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  1. Htay MNN, Dahlui M, Schliemann D, Loh SY, Ibrahim Tamin NSB, Somasundaram S, et al.
    Eur J Cancer Care (Engl), 2022 Sep;31(5):e13675.
    PMID: 35946147 DOI: 10.1111/ecc.13675
    OBJECTIVES: This study investigated women's health beliefs, the use of breast cancer (BC) screening services, and the factors that potentially influence uptake of screening.

    METHODS: Face-to-face interviews were conducted with a randomly selected community sample of 992 women (>40 years old) in Selangor State, Malaysia.

    RESULTS: Approximately 35% of women received a clinical breast examination (CBE) and 27% had a mammogram within the last 1 to 2 years. The regression analyses indicated that Chinese ethnicity has higher perceived susceptibility to BC compared to Malay ethnicity (mean 7.74, SD: 2.75; 95% CI 0.09, 1.03) whilst a lower perceived susceptibility was observed in women aged ≥70 years (mean 6.67, SD: 3.01; 95% CI -1.66, -0.24) compared to women aged 40-49 years. Indian Malaysian women (mean 16.87, SD: 2.59; 95% CI 0.12, 1.01) and women who had received a CBE (mean 16.10, SD:2.35; 95% CI 0.18, 0.89) were more likely to have higher perceived benefits scoring. Indian ethnicity, secondary education and tertiary education, top 20% income group, past history of CBE and mammogram uptake were significantly associated with lower barriers scoring.

    CONCLUSIONS: There is a need to target BC screening uptake improvement programmes towards communities in which women experience disadvantages related to income, education, employment, and, in particular, to tailor programmes to take into consideration differences between ethnic groups regarding their beliefs about cancer screening.

    Matched MeSH terms: Breast Neoplasms*
  2. Kwok LS, Yian SS, Ismael LQ, Bee YTG, Harn GL, Yin KB
    Mol Biol Rep, 2024 Feb 21;51(1):317.
    PMID: 38381204 DOI: 10.1007/s11033-024-09269-z
    BACKGROUND: Our previous study investigated the levels of soluble growth factors in the conditioned media of bone marrow-derived mesenchymal stem cells (BMSCs) pre-treated with thiazolidinedione solutions. The present study aimed to investigate the complex intracellular proteins extracted from BMSCs pre-treated with pioglitazone and/or rosiglitazone using proteomics.

    METHODS: The proliferative effect of the identified protein on MCF-7 cells that interacted non-adhesively with BMSCs pre-treated with pioglitazone and/or rosiglitazone was evaluated using cell culture inserts and conditioned media. The mRNA expression of proliferation and lipid accumulation markers was also evaluated in the interacted MCF-7 cells by reverse transcription-quantitative PCR. Finally, the correlation between the identified protein and fibroblast growth factor 4 (FGF-4) protein in the conditioned media of the pre-treated BMSCs was evaluated by ELISA.

    RESULTS: The present study identified vimentin as the specific protein among the complex intracellular proteins that likely plays a role in MCF-7 cell proliferation when the breast cancer cells interacted non-adhesively with BMSCs pre-treated with a combination of pioglitazone and rosiglitazone. The inhibition of this protein promoted the proliferation of MCF-7 cells when the breast cancer cells interacted with pre-treated BMSCs. Gene expression analysis indicated that pre-treatment of BMSCs with a combination of pioglitazone and rosiglitazone decreased the mRNA expression of Ki67 and proliferating cell nuclear antigen in MCF-7 cells. The pre-treatment did not induce mRNA expression of PPARγ, which is a sign of lipid accumulation. The level of vimentin protein was also associated with the FGF-4 protein expression level in the conditioned media of the pre-treated BMSCs. Bioinformatics analysis revealed that vimentin regulated the expression of FGF-4 through its interaction with SRY-box 2 and POU class 5 homeobox 1.

    CONCLUSIONS: The present study identified a novel intracellular protein that may represent the promising target in pre-treated BMSCs to decrease the proliferation of breast cancer MCF-7 cells for human health and wellness.

    Matched MeSH terms: Breast Neoplasms*
  3. Mohamad S, Isa NM, Muhammad R, Emran NA, Kitan NM, Kang P, et al.
    PLoS One, 2015;10(1):e0117104.
    PMID: 25629968 DOI: 10.1371/journal.pone.0117104
    CHEK2 is a protein kinase that is involved in cell-cycle checkpoint control after DNA damage. Germline mutations in CHEK2 gene have been associated with increase in breast cancer risk. The aim of this study is to identify the CHEK2 gene germline mutations among high-risk breast cancer patients and its contribution to the multiethnic population in Malaysia. We screened the entire coding region of CHEK2 gene on 59 high-risk breast cancer patients who tested negative for BRCA1/2 germline mutations from UKM Medical Centre (UKMMC), Hospital Kuala Lumpur (HKL) and Hospital Putrajaya (HPJ). Sequence variants identified were screened further in case-control cohorts consisting of 878 unselected invasive breast cancer patients (180 Malays, 526 Chinese and 172 Indian) and 270 healthy individuals (90 Malays, 90 Chinese and 90 Indian). By screening the entire coding region of the CHEK2 gene, two missense mutations, c.480A>G (p.I160M) and c.538C>T (p.R180C) were identified in two unrelated patients (3.4%). Further screening of these missense mutations on the case-control cohorts unveiled the variant p.I160M in 2/172 (1.1%) Indian cases and 1/90 (1.1%) Indian control, variant p.R180C in 2/526 (0.38%) Chinese cases and 0/90 Chinese control, and in 2/180 (1.1%) of Malay cases and 1/90 (1.1%) of Malay control. The results of this study suggest that CHEK2 mutations are rare among high-risk breast cancer patients and may play a minor contributing role in breast carcinogenesis among Malaysian population.
    Matched MeSH terms: Breast Neoplasms/ethnology; Breast Neoplasms/genetics*; Breast Neoplasms/pathology
  4. Li J, Lindström LS, Foo JN, Rafiq S, Schmidt MK, Pharoah PD, et al.
    Nat Commun, 2014 Jun 17;5:4051.
    PMID: 24937182 DOI: 10.1038/ncomms5051
    Large population-based registry studies have shown that breast cancer prognosis is inherited. Here we analyse single-nucleotide polymorphisms (SNPs) of genes implicated in human immunology and inflammation as candidates for prognostic markers of breast cancer survival involving 1,804 oestrogen receptor (ER)-negative patients treated with chemotherapy (279 events) from 14 European studies in a prior large-scale genotyping experiment, which is part of the Collaborative Oncological Gene-environment Study (COGS) initiative. We carry out replication using Asian COGS samples (n=522, 53 events) and the Prospective Study of Outcomes in Sporadic versus Hereditary breast cancer (POSH) study (n=315, 108 events). Rs4458204_A near CCL20 (2q36.3) is found to be associated with breast cancer-specific death at a genome-wide significant level (n=2,641, 440 events, combined allelic hazard ratio (HR)=1.81 (1.49-2.19); P for trend=1.90 × 10(-9)). Such survival-associated variants can represent ideal targets for tailored therapeutics, and may also enhance our current prognostic prediction capabilities.
    Matched MeSH terms: Breast Neoplasms/diagnosis*; Breast Neoplasms/drug therapy*; Breast Neoplasms/genetics*
  5. Zain NM, Chelliah KK
    Asian Pac J Cancer Prev, 2014;15(3):1327-31.
    PMID: 24606460
    BACKGROUND: Electrical impedance tomography (EIT) is a new non-invasive, mobile screening method which does not use ionizing radiation to the human breast; allows conducting quantitative assessment of the images besides the visual interpretation. The aim of this study was to correlate the quantitative assessment and visual interpretation of breast electrical impedance tomographs and associated factors.

    MATERIALS AND METHODS: One hundred and fifty mammography patients above 40 years and undergoing EIT were chosen using convenient sampling. Visual interpretation of the images was carried out by a radiologist with minimum of three years experience using the breast imaging - electrical impedance (BI-EIM) classification for detection of abnormalities. A set of thirty blinded EIT images were reinterpreted to determine the intra-rater reliability using kappa. Quantitative assessment was by comparison of the breast average electric conductivity with the norm and correlations with visual interpretation of the images were determined using Chi-square. One-way ANOVA was used to compare the mean electrical conductivity between groups and t-test was used for comparisons with pre-existing Caucasians statistics. Independent t-tests were applied to compare the mean electrical conductivity of women with factors like exogenous hormone use and family history of breast cancer.

    RESULTS: The mean electrical conductivity of Malaysian women was significantly lower than that of Caucasians (p<0.05). Quantitative assessment of electrical impedance tomography was significantly related with visual interpretation of images of the breast (p<0.05).

    CONCLUSIONS: Quantitative assessment of electrical impedance tomography images was significantly related with visual interpretation.

    Matched MeSH terms: Breast/physiology*; Breast Neoplasms/prevention & control
  6. Lim GC, Aina EN, Cheah SK, Ismail F, Ho GF, Tho LM, et al.
    BMC Cancer, 2014;14:212.
    PMID: 24650245 DOI: 10.1186/1471-2407-14-212
    BACKGROUND: Cancer is the leading cause of deaths in the world. A widening disparity in cancer burden has emerged between high income and low-middle income countries. Closing this cancer divide is an ethical imperative but there is a dearth of data on cancer services from developing countries.
    METHODS: This was a multi-center, retrospective observational cohort study which enrolled women with breast cancer (BC) attending 8 participating cancer centers in Malaysia in 2011. All patients were followed up for 12 months from diagnosis to determine their access to therapies. We assess care performance using measures developed by Quality Oncology Practice Initiative, American Society of Clinical Oncology/National Comprehensive Cancer Network, American College of Surgeons' National Accreditation Program for Breast Centers as well as our local guideline.
    RESULTS: Seven hundred and fifty seven patients were included in the study; they represent about 20% of incident BC in Malaysia. Performance results were mixed. Late presentation was 40%. Access to diagnostic and breast surgery services were timely; the interval from presentation to tissue diagnosis was short (median = 9 days), and all who needed surgery could receive it with only a short wait (median = 11 days). Performance of radiation, chemo and hormonal therapy services showed that about 75 to 80% of patients could access these treatments timely, and those who could not were because they sought alternative treatment or they refused treatment. Access to Trastuzumab was limited to only 19% of eligible patients.
    CONCLUSIONS: These performance results are probably acceptable for a middle income country though far below the 95% or higher adherence rates routinely reported by centres in developed countries. High cost trastuzumab was inaccessible to this population without public funding support.
    Matched MeSH terms: Breast Neoplasms/diagnosis; Breast Neoplasms/economics*; Breast Neoplasms/epidemiology*
  7. Fouz N, Amid A, Hashim YZ
    Asian Pac J Cancer Prev, 2014 Jan;14(11):6709-14.
    PMID: 24377593
    BACKGROUND: Breast cancer is a leading cause of death in women. The available chemotherapy drugs have been associated with many side effects. Bromelain has novel medicinal qualities including anti-inflammatory, anti-thrombotic, fibrinolytic and anti-cancer functions. Commercially available bromelain is obtained through tedious methods; therefore, recombinant bromelain may provide a cheaper and simpler choice with similar quality.

    MATERIALS AND METHODS: This study aimed to assess the effects of commercial and recombinant bromelain on the cytokinetic behavior of MCF-7 breast cancer cells and their potential as therapeutic alternatives in cancer treatment. Cytotoxic activities of commercial and recombinant bromelain were determined using (sulforhodamine) SRB assay. Next, cell viability assays were conducted to determine effects of commercial and recombinant bromelain on MCF-7 cell cytokinetic behavior. Finally, the established growth kinetic data were used to modify a model that predicts the effects of commercial and recombinant bromelain on MCF-7 cells.

    RESULTS: Commercial and recombinant bromelain exerted strong effects towards decreasing the cell viability of MCF-7 cells with IC50 values of 5.13 μg/mL and 6.25 μg/mL, respectively, compared to taxol with an IC50 value of 0.063 μg/mL. The present results indicate that commercial and recombinant bromelain both have anti-proliferative activity, reduced the number of cell generations from 3.92 to 2.81 for commercial bromelain and to 2.86 for recombinant bromelain, while with taxol reduction was to 3.12. Microscopic observation of bromelain-treated MCF-7 cells demonstrated detachment. Inhibition activity was verified with growth rates decreased dynamically from 0.009 h-1 to 0.0059 h-1 for commercial bromelain and to 0.0063 h-1 for recombinant bromelain.

    CONCLUSIONS: Commercial and recombinant bromelain both affect cytokinetics of MCF-7 cells by decreasing cell viability, demonstrating similar strength to taxol.

    Matched MeSH terms: Breast Neoplasms/drug therapy; Breast Neoplasms/metabolism*; Breast Neoplasms/pathology*
  8. Nik Jaafar NR, Selamat Din SH, Mohamed Saini S, Ahmad SN, Midin M, Sidi H, et al.
    Compr Psychiatry, 2014 Jan;55 Suppl 1:S52-9.
    PMID: 23706655 DOI: 10.1016/j.comppsych.2013.03.003
    The period of the cancer patients undergoing treatment is also the most stressful time for their family caregivers. This study aimed to determine the rates of major depressive disorder and dysthymia; and their associated factors in the caregivers during this time.

    Study site: Oncology centre, Pusat Perubatan Universiti Kebangsaan Malaysia
    Matched MeSH terms: Breast Neoplasms/nursing*; Breast Neoplasms/epidemiology; Breast Neoplasms/therapy
  9. Dahlui M, Gan DE, Taib NA, Pritam R, Lim J
    Asian Pac J Cancer Prev, 2012;13(7):3443-9.
    PMID: 22994775
    INTRODUCTION: Despite health education efforts to educate women on breast cancer and breast cancer screening modalities, the incidence of breast cancer and presentation at an advanced stage are still a problem in Malaysia.

    OBJECTIVES: To determine factors associated with the uptake of breast cancer screening among women in the general population.

    METHODS: This pre-intervention survey was conducted in a suburban district. All households were approached and women aged 20 to 60 years old were interviewed with pre-tested guided questionnaires. Variables collected included socio-demographic characteristics, knowledge on breast cancer and screening practice of breast cancer. Univariate and multivariate analysis were performed.

    RESULTS: 41.5% of a total of 381 respondents scored above average; the mean knowledge score on causes and risks factors of breast cancer was 3.41 out of 5 (SD1.609). 58.5% had ever practiced BSE with 32.5% performing it at regular monthly intervals. Uptake of CBE by nurses and by doctors was 40.7% and 37.3%, respectively. Mammogram uptake was 14.6%. Significant predictors of BSE were good knowledge of breast cancer (OR=2.654, 95% CI: 1.033-6.816), being married (OR=2.213, 95% CI: 1.201-4.076) and attending CBE (OR=1.729, 95% CI: 1.122-2.665). Significant predictors for CBE included being married (OR=2.161, 95% CI: 1.174-3.979), good knowledge of breast cancer (OR=2.286, 95% CI: 1.012-5.161), and social support for breast cancer screening (OR=2.312, 95% CI: 1.245-4.293). Women who had CBE were more likely to undergo mammographic screening of the breast (OR=5.744, 95% CI: 2.112-15.623), p<0.005.

    CONCLUSION: CBE attendance is a strong factor in promoting BSE and mammography, educating women on the importance of breast cancer screening and on how to conduct BSE. The currently opportunistic conduct of CBE should be extended to active calling of women for CBE.
    Matched MeSH terms: Breast Neoplasms/diagnosis*; Breast Self-Examination/methods
  10. Ahmad ZA, Yeap SK, Ali AM, Ho WY, Alitheen NB, Hamid M
    Clin. Dev. Immunol., 2012;2012:980250.
    PMID: 22474489 DOI: 10.1155/2012/980250
    To date, generation of single-chain fragment variable (scFv) has become an established technique used to produce a completely functional antigen-binding fragment in bacterial systems. The advances in antibody engineering have now facilitated a more efficient and generally applicable method to produce Fv fragments. Basically, scFv antibodies produced from phage display can be genetically fused to the marker proteins, such as fluorescent proteins or alkaline phosphatase. These bifunctional proteins having both antigen-binding capacity and marker activity can be obtained from transformed bacteria and used for one-step immunodetection of biological agents. Alternatively, antibody fragments could also be applied in the construction of immunotoxins, therapeutic gene delivery, and anticancer intrabodies for therapeutic purposes. This paper provides an overview of the current studies on the principle, generation, and application of scFv. The potential of scFv in breast cancer research is also discussed in this paper.
    Matched MeSH terms: Breast Neoplasms/diagnosis; Breast Neoplasms/immunology; Breast Neoplasms/therapy*
  11. Matalqah L, Radaideh K, Yusoff ZM, Awaisu A
    Asian Pac J Cancer Prev, 2011;12(6):1549-53.
    PMID: 22126497
    BACKGROUND: Breast cancer has been increased in South East Asia countries, but there are limited data for breast cancer risk factors in these countries. To clarify the risk for breast cancer among the Malaysian women, a matched case-control study was conducted.

    METHOD: Between October 2009 and April 2010, a survey was prospectively conducted among women admitted to clinics of Penang General Hospital for examination and/or treatment by using a questionnaire. Therefore, characteristics of patients diagnosed with breast cancer (n=150) were compared with control cases (n=150) admitted to hospital for non-neoplastic, non-hormone related diseases.

    RESULTS: Family history of a distant relative with breast cancer (OR=2.84), history of first-degree relatives with breast cancer (OR=2.95), history of benign breast disease (OR=2.43), menstrual irregularity (OR=4.24), and use of oral contraceptive pills (OCP) (OR=2.15) were found to be significant risk factors for breast cancer in our population. Furthermore, education more than 11 years (OR=0.40), breastfeeding (OR=0.50), being employed (OR=0.45) and practicing low fat diet (OR=0.53) were strongly protective against breast cancer development.

    CONCLUSION: The results emphasize the importance of conducting a series of awareness campaigns that highlights the protective role of longer breastfeeding period against breast cancer and the negative relationships between OCP use and high fat diet with this disease.

    Matched MeSH terms: Breast Feeding; Breast Neoplasms/diagnosis*; Breast Neoplasms/epidemiology*
  12. Loch A, Singh RV, Abidin IZ, Han CK, Ahmad WA
    J Thorac Oncol, 2011 Jul;6(7):1292.
    PMID: 21847043 DOI: 10.1097/JTO.0b013e31821f9771
    Matched MeSH terms: Breast Neoplasms/blood; Breast Neoplasms/complications; Breast Neoplasms/drug therapy
  13. Lei CP, Har YC, Abdullah KL
    Asian Pac J Cancer Prev, 2011;12(3):797-802.
    PMID: 21627386
    BACKGROUND: Cancer and chemotherapy are sources of anxiety and worry for cancer patients. Information provision is therefore very important to empower them to overcome and adjust to the stressful experience. Thus, nurses should be aware of the informational needs of the patients throughout the course of their care.
    PURPOSE: The purpose of the study was to identify the important information required by breast cancer patients during the first and fourth cycles of chemotherapy from both the patients' and nurses' perceptions.
    METHODOLOGY: This is a longitudinal study used a questionnaire adapted from the Toronto Informational Needs Questionnaires-Breast Cancer (TINQ-BC). Some modifications were made to meet the specific objectives of the study. The study was conducted in the Chemotherapy Day Care at the University of Malaya Medical Centre (UMMC), Malaysia. A total of 169 breast cancer patients who met the inclusion criteria, and 39 nurses who were involved in their care were recruited into the study.
    RESULTS: The overall mean scores at first and fourth cycle of chemotherapy were 3.91 and 3.85 respectively: i.e., between 3 (or important) and 4 (or very important), which indicated a high level of informational needs. There was no significant difference in information needed by the breast cancer patients between the two cycles of chemotherapy (p=0.402). The most important information was from the subscale of disease, followed closely by treatment, physical care, investigative tests and psychosocial needs. Nurses had different views on the important information needed by breast cancer patients at both time points (p = 0.023).
    CONCLUSIONS: Breast cancer patients on chemotherapy have high levels of informational needs with no significant differences in information needed at first cycle as opposed to fourth cycle. There were differences between the perceptions of the breast cancer patients and the nurses on important information needed. A paradigm shift, with an emphasis on patients as the central focus, is needed to enhance the information giving sessions conducted by nurses based on the perceptions of the patients themselves.
    Matched MeSH terms: Breast Neoplasms/drug therapy*; Breast Neoplasms/nursing; Breast Neoplasms/psychology*
  14. Shahar S, Salleh RM, Ghazali AR, Koon PB, Mohamud WN
    Asian Pac J Cancer Prev, 2010;11(1):61-6.
    PMID: 20593932
    BACKGROUND: Lack of physical activities throughout life is related to obesity and is a risk factor of breast cancer, however, the associations of these factors with adiponectin in the occurrence of breast cancer have not been well investigated.

    OBJECTIVE: This study investigated the relationship between adiposity, lifetime physical activities and serum adiponectin as breast cancer risk factors among Malaysian women in Klang Valley, Malaysia.

    DESIGN: A case-control study was carried out among 70 newly diagnosed breast cancer patients and 138 controls aged 29 to 65 years old in Klang Valley.

    SUBJECTS: The inclusion criteria for both groups were not having menstruation for premenopausal women, no evidence of pregnancy, not lactating and no chronic diseases such as hypertension and diabetes at the time of data collection. In addition, the cases must be pathologically newly diagnosed with breast cancer (stage I to III) and not on any therapy for cancer, with the exception of surgery. The controls were matched with cases for age +/- 5 years and menopausal status.

    MEASUREMENTS: Subjects were interviewed to obtain information on socio-demography, health and reproductive history using a pretested questionnaire. Subjects were also asked on their engagement of physical activity since secondary school. Anthropometric parameters included height, weight, waist and hips were also measured. A total of 6 ml of fasting venous blood was drawn for analysis of serum adiponectin in duplicate using Linko Adiponectin ELISA Kit. Fasting blood glucose (FBG) and blood pressure were also measured.

    RESULTS: Mean body mass index (BMI) among cases and controls were not significantly different (p> 0.05) at 26.1 -/+ 4.8 kg/m2 and 25.3 -/+ 4.5 kg/m2, respectively. FBG among cases (6.3 -/+ 1.8 mmol/L) was higher than controls (5.6 -/+ 1.1 mmol/L) (p<0.05). Waist hip ratio (WHR) of cases (0.85 -/+ 0.07) was also higher than controls (0.80 -/+ 0.06) (p<0.05). Abdominal obesity (WHR > 0.85) increased risk of breast cancer by three folds [Adjusted OR 3.3 (95%CI 1.8-6.2)] (p<0.05). Adiponectin level was inversely related to waist circumference (r=-0.510, p=0.000), BMI (r=-0.448, p=0.000) and FBG (r=-0.290, p=0.026). Adiponectin level in cases (11.9 -/+ 4.8 microg/ml) were lower than controls (15.2 -/+ 7.3 microg/ml) (p<0.05). A greater reduction of breast cancer risk was observed with the increasing level of serum adiponectin level according to percentiles (p<0.05). Subjects with mean serum adiponectin level at the highest quintile (> 75th)( >or= 16.7 microg/ml) had 80% reduced risk of breast cancer [Adjusted OR 0.2 (0.0-0.6)](p<0.05). A higher percentage of cases (47%) had not engaged in any physical activity throughout life as compared to controls (19%)[Adjusted OR 3.7 (1.7-7.7)](p<0.001).

    CONCLUSIONS: Abdominal obesity and physical inactivity throughout life were associated with low serum adiponectin and breast cancer risk among subjects. Thus, it is essential for Malaysian women to be physically active and achieve a healthy waistline in order to increase serum adiponectin level and reduce breast cancer risk.

    Matched MeSH terms: Breast Neoplasms/blood*; Breast Neoplasms/etiology*; Breast Neoplasms/epidemiology
  15. Mohd Taib NA, Yip CH, Mohamed I
    Asian Pac J Cancer Prev, 2008 Apr-Jun;9(2):197-202.
    PMID: 18712958
    BACKGROUND: Breast cancer is the commonest cancer amongst Malaysian women but local survival data are scarce. The present study was therefore conducted to assess overall survival and prognostic factors in Malaysian breast cancer patients.

    METHODS: The research sample was a prospective cohort of 413 patients diagnosed with breast cancer in the University of Malaya Medical Centre between 1993 to 1997. Survival data were obtained from the National Registry of Birth and Deaths in December 2000. The clinico-pathological variables studied were age, ethnic group, stage, tumour size, lymph node status, oestrogen receptor status and grade. The data were analysed utilizing Splus statistical software. The important prognostic factors were identified by fitting the Cox's proportional hazard model to the data set. Survival probabilities were estimated using the Kaplan-Meier method and differences were compared by the log-rank test.

    RESULTS: The overall 5-year survival was 59.1%. The Cox's proportional hazard model identified stage, lymph node status, size and grade as factors that correlated with prognosis. Age was not a significant prognostic factor. The Cox regression model by stepwise selection showed stage, nodal status and grade of tumour to be independent prognostic factors, whereas ethnicity, age and ER status were not.

    INTERPRETATION: The overall survival in our centre was low. Recognizing factors that affect prognosis of breast cancer patients in Malaysia may improve delivery of health care to at-risk groups by strategizing interventions as survival depends on early detection and effective treatment.
    Matched MeSH terms: Breast Neoplasms/metabolism; Breast Neoplasms/mortality*; Breast Neoplasms/therapy
  16. Tee TT, Cheah YH, Hawariah LP
    Anticancer Res, 2007 Sep-Oct;27(5A):3425-30.
    PMID: 17970090
    F16 is a plant-derived pharmacologically active fraction extracted from Eurycoma longifolia Jack. Previously, we have reported that F16 inhibited the proliferation of MCF-7 human breast cancer cells by inducing apoptotic cell death while having some degree of cytoselectivity on a normal human breast cell line, MCF-10A. In this study, we attempted to further elucidate the mode of action of F16. We found that the intrinsic apoptotic pathway was invoked, with the reduction of Bcl-2 protein. Then, executioner caspase-7 was cleaved and activated in response to F16 treatment. Furthermore, apoptosis in the MCF- 7 cells was accompanied by the specific proteolytic cleavage of poly(ADP-ribose) polymerase-1 (PARP-1). Surprisingly, caspase-9 and p53 were unchanged with F16 treatment. We believe that the F16-induced apoptosis in MCF-7 cells occurs independently of caspase-9 and p53. Taken together, these results suggest that F16 from E. longifolia exerts anti-proliferative action and growth inhibition on MCF-7 cells through apoptosis induction and that it may have anticancer properties.
    Matched MeSH terms: Breast Neoplasms/drug therapy*; Breast Neoplasms/enzymology; Breast Neoplasms/pathology
  17. Jayaram G, Swain M, Chew MT, Yip CH, Moosa F
    Malays J Pathol, 2000 Dec;22(2):65-71.
    PMID: 16329537
    Pure mucinous carcinoma (MC) of the breast is a relatively uncommon variant of breast carcinoma with distinctive histological and cytological features. In this study we have analysed fine needle aspiration (FNA) cytological material from 28 cases of MC of breast and correlated the cytomorphological features with histopathology. The 28 patients consisted of 27 females and one male patient. 14 patients were Chinese, 10 were Indian and four were Malay. Their ages ranged from 38 to 90 with a mean at 52 years. The left breast was involved in 17 and the right in 11 cases. The duration of the lump varied from two weeks to 10 years. The cytological picture was characterized by abundant extracellular mucin giving a "sea of mucin" or "whirlpools of mucin" effect, in which were seen floating clusters of tumour cells with relatively bland cytological features. Myxo-vascular fragments were seen in 12 cases. Dissociated tumour cells showed a plasmacytoid appearance with eccentric nuclei. In four cases, the mucin was scanty in amount and the cellularity was high while in two cases, the cellularity was very low. Psammoma bodies were seen in cytological smears in one case. Histological study of excision or mastectomy specimens confirmed all 28 cases to be pure MC. Knowledge of the distinctive cytomorphological appearance of MC would enable correct identification of these lesions as malignant and prompt treatment that could further enhance the survival of these prognostically good breast cancers.
    Matched MeSH terms: Breast Neoplasms/metabolism; Breast Neoplasms/pathology*; Breast Neoplasms/surgery
  18. Hasan TN, Shah SA, Hassan MR, Safian N, Azhar ZI, Syed Abdul Rahim SS, et al.
    Asian Pac J Cancer Prev, 2015;16(15):6669-72.
    PMID: 26434892
    BACKGROUND: Breast cancer is one of the most common cancers among females worldwide. The aim of this study was to assess the knowledge and practice about breast cancer and its related factors among women in Baghdad city, Iraq.

    MATERIALS AND METHODS: A cross-sectional study was conducted among 508 women aged 18 to 55 years from four non-governmental organizations (NGO) in Baghdad city, Iraq. A self-administered questionnaire on breast cancer knowledge and practice was distributed to participants during weekly activity of the NGO.

    RESULTS: A total of 61.2% of the respondents had poor knowledge, only 30.3% performed breast self-examination (BSE) and 41.8% said that they did not know the technique to perform BSE. Associations between knowledge and marital status and age were significant. For practice, working status, education, age and family income were significant. After controlling for cofounders, the most important contributing factors for poor knowledge among respondents were marital status and not performing BSE, with adjusted odds ratio of 1.6 and 1.8 respectively.

    CONCLUSIONS: Breast cancer knowledge and practice of BSE are poor among women in Baghdad city, Iraq. More promotion regarding breast cancer signs and symptoms and also how to perform BSE should be conducted using media such as television and internet as these constituted the main sources of information for most women in our study.

    Matched MeSH terms: Breast Neoplasms/diagnosis*; Breast Self-Examination/statistics & numerical data*
  19. Akhtari-Zavare M, Latiff LA, Juni MH, Said SM, Ismail IZ
    Asian Pac J Cancer Prev, 2015;16(15):6231-5.
    PMID: 26434821
    BACKGROUND: In Malaysia, breast cancer is the first cancer among females regardness of race.

    AIM: The purpose of this study was to identify the knowledge and BSE practice among undergraduate female students at four public universities in Klang Valley, Malaysia.

    MATERIALS AND METHODS: This cross-sectional study was conducted among 820 undergraduate female students using a self-administered questionnaire covering socio-demographic data, knowledge of breast cancer and BSE practice.

    RESULTS: The mean age of the respondents was 21.7±1.2 years. The majority of them were single (96.8%), Malay (91.9%) and 16.5% of respondents had a family history of breast cancer. This study showed low level of knowledge on breast cancer and breast self-examination among participants. Only 19.6% participants were performing BSE regularly. Knowledge of breast self-examination was significantly associated with BSE practice (p=0.00). Also, there were significant associations between performing BSE with age, marital status and being trained by a doctor for doing BSE (p<0.05).

    CONCLUSIONS: Our findings showed that the rate of BSE practice and knowledge of breast cancer is inadequate among young Malaysian females. A public health education program is essential to improve breast cancer prevention among this group.
    Matched MeSH terms: Breast Neoplasms/diagnosis*; Breast Self-Examination*
  20. Radwan EM, Abdullah R, Al-Qubaisi MS, El Zowalaty ME, Naadja SE, Alitheen NB, et al.
    Mol Med Rep, 2016 May;13(5):3945-52.
    PMID: 26987078 DOI: 10.3892/mmr.2016.4989
    Patients with cancer often exhibit signs of anemia as the result of the disease. Thus, cancer chemotherapies often include erythropoietin (EPO) in the regime to improve the survival rate of these patients. The aim of the present study was to determine the effect of EPO on doxorubicin-treated breast cancer cells. The cytotoxicity of doxorubicin alone or in combination with EPO against the MCF-7 and MDA-MB‑231 human breast cancer cells were determined using an MTT cell viability assay, neutral red (NR) uptake assay and lactate dehydrogenase (LDH) assay. The estimated half maximal inhibitory concentration values for doxorubicin and the combination of doxorubicin with EPO were between 0.140 and 0.260 µg/ml for all cells treated for 72 h. Treatment with doxorubicin in combination with EPO led to no notable difference in cytotoxicity, compared with treatment with doxorubicin alone. The antiproliferative effect of doxorubicin at a concentration of 1 µg/ml on the MDA‑MB‑231 cells was demonstrated by the decrease in viable cells from 3.6x10(5) at 24 h to 2.1x10(5) at 72 h of treatment. In order to confirm apoptosis in the doxorubicin-treated cells, the activities of caspases-3/7 and ‑9 were determined using a TBE assay. The results indicated that the activities of caspases-3/7 and ‑9 were significantly elevated in the doxorubicin-treated MDA-MB-231 cells by 571 and 645%, respectively, and in the MCF 7 cells by 471 and 345%, respectively, compared with the control cells. EPO did not modify the effect of doxorubicin on these cell lines. The results of the present study suggested that EPO was safe for use in combination with doxorubicin in the treatment of patients with breast cancer and concurrent anemia.
    Matched MeSH terms: Breast Neoplasms/drug therapy*; Breast Neoplasms/metabolism; Breast Neoplasms/pathology
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