiographs taken at 8 and 12 weeks showed that the implants had been resorbed and left the space that much reduced in size. There was no sign of implant rejection observed in all animals. The results showed that processed coral has potential to become bone substitute for reconstructive bone surgery.
  14. Fadilah A, Zuki AB, Loqman MY, Zamri-Saad M, Al-Salihi KA, Norimah Y, et al.
    Med J Malaysia, 2004 May;59 Suppl B:127-8.
    PMID: 15468851
    The study was carried out with the aim to evaluate natural coral (Porites spp.) implanted in sheep femur microscopically. Twelve adult, male sheep were used in this study. The defect area was implanted with coral and monitored for up to 12 weeks. The sheep were euthanased at 2,4,8, and 12 weeks post-implantation. Microscopically, natural coral implanted into bone tissue have shown gradual resorption and progressively replaced by new bone. At 12 weeks post-implantation, the implanted site was almost completely surrounded by mature bone. The results showed that natural coral was found to be a biodegradable and osteo-conductive biomaterial, which acted as a scaffold for a direct osteoblastic apposition.
  15. Abu Nor N, Zamri-Saad M, Md Yasin IS, Salleh A, Mustaffa-Kamal F, Matori MF, et al.
    Vaccines (Basel), 2020 Dec 04;8(4).
    PMID: 33291587 DOI: 10.3390/vaccines8040734
    Vibrio harveyi causes vibriosis in various commercial marine fish species. The infection leads to significant economic losses for aquaculture farms, and vaccination is an alternative approach for the prevention and control of fish diseases for aquaculture sustainability. This study describes the use of formalin-killed Vibrio harveyi (FKVh) strain Vh1 as a vaccine candidate to stimulate innate and adaptive immunities against vibriosis in a marine red hybrid tilapia model. Tilapia are fast growing; cheap; resistant to diseases; and tolerant to adverse environmental conditions of fresh water, brackish water, and marine water and because of these advantages, marine red hybrid tilapia is a suitable candidate as a model to study fish diseases and vaccinations against vibriosis. A total of 180 healthy red hybrid tilapias were gradually adapted to the marine environment before being divided into two groups, with 90 fish in each group and were kept in triplicate with 30 fish per tank. Group 1 was vaccinated intraperitoneally with 100 µL of FKVh on week 0, and a booster dose was similarly administered on week 2. Group 2 was similarly injected with PBS. Skin mucus, serum, and gut lavage were collected weekly for enzyme-linked immunosorbent assay (ELISA) and a lysozyme activity assay from a total of 30 fish of each group. On week 4, the remaining 60 fish of Groups 1 and 2 were challenged with 108 cfu/fish of live Vibrio harveyi. The clinical signs were monitored while the survival rate was recorded for 48 h post-challenge. Vaccination with FKVh resulted in a significantly (p < 0.05) higher rate of survival (87%) compared to the control (20%). The IgM antibody titer and lysozyme activities of Group 1 were significantly (p < 0.05) higher than the unvaccinated Groups 2 in most weeks throughout the experiment. Therefore, the intraperitoneal exposure of marine red hybrid tilapia to killed V. harveyi enhanced the resistance and antibody response of the fish against vibriosis.
  16. Zamri-Saad M, Effendy AW, Israf DA, Azmi ML
    Vet Microbiol, 1999 Mar 12;65(3):233-40.
    PMID: 10189198
    A study to determine the immunoglobulin and cellular responses in the respiratory tract of goats following intranasal exposures to formalin-killed Pasteurella haemolytica A2 was carried out. Forty-two goats were divided into two groups. Goats in Group 1 were subjected to double intranasal exposures to formalin-killed P. haemolytica A2 while goats in Group 2 were the unexposed control. Prior to and at weekly intervals post-exposure, three goats from each group were killed, serum samples were collected while the lungs were flushed with 50 ml normal saline before the right apical lobes were fixed in 10% buffered formalin. Both serum and lung lavage fluid were subjected to enzyme-linked immunosorbent assay (ELISA) to determine the levels of IgA, IgM and IgG while the formalin-fixed tissues were examined histologically. IgA levels in the lung lavage fluid increased rapidly to reach a significantly (p < 0.05) high level as early as Week 2 post-exposure and remained significantly (p < 0.05) high throughout the study period. The IgM levels increased at an intermediate rate to reach a significantly (p < 0.05) high level at Week 3 post-exposure before they decreased to an insignificant (p > 0.05) level the following week and the weeks thereafter. IgG levels increased gradually and only reached a significantly (p < 0.01) high level at Weeks 5 and 6 of the study. The size of the bronchus-associated lymphoid tissue (BALT) and the number of lymphocytes in BALT increased significantly from Week 2 and remained high thereafter. However, differences in the numbers of BALT were insignificant (p > 0.05) initially before becoming significantly (p < 0.05) high at Weeks 5 and 6. The BALT responses were parallel to those of imunoglobulins in the lung lavage fluid.
  17. Al-Hamidhi S, Mahdy MA, Idris MA, Bin Dajem SM, Al-Sheikh AA, Al-Qahtani A, et al.
    Infect Genet Evol, 2014 Oct;27:25-31.
    PMID: 24981966 DOI: 10.1016/j.meegid.2014.06.015
    In the Arabian Peninsula malaria control is progressing steadily, backed by adequate logistic and political support. As a result, transmission has been interrupted throughout the region, with exception of limited sites in Yemen and Saudi Arabia. Here we examined Plasmodium falciparum parasites in these sites to assess if the above success has limited diversity and gene flow.
  18. Zamri-Saad M, Salmiyah TS, Jasni S, Cheng BY, Basri K
    Vet Rec, 1990 Nov 10;127(19):480.
    PMID: 2270639
  19. Bhoo-Pathy NT, Inaida S, Tanaka S, Taib NA, Yip CH, Saad M, et al.
    Cancer Epidemiol, 2017 06;48:56-61.
    PMID: 28371729 DOI: 10.1016/j.canep.2017.03.007
    BACKGROUND: The benefit of adjuvant chemotherapy in women with T1N0M0 breast cancers is unclear. While gene expression-based prognostic assays may aid management of women with early estrogen receptor (ER) positive tumors, therapeutic decision-making in women with early stage ER negative tumors remains fraught with difficulties. We investigated the association between adjuvant chemotherapy and overall survival in women with T1N0M0, hormone receptor negative breast cancers.

    METHOD: All newly diagnosed breast cancer patients with node-negative and hormone receptor negative tumors measuring≤2cm at the University Malaya Medical Centre (Malaysia) from 1993 to 2013 were included. Mortality of patients with and without adjuvant chemotherapy were compared and adjusted for possible confounders using propensity score.

    RESULTS: Of 6732 breast cancer patients, 341 (5.1%) had small (≤2cm), node-negative and hormone receptor negative tumors at diagnosis. Among them, only 214 (62.8%) received adjuvant chemotherapy. Five-year overall survival was 88.1% (95% confidence interval (CI): 82.0%-94.2%) for patients receiving chemotherapy and 89.6% (95% CI: 85.1%-94.1%) for patients without chemotherapy. Chemotherapy was not associated with survival following adjustment for age, ethnicity, tumor size, tumor grade, HER2 status, lympho-vascular invasion, type of surgery and radiotherapy administration. However, chemotherapy was associated with a significant survival advantage (adjusted hazard ratio: 0.35, 95%CI: 0.14-0.91) in a subgroup of women with high-grade tumors.

    CONCLUSION: Adjuvant chemotherapy does not appear to be associated with a survival benefit in women with T1N0M0, hormone receptor negative breast cancer except in those with high-grade tumors.

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