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Intention of pregnant women to exclusively breastfeed their infants: The role of beliefs in the theory of planned behaviour

Ismail TA, Muda WM, Bakar MI

J Child Health Care, 2014 Jun;18(2):123-32.
PMID: 23728933 DOI: 10.1177/1367493512473857

This study was aimed at identifying behavioural, normative and control belief influencing intention to practise exclusive breastfeeding among pregnant women in Malaysia. An interviewer-guided questionnaire assessing behavioural, normative and control belief was developed based on the findings elicited from focus group discussions. Intention referred to the respondent's intended duration of exclusive breastfeeding, which was measured in weeks. Bivariate correlational analysis, linear regression analysis and independent t test comparing intenders and non-intenders were conducted to identify the composite belief measures and individual beliefs significantly influencing intention. Composite measures of all the beliefs were significantly correlated with intention, but injunctive normative belief and behavioural belief were the only significant factors identified from linear regression analysis. The respondents agreed to comply with four referents of their mother, husband, nurses and mother-in-law. Non-intenders believed that those referents would oppose them practising exclusive breastfeeding for six months. The behavioural belief concerning difficulty to leave the infant significantly differentiated intenders from non-intenders. Exclusive breastfeeding promotion should include the woman's mother, husband and mother-in-law. Nurses should provide accurate and complete information related to breastfeeding practise. Providing support for women to continue the practise even though separated from their infants may improve their intention and practise of exclusive breastfeeding.

Matched MeSH terms: Breast Feeding*
Expression of Bax and Bcl-2 in tumour cells and blood vessels of breast cancer and their association with angiogenesis and hormonal receptors

Jaafar H, Abdullah S, Murtey MD, Idris FM

Asian Pac J Cancer Prev, 2012;13(8):3857-62.
PMID: 23098483

A total of 96 cases of invasive breast ductal carcinoma were examined for immunohistochemical expression of Bax and Bcl-2 in the epithelial tumor cells and endothelial cells of the blood vessels. We also investigated the association between both proteins in the epithelium in relation to tumor characteristics such as tumor size, grade, lymph node involvement, microvessel density (MVD), hormonal receptors expression and c-erbB-2 overexpression. Bax expression showed a significant association between tumor and endothelial cells (p<0.001) while Bcl-2 expression in tumor cells was inversely associated with that in the endothelial cells (p<0.001). Expression of Bcl-2 in tumor cells was strongly associated with expression of estrogen and progesterone receptors (p=0.003 and p=0.004, respectively). In addition, intratumoral MVD was significantly higher than peritumoral MVD (p<0.001) but not associated with Bax or Bcl-2 expression and other tumor characteristics. We concluded that the number of endothelial cells undergoing apoptosis was in direct linkage with the number of apoptotic tumor cells. Anti-apoptotic activity of the surviving tumor cells appears to propagate cancer progression and this was influenced by the hormonal status of the cells. Tumor angiogenesis was especially promoted in the intratumoral region and angiogenesis was independent of anti-apoptotic activity.

Matched MeSH terms: Breast Neoplasms/blood supply; Breast Neoplasms/metabolism*; Breast Neoplasms/pathology; Carcinoma, Ductal, Breast/blood supply; Carcinoma, Ductal, Breast/metabolism; Carcinoma, Ductal, Breast/pathology
Fulltext Family support in cancer survivorship

Muhamad M, Afshari M, Kazilan F

Asian Pac J Cancer Prev, 2011;12(6):1389-97.
PMID: 22126470

This paper raises issues about the role of family members in providing support for breast cancer survivors. Data were collected from 400 breast cancer survivors in Peninsular Malaysia through a custom-designed questionnaire fielded at hospitals and support group meetings. The data were analyzed using descriptive statistics. The analyses show that all family members could be supportive, especially in decision making and help with emotional issues. The spouse was the main support provider among the family members (others were children, parents, siblings and more distant relatives). The results also indicated that a significant percentage practiced collaborative decision-making. Breast cancer survivors needed their family members' support for information on survivorship strategies such as managing emotions, health, life style and dietary practice. The family members' supportive role may be linked to the Malaysian strong family relationship culture. For family members to contribute more adequately to cancer survivorship, it is suggested that appropriate educational intervention also be provided to them.

Matched MeSH terms: Breast Neoplasms/psychology*
Knowledge towards breast cancer among Malaysian university students

Khan TM, Anwar M, Gillani W

Breast J, 2011 Sep-Oct;17(5):553-4.
PMID: 21827564 DOI: 10.1111/j.1524-4741.2011.01142.x
Matched MeSH terms: Breast Neoplasms/psychology*
Fulltext Do the majority of Malaysian women have dense breasts on mammogram?

Zulfiqar M, Rohazly I, Rahmah M

Biomed Imaging Interv J, 2011 Apr;7(2):e14.
PMID: 22291859 MyJurnal DOI: 10.2349/biij.7.2.e14

PURPOSE: TO DETERMINE: (i) the mammographic parenchymal patterns in Malaysian women and whether the breasts are dense on mammogram; (ii) the effect of age on breast density; (iii) the effect of parity on breast density; (iv) the difference in breast parenchymal patterns among the major races of women in Malaysia.
METHODS: This was a descriptive cross-sectional study of 1,784 patients (981 Malays, 571 Chinese, 214 Indians and 18 others) who had undergone mammography during the 1-year study period. Majority of women (41.7%) were aged between 51 and 60 years and majority (43%) had 3-4 children. The Tabar classification (Pattern I - V) was used to evaluate breast parenchymal patterns on mammogram. Tabar Pattern I was further divided into 3 sub-groups (Pattern IA, IB, and IC). The different patterns were then grouped into dense (IB, IC, IV, V) and not dense (IA, II, III) breasts. The SPSS package was used for statistical analysis.
RESULTS: Majority (59%) of Malaysian women had dense breasts (Pattern IB 29%, IC 20%, IV 5%, and V 5%) and 41% did not have dense breasts (Pattern IA 28%, II 6%, and III 7%). Age and parity were inversely related to breast density (p < 0.0001). Chinese women (65.7%) had the highest percentage of dense breasts (p = 0.69, odds ratio = 1.22), followed by the Indians (57.2%) and the Malays (50.5%).
CONCLUSION: Majority of women had dense breasts but Pattern IV, which has been associated with increased risk of breast cancer, was seen in only 5% of the women. The breast density reduced steadily with increasing age and parity. There was no statistically significant difference in breast density in the three main races.
KEYWORDS: Mammography; breast density; breast parenchymal patterns

Matched MeSH terms: Breast; Breast Density
Fulltext Breastfeeding--anti-viral potential and relevance to the influenza virus pandemic

Prameela KK

Med J Malaysia, 2011 Jun;66(2):166-9; quiz 170.
PMID: 22106709

Essential nutritive and immunological ingredients abundantly present in breastmilk make it the choice infant nutrition. The uniqueness of mother's milk, in contrast to most therapeutics and immunizations, lies in its potential to adapt itself to the requirements of the infant so that timely immune defenses are tapped from its constituents by immune regulation, modulation and immune acceleration to stimulate novel substances; these render it pertinent as defense when faced with challenging organisms. While it is appreciated that immunity can be transferred from mother to infant through breastmilk following maternal influenza vaccination, the immense benefits conferred by breastfeeding per se during influenza pandemics may not be fully valued. This is substantiated by debates and ambiguities for continued breastfeeding in the face of maternal influenza infections. This article emphasises the utmost importance of breastfeeding in viral pandemics in the light of the changing immunological strategies used by viruses at different times and the urgent need for such opportune defenses. The prolific interaction of its constituents is frequently understated as enormous advantages to the suckling infant.

Matched MeSH terms: Breast Feeding*
Fulltext Diabetic mastopathy: a case report and literature review

Neetu G, Pathmanathan R, Weng NK

Case Rep Oncol, 2010 Jul 16;3(2):245-251.
PMID: 20740205 DOI: 10.1159/000318641

Diabetic mastopathy is a rare fibroinflammatory breast disease characterized by lymphocytic lobulitis, ductitis, and perivasculitis with stromal fibrosis. This lesion often presents as a discretely palpable uni- or bilateral mass in long-standing type I diabetes and other autoimmune diseases. We report a case of insulin-dependent diabetic mastopathy, which presented clinically as an indeterminate breast lump suspicious for malignancy. The patient is a 36-year-old woman who had type 1 insulin-dependent diabetes mellitus. Mammography and ultrasonography raised a suspicion of malignancy, and an excisional biopsy was performed. A previous biopsy had shown no evidence of malignancy. Histopathological examination now showed dense keloid-like stromal fibrosis with epithelioid-like and spindly myofibroblasts and a characteristic lymphocytic infiltration around blood vessels in and around lobules and ducts, features consistent with diabetic mastopathy. The literature is briefly reviewed.

Matched MeSH terms: Breast; Breast Diseases
Fulltext Work related determinants of breastfeeding discontinuation among employed mothers in Malaysia

Amin RM, Said ZM, Sutan R, Shah SA, Darus A, Shamsuddin K

Int Breastfeed J, 2011;6(1):4.
PMID: 21342506 DOI: 10.1186/1746-4358-6-4

This cross-sectional study assesses factors that contribute to discontinuing breastfeeding among employed mothers in Malaysia.

Matched MeSH terms: Breast Feeding*
Age specific histologic types of carcinoma breast in Malaysians

Sheikh MK, Khan FA, Imran Abdul Khalid IK, Kumar G

J Coll Physicians Surg Pak, 2009 Mar;19(3):201-2.
PMID: 19268026 DOI: 03.2009/JCPSP.201202

The influence of age on various histological types of breast cancer at both age <50 years and >50 years to simulate menopause was studied retrospective from 2002 to 2004 in Malaysia. One hundred and fifty five cases were reviewed. Ninety two cases recorded at age <50 years, 60 (65.2%, 95%CI: 54.6 - 74.8%) were infiltrating ductal carcinoma in 11(12.0%, 95% CI: 6.1-20.4%), ductal carcinoma in situ (DCIS) in 9 (9.8%, 95% CI: 4.6-17.8%), medullary carcinoma in 6 (6.5%, 85%CI: 2.4-13.6%), invasive lobular carcinoma in 4 (4.3%, 95%CI: 1.2-10.8%), mucinous carcinoma and poorly differentiated carcinoma in 2 cases (2.2%, 95%CI: 0.3-7.6%). At >50 years of age, 63 cases were recorded. Forty seven (74.6%, 95%CI: 62.0- 84.7%) cases were of infiltrating ductal carcinoma, ductal carcinoma in situ in 9 (14.3%, 95%CI: 6.7-25.4%), mucinous carcinoma in 5 (7.9%, 95%CI: 2.6-17.6%), medullary carcinoma (8.5%) and papillary carcinoma in 1 case each (1.6%, 95%CI: 0.0-8.5%). Infiltrating ductal carcinoma was the commonest histology at both age <50 years and >50 years.

Matched MeSH terms: Breast Neoplasms/pathology*
A comparison of wavelet and curvelet for breast cancer diagnosis in digital mammogram

Meselhy Eltoukhy M, Faye I, Belhaouari Samir B

Comput Biol Med, 2010 Apr;40(4):384-91.
PMID: 20163793 DOI: 10.1016/j.compbiomed.2010.02.002

This paper presents a comparative study between wavelet and curvelet transform for breast cancer diagnosis in digital mammogram. Using multiresolution analysis, mammogram images are decomposed into different resolution levels, which are sensitive to different frequency bands. A set of the biggest coefficients from each decomposition level is extracted. Then a supervised classifier system based on Euclidian distance is constructed. The performance of the classifier is evaluated using a 2 x 5-fold cross validation followed by a statistical analysis. The experimental results suggest that curvelet transform outperforms wavelet transform and the difference is statistically significant.

Matched MeSH terms: Breast Neoplasms/diagnosis*
Fulltext Wandering humeral head mimicking a breast mass

Tan GJS, Tan AGS, Peh WCG

Med J Malaysia, 2008 Jun;63(2):164-5.
PMID: 18942311

A 74-year-old woman was incidentally found to have a left breast mass. The mass could not be adequately compressed to be visualized on mammography. Ultrasonography showed a heavily-calcified rounded mass in the left axillary tail of the left breast. Chest radiograph confirmed that the mass was a migrated humeral head. Remotely-displaced fracture-dislocations of the humeral head are very rare and to our knowledge, displacement into the breast, clinically mimicking a breast mass, has not been previously described.

Matched MeSH terms: Breast Neoplasms/diagnosis*
Fulltext Mucinous adenocarcinoma of the rectum with breast and ocular metastases

Hisham RB, Thuaibah H, Gul YA

Asian J Surg, 2006 Apr;29(2):95-7.
PMID: 16644510

We present the case of a 32-year-old woman who, 10 months after abdominoperineal resection and total mesorectal excision for a locally advanced mucinous adenocarcinoma of the rectum, presented with local recurrence and metastases to the breast, spine, the left eye and orbit. Following surgery, due to the patient's personal reasons, adjuvant chemoradiation was not given. The patient died 2 months later, with disseminated cancer. To the best of our knowledge, breast as well as ocular metastasis in a patient with mucinous adenocarcinoma of the rectum has never been reported and, therefore, needs to be documented.

Matched MeSH terms: Breast Neoplasms/secondary*
Characteristics of invasive breast ductal carcinoma, NOS, diagnosed in a tertiary institution in the East Coast of Malaysia with a focus on tumor angiogenesis

Ch'ng ES, Tuan Sharif SE, Jaafar H

Asian Pac J Cancer Prev, 2012;13(9):4445-52.
PMID: 23167359

BACKGROUND: Prognosis of breast cancer depends on classic pathological factors and also tumor angiogenesis. This study aimed to evaluate the clinicopathological factors of breast cancer in a tertiary centre with a focus on the relationship between tumor angiogenesis and clinicopathological factors.
METHODS: Clinicopathological data were retrieved from the archived formal pathology reports for surgical specimens diagnosed as invasive ductal carcinoma, NOS. Microvessels were immunohistochemically stained with anti-CD34 antibody and quantified as microvessel density.
RESULTS: At least 50% of 94 cases of invasive breast ductal carcinoma in the study were advanced stage. The majority had poor prognosis factors such as tumor size larger than 50mm (48.9%), positive lymph node metastasis (60.6%), and tumor grade III (52.1%). Higher percentages of estrogen and progesterone receptor negative cases were recorded (46.8% and 46.8% respectively). Her-2 overexpression cases and triple negative breast cancers constituted 24.5% and 22.3% respectively. Significantly higher microvessel density was observed in the younger patient age group (p=0.012). There were no significant associations between microvessel density and other clinicopathological factors (p>0.05).
CONCLUSIONS: Majority of the breast cancer patients of this institution had advanced stage disease with poorer prognostic factors as compared to other local and western studies. Breast cancer in younger patients might be more proangiogenic.

Matched MeSH terms: Breast Neoplasms/blood supply*; Breast Neoplasms/metabolism; Breast Neoplasms/pathology*; Carcinoma, Ductal, Breast/blood supply*; Carcinoma, Ductal, Breast/metabolism; Carcinoma, Ductal, Breast/secondary*
Fulltext Pulmonary resection for metastatic breast cancer

Gooi BH, Premnath N, Manjit S

Med J Malaysia, 2004 Mar;59(1):112-4.
PMID: 15535346

The management of pulmonary metastasis from breast carcinoma is challenging and often consists of palliation of symptoms. Surgical resection of pulmonary metastasis is considered inappropriate in view of the disseminated nature of the disease and limited life expectancy. It can however be a worthwhile option if imaging, including bone scans rule out metastatic disease in other part of the body. We report a patient with pulmonary metastasis from breast carcinoma who was successfully treated with pulmonary wedge resection of the metastatic lesion.

Matched MeSH terms: Breast Neoplasms/pathology*
Fulltext Resource security impacts men's female breast size preferences

Swami V, Tovée MJ

PLoS One, 2013;8(3):e57623.
PMID: 23483919 DOI: 10.1371/journal.pone.0057623

It has been suggested human female breast size may act as signal of fat reserves, which in turn indicates access to resources. Based on this perspective, two studies were conducted to test the hypothesis that men experiencing relative resource insecurity should perceive larger breast size as more physically attractive than men experiencing resource security. In Study 1, 266 men from three sites in Malaysia varying in relative socioeconomic status (high to low) rated a series of animated figures varying in breast size for physical attractiveness. Results showed that men from the low socioeconomic context rated larger breasts as more attractive than did men from the medium socioeconomic context, who in turn perceived larger breasts as attractive than men from a high socioeconomic context. Study 2 compared the breast size judgements of 66 hungry versus 58 satiated men within the same environmental context in Britain. Results showed that hungry men rated larger breasts as significantly more attractive than satiated men. Taken together, these studies provide evidence that resource security impacts upon men's attractiveness ratings based on women's breast size.

Matched MeSH terms: Breast/anatomy & histology*
Influence of support group intervention on quality of life of Malaysian breast cancer survivors

Abu Kassim NL, Mohd Hanafiah K, Samad-Cheung H, Rahman MT

Asia Pac J Public Health, 2015 Mar;27(2):NP495-505.
PMID: 23386747 DOI: 10.1177/1010539512471074

Given that breast cancer is the most prevalent form of cancer affecting Malaysian women and its low survival rate, this study investigates the possible influence of support group intervention on quality of life (QOL). It also examines the interrelationships between QOL subdomains as research has shown the influence of emotional expression on psychological and physical well-being. Rasch analysis was implemented to examine perception of QOL and the comparability of the Functional Assessment of Cancer Therapy General and Breast Cancer scales (FACT-G and FACT-B) of the Functional Assessment of Chronic Illness Therapy inventory. Results indicated that perception of QOL may be influenced by factors other than support group intervention. The FACT-G and FACT-B scales were comparable in the measurement of QOL for breast cancer, and the interrelationships between the QOL subdomains were supported. The findings of this study accentuate the importance of focusing support group interventions on improvement of emotional well-being to maintain patients' QOL despite the cancer.

Matched MeSH terms: Breast Neoplasms/psychology*
Advanced MRI applications and findings of malignant phyllodes tumour: review of two cases

Alhabshi SM, Rahmat K, Abu Hassan H, Westerhout CJ, Chandran PA

Jpn J Radiol, 2013 May;31(5):342-8.
PMID: 23385379 DOI: 10.1007/s11604-013-0183-y

Phyllodes tumour or cystosarcoma phyllodes is a rare stromal breast tumour that is usually benign but on rare occasions can turn malignant. Non-specificity of the imaging features on sonography and mammography makes it difficult to distinguish malignant from benign counterparts solely based on imaging. The final diagnosis is still highly dependent on histopathological assessment. Herein, we describe two cases of malignant phyllodes tumour with emphasis on magnetic resonance (MR) imaging features using advanced MR applications.

Matched MeSH terms: Breast Neoplasms/pathology*
The Long-Term Public Health Benefits of Breastfeeding

Binns C, Lee M, Low WY

Asia Pac J Public Health, 2016 Jan;28(1):7-14.
PMID: 26792873 DOI: 10.1177/1010539515624964

Breastfeeding has many health benefits, both in the short term and the longer term, to infants and their mothers. There is an increasing number of studies that report on associations between breastfeeding and long-term protection against chronic disease. Recent research evidence is reviewed in this study, building on previous authoritative reviews. The recent World Health Organization reviews of the short- and long-term benefits of breastfeeding concluded that there was strong evidence for many public health benefits of breastfeeding. Cognitive development is improved by breastfeeding, and infants who are breastfed and mothers who breastfeed have lower rates of obesity. Other chronic diseases that are reduced by breastfeeding include diabetes (both type 1 and type 2), obesity, hypertension, cardiovascular disease, hyperlipidemia, and some types of cancer.

Matched MeSH terms: Breast Feeding/statistics & numerical data*
Fulltext On the Use of Optically Stimulated Luminescent Dosimeter for Surface Dose Measurement during Radiotherapy

Yusof FH, Ung NM, Wong JH, Jong WL, Ath V, Phua VC, et al.

PLoS One, 2015;10(6):e0128544.
PMID: 26052690 DOI: 10.1371/journal.pone.0128544

This study was carried out to investigate the suitability of using the optically stimulated luminescence dosimeter (OSLD) in measuring surface dose during radiotherapy. The water equivalent depth (WED) of the OSLD was first determined by comparing the surface dose measured using the OSLD with the percentage depth dose at the buildup region measured using a Markus ionization chamber. Surface doses were measured on a solid water phantom using the OSLD and compared against the Markus ionization chamber and Gafchromic EBT3 film measurements. The effect of incident beam angles on surface dose was also studied. The OSLD was subsequently used to measure surface dose during tangential breast radiotherapy treatments in a phantom study and in the clinical measurement of 10 patients. Surface dose to the treated breast or chest wall, and on the contralateral breast were measured. The WED of the OSLD was found to be at 0.4 mm. For surface dose measurement on a solid water phantom, the Markus ionization chamber measured 15.95% for 6 MV photon beam and 12.64% for 10 MV photon beam followed by EBT3 film (23.79% and 17.14%) and OSLD (37.77% and 25.38%). Surface dose increased with the increase of the incident beam angle. For phantom and patient breast surface dose measurement, the response of the OSLD was higher than EBT3 film. The in-vivo measurements were also compared with the treatment planning system predicted dose. The OSLD measured higher dose values compared to dose at the surface (Hp(0.0)) by a factor of 2.37 for 6 MV and 2.01 for 10 MV photon beams, respectively. The measurement of absorbed dose at the skin depth of 0.4 mm by the OSLD can still be a useful tool to assess radiation effects on the skin dermis layer. This knowledge can be used to prevent and manage potential acute skin reaction and late skin toxicity from radiotherapy treatments.

Matched MeSH terms: Breast Neoplasms/radiotherapy
Fulltext Revealing Glycoproteins in the Secretome of MCF-7 Human Breast Cancer Cells

Tan AA, Phang WM, Gopinath SC, Hashim OH, Kiew LV, Chen Y

Biomed Res Int, 2015;2015:453289.
PMID: 26167486 DOI: 10.1155/2015/453289

Breast cancer is one of the major issues in the field of oncology, reported with a higher prevalence rate in women worldwide. In attempt to reveal the potential biomarkers for breast cancer, the findings of differentially glycosylated haptoglobin and osteonectin in previous study have drawn our attention towards glycoproteins of secretome from the MCF-7 cancer cell line. In the present study, further analyses were performed on the medium of MCF-7 cells by subjecting it to two-dimensional analyses followed by image analysis in contrast to the medium of human mammary epithelial cells (HMEpC) as a negative control. Carboxypeptidase A4 (CPA4), alpha-1-antitrypsin (AAT), haptoglobin (HP), and HSC70 were detected in the medium of MCF-7, while only CPA4 and osteonectin (ON) were detected in HMEpC medium. In addition, CPA4 was detected as upregulated in the MCF-7 medium. Further analysis by lectin showed that CPA4, AAT, HP, and HSC70 were secreted as N-glycan in the medium of MCF-7, with HP also showing differentially N-glycosylated isoforms. For the HMEpC, only CPA4 was detected as N-glycan. No O-glycan was detected in the medium of HMEpC but MCF-7 expressed O-glycosylated CPA4 and HSC70. All these revealed that glycoproteins could be used as glycan-based biomarkers for the prognosis of breast cancer.

Matched MeSH terms: Breast Neoplasms/secretion*

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