Displaying publications 81 - 100 of 167 in total

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  1. Fulltext In vivo and in vitro studies suggest a possible involvement of HPV infection in the early stage of breast carcinogenesis via APOBEC3B induction
    Ohba K, Ichiyama K, Yajima M, Gemma N, Nikaido M, Wu Q, et al.
    PLoS One, 2014;9(5):e97787.
    PMID: 24858917 DOI: 10.1371/journal.pone.0097787
    High prevalence of infection with high-risk human papilloma virus (HPV) ranging from 25 to 100% (average 31%) was observed in breast cancer (BC) patients in Singapore using novel DNA chip technology. Early stage of BC demonstrated higher HPV positivity, and BC positive for estrogen receptor (ER) showed significantly higher HPV infection rate. This unique association of HPV with BC in vivo prompted us to investigate a possible involvement of HPV in early stages of breast carcinogenesis. Using normal breast epithelial cells stably transfected with HPV-18, we showed apparent upregulation of mRNA for the cytidine deaminase, APOBEC3B (A3B) which is reported to be a source of mutations in BC. HPV-induced A3B overexpression caused significant γH2AX focus formation, and DNA breaks which were cancelled by shRNA to HPV18 E6, E7 and A3B. These results strongly suggest an active involvement of HPV in the early stage of BC carcinogenesis via A3B induction.
    Matched MeSH terms: Breast Neoplasms/diagnosis
  2. Fulltext Closing the global cancer divide--performance of breast cancer care services in a middle income developing country
    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
  3. Diet and physical activity in relation to weight change among breast cancer patients
    Yaw YH, Shariff ZM, Kandiah M, Weay YH, Saibul N, Sariman S, et al.
    Asian Pac J Cancer Prev, 2014;15(1):39-44.
    PMID: 24528062
    BACKGROUND: This study aimed to provide an overview of lifestyle changes after breast cancer diagnosis and to examine the relationship between dietary and physical activity changes with weight changes in breast cancer patients. Women with breast carcinomas (n=368) were recruited from eight hospitals and four breast cancer support groups in peninsular Malaysia. Dietary and physical activity changes were measured from a year preceding breast cancer diagnosis to study entry. Mean duration since diagnosis was 4.86±3.46 years. Dietary changes showed that majority of the respondents had decreased their intake of high fat foods (18.8-65.5%), added fat foods (28.3-48.9%), low fat foods (46.8-80.7%), red meat (39.7%), pork and poultry (20.1-39.7%) and high sugar foods (42.1-60.9%) but increased their intake of fish (42.7%), fruits and vegetables (62.8%) and whole grains (28.5%). Intake of other food groups remained unchanged. Only a small percentage of the women (22.6%) had increased their physical activity since diagnosis where most of them (16.0%) had increased recreational activities. Age at diagnosis (β= -0.20, p= 0.001), and change in whole grain (β= -0.15, p= 0.003) and fish intakes (β= 0.13, p= 0.013) were associated with weight changes after breast cancer diagnosis. In summary, the majority of the women with breast cancer had changed their diets to a healthier one. However, many did not increase their physical activity levels which could improve their health and lower risk of breast cancer recurrence.
    Matched MeSH terms: Breast Neoplasms/diagnosis
  4. Improved diagnostic accuracy in differentiating malignant and benign lesions using single-voxel proton MRS of the breast at 3 T MRI
    Suppiah S, Rahmat K, Mohd-Shah MN, Azlan CA, Tan LK, Aziz YF, et al.
    Clin Radiol, 2013 Sep;68(9):e502-10.
    PMID: 23706826 DOI: 10.1016/j.crad.2013.04.002
    To investigate the diagnostic accuracy of single-voxel proton magnetic resonance spectroscopy (SV (1)H MRS) by quantifying total choline-containing compounds (tCho) in differentiating malignant from benign lesions, and subsequently, to analyse the relationship of tCho levels in malignant breast lesions with their histopathological subtypes.
    Matched MeSH terms: Breast Neoplasms/diagnosis*
  5. Fulltext Primary extraskeletal Ewing's sarcoma/primitive neuroectodermal tumour of breast
    Ikhwan SM, Kenneth VK, Seoparjoo A, Zin AA
    BMJ Case Rep, 2013 Jun 21;2013.
    PMID: 23813511 DOI: 10.1136/bcr-2013-009584
    Primary primitive neuroectodermal tumour (PNET) and extraskeletal Ewing's sarcoma belongs to the Ewing's family of tumours. Primary tumours arising from breast are very rare. There are only a few case reports published on primary extraskeletal Ewing's sarcoma and PNET arising from breast. We present an extremely rare case of an inoperable primary Ewing's sarcoma arising from left breast with contralateral breast, lymphatic and lung metastasis.
    Matched MeSH terms: Breast Neoplasms/diagnosis*
  6. Fulltext Breast cancer research in Asia: adopt or adapt Western knowledge?
    Bhoo-Pathy N, Yip CH, Hartman M, Uiterwaal CS, Devi BC, Peeters PH, et al.
    Eur J Cancer, 2013 Feb;49(3):703-9.
    PMID: 23040889 DOI: 10.1016/j.ejca.2012.09.014
    The incidence and mortality of breast cancer continues to rise rapidly in Asian countries. However, most of our current knowledge on breast cancer has been generated in Western populations. As the socio-economic profile, life style and culture of Asian and Western women are substantially different, and genetic backgrounds vary to some extent, we need to answer the question on whether to 'adopt' or 'adapt' Western knowledge before applying it in the Asian setting. It is generally accepted that breast cancer risk factors, which have mainly been studied in Western populations are similar worldwide. However, the presence of gene-environment or gene-gene interactions may alter their importance as causal factors across populations. Diagnostic and prognostic study findings, including breast cancer prediction rules, are increasingly shown to be 'setting specific' and must therefore be validated in Asian women before implementing them in clinical care in Asia. Interventional research findings from Caucasian patients may not be applicable in patients in Asia due to differences in tumour biology/profiles, metabolism of drugs and also health beliefs which can influence treatment acceptance and adherence. While breast cancer research in Asia is warranted in all domains of medical research, it is felt that for Asian breast cancer patients, needs are highest for diagnostic and prognostic studies. International clinical trials meanwhile need to include breast cancer patients from various Asian settings to provide an insight into the effectiveness of new treatment modalities in this part of the world.
    Matched MeSH terms: Breast Neoplasms/diagnosis
  7. Fulltext Breast cancer awareness of rural women in Malaysia: is it the same as in the cities?
    Norlaili AA, Fatihah MA, Daliana NF, Maznah D
    Asian Pac J Cancer Prev, 2013;14(12):7161-4.
    PMID: 24460269
    Breast cancer is the most common cancer among women globally. This study was conducted to compare the awareness of breast cancer and the practice of breast self-examination (BSE), clinical breast examination (CBE) and mammography screening among rural females in Pahang and Perak. A cross-sectional study was carried out in five selected rural districts of Pahang and Perak. Two hundred and fifty households were randomly selected and interviewed face to face using a semi-structured questionnaire. The majority of residents from both states were Malay, aged between 50 and 60 years and had a secondary level of education. Malay women aged 40-49 years and women with a higher level of education were significantly more aware of breast cancer (p<0.05). About half of these women practiced BSE (60.7%) and CBE (56.1%), and 7% had underwent mammography screening. The results of this study suggest that women in Pahang and Perak have good awareness of breast cancer and that more than half practice BSE and CBE. The women's level of education appears to contribute to their level of knowledge and health behaviour. However, more effort is needed to encourage all women in rural areas to acquire further knowledge on breast cancer.
    Matched MeSH terms: Breast Neoplasms/diagnosis*
  8. Fulltext The decision-making journey of Malaysian women with early breast cancer: a qualitative study
    Abdullah A, Abdullah KL, Yip CH, Teo SH, Taib NA, Ng CJ
    Asian Pac J Cancer Prev, 2013;14(12):7143-7.
    PMID: 24460266
    BACKGROUND: The survival outcomes for women presenting with early breast cancer are influenced by treatment decisions. In Malaysia, survival outcome is generally poor due to late presentation. Of those who present early, many refuse treatment for complementary therapy.
    OBJECTIVE: This study aimed to explore the decision making experiences of women with early breast cancer.
    MATERIALS AND METHODS: A qualitative study using individual in-depth interviews was conducted to capture the decision making process of women with early breast cancer in Malaysia. We used purposive sampling to recruit women yet to undergo surgical treatment. A total of eight participants consented and were interviewed using a semi-structured interview guide. These women were recruited from a period of one week after they were informed of their diagnoses. A topic guide, based on the Ottawa decision support framework (ODSF), was used to facilitate the interviews, which were audio recorded, transcribed and analysed using a thematic approach.
    RESULTS: We identified four phases in the decision-making process of women with early breast cancer: discovery (pre-diagnosis); confirmatory ('receiving bad news'); deliberation; and decision (making a decision). These phases ranged from when women first discovered abnormalities in their breasts to them making final surgical treatment decisions. Information was vital in guiding these women. Support from family members, friends, healthcare professionals as well as survivors also has an influencing role. However, the final say on treatment decision was from themselves.
    CONCLUSIONS: The treatment decision for women with early breast cancer in Malaysia is a result of information they gather on their decision making journey. This journey starts with diagnosis. The women's spouses, friends, family members and healthcare professionals play different roles as information providers and supporters at different stages of treatment decisions. However, the final treatment decision is influenced mainly by women's own experiences, knowledge and understanding.
    Study site: Breast surgical units, Klang Valley, Malaysia
    Matched MeSH terms: Breast Neoplasms/diagnosis
  9. Fulltext Breast cancer knowledge and screening behaviour among women with a positive family history: a cross sectional study
    Subramanian P, Oranye NO, Masri AM, Taib NA, Ahmad N
    Asian Pac J Cancer Prev, 2013;14(11):6783-90.
    PMID: 24377606
    BACKGROUND: Breast cancer is the commonest type of cancer among women, and in Malaysia 50-60% of the new cases are being detected at late stages. Do age, education level, income, ethnicity, relationship with breast cancer patients and knowledge of breast cancer risk factors influence breast screening practices? This study revealed interesting but significant differences.

    OBJECTIVES: To assess the knowledge of breast cancer risk factors and early detection measures among women in a high risk group.

    MATERIALS AND METHODS: A cross sectional survey of one hundred and thirty one women relatives of breast cancer patients was carried out. Participants were selected through purposive sampling, during hospital visits. A self-administered questionnaire was used for data collection.

    RESULTS: The majority of the respondents (71%) had poor knowledge of the risk factors for breast cancer. Income, relationship with a patient and practise of breast cancer screening predicted performance of mammography, R2=0.467, F=12.568, p<0.0001.

    CONCLUSIONS: The finding shows inadequate knowledge of breast cancer risk factors and poor cancer screening practise among women with family history of breast cancer. Poor knowledge and practise of breast screening are likely to lead to late stage presentation of breast cancer disease. Some important predictors of breast cancer screening behaviour among women with positive family history of breast cancer were identified. An understanding of the strengths and significance of the association between these factors and breast screening behaviour is vital for developing more targeted breast health promotion.
    Matched MeSH terms: Breast Neoplasms/diagnosis
  10. Fulltext Changes following nipple areolar complex reconstruction and tattooing resembling a recurrent Paget's disease of the breast
    Hanafiah M, Alhabshi SM, Mahin AH
    BMJ Case Rep, 2013;2013.
    PMID: 24165504 DOI: 10.1136/bcr-2013-201281
    Matched MeSH terms: Breast Neoplasms/diagnosis
  11. Application of health behavior theories to breast cancer screening among Asian women
    Ahmadian M, Samah AA
    Asian Pac J Cancer Prev, 2013;14(7):4005-13.
    PMID: 23991945
    BACKGROUND: Although breast cancer is a major public health worry among Asian women, adherence to screening for the disease remains an obstacle to its prevention. A variety of psycho-social and cultural factors predispose women to delay or avoidance of screening for breast cancer symptoms at the early stages when cure is most likely to be successful. Yet few interventions implemented to date to address this condition in this region have drawn on health behavior theory.

    MATERIALS AND METHODS: This paper reviews the existing literature on several cognitive theories and models associated with breast cancer screening, with an emphasis on the work that has been done in relation to Asian women. To conduct this review, a number of electronic databases were searched with context-appropriate inclusion criteria.

    RESULTS: Little empirical work was found that specifically addressed the applicability of health theories in promoting adherence to the current breast cancer prevention programs Among Asian women. However, a few studies were found that addressed individual cognitive factors that are likely to encourage women's motivation to protect themselves against breast cancer in this region of the world. The findings suggest that multi-level, socio-cultural interventions that focus on cognitive factors have much promise with this issue.

    CONCLUSIONS: Interventions are needed that effectively and efficiently target the personal motivation of at-risk Asian women to seek out and engage in breast cancer prevention. Concerning implications, personal motivation to seek out and engage in individual preventive actions for breast cancer prevention among Asian women is a timely, high priority target with practical implications for community development and health promotion. Further studies using qualitative, anthropologic approaches shaped for implementation in multi-ethnic Asian settings are needed to inform and guide these interventions.

    Matched MeSH terms: Breast Neoplasms/diagnosis*
  12. Non-practice of breast self examination and marital status are associated with delayed presentation with breast cancer
    Ghazali SM, Othman Z, Cheong KC, Hock LK, Wan Mahiyuddin WR, Kamaluddin MA, et al.
    Asian Pac J Cancer Prev, 2013;14(2):1141-5.
    PMID: 23621202
    Delay in seeking treatment for breast cancer is a barrier to the early diagnosis and management of the disease, resulting in a poorer prognosis. We here estimated the prevalence of delayed presentation for breast cancer and identified possible influential sociodemographic factors in a cross-sectional study of 250 patients diagnosed with primary breast cancer at the Radiotherapy and Oncology Clinic in Kuala Lumpur Hospital. Data were collected by face-to-face interview using a structured questionnaire and from medical records. We examined associations between delayed presentation (presenting to a physician more than 3 months after self-discovery of a symptom) and sociodemographic characteristics, practice of breast self examination (BSE), history of benign breast disease, family history of breast cancer and type of symptom, symptom disclosure and advice from others to seek treatment using multiple logistic regression. Time from self-discovery of symptom to presentation ranged from tghe same day to 5 years. Prevalence of delayed presentation was 33.1% (95%CI: 27.4, 39.3). A significantly higher proportion of delayers presented with late stages (stage III/IV) (58.3% vs. 26.9%, p<0.001). Divorced or widowed women (OR: 2.23, 95% CI: 1.11, 4.47) had a higher risk of delayed presentation than married women and women who never performed breast self examination were more likely to delay presentation compared to those who regularly performed BSE (OR: 2.74, 95% CI: 1.33, 5.64). Our findings indicate that delayed presentation for breast cancer symptoms among Malaysian women is high and that marital status and breast self examination play major roles in treatment-seeking for breast cancer symptoms.
    Matched MeSH terms: Breast Neoplasms/diagnosis*
  13. Fulltext Beliefs and behavior of Malaysia undergraduate female students in a public university toward breast self-examination practice
    Akhtari-Zavare M, Juni MH, Said SM, Ismail IZ
    Asian Pac J Cancer Prev, 2013;14(1):57-61.
    PMID: 23534796
    BACKGROUND: Breast cancer is the most common cancer and the second principal cause of cancer deaths among women worldwide, including Malaysia.

    METHODS: A cross-sectional study was carried out among 262 female undergraduate students in University Putra Malaysia using a validated questionnaire which was developed for this study.

    RESULTS: The mean age of respondents was 22∓2.3 years. Most of them were single (83.1%), Malay (42.3%) and 20.7% reported having a family history of breast cancer. Eighty-seven (36.7%) claimed they had practiced BSE. Motivation and self-efficacy of the respondents who performed BSE were significantly higher compared with women who did not (p<0.05).There was no association between BSE practice and demographic details (p<0.05). Logistic regression analysis indicated that women who perceived greater motivation (OR=1.089, 95%CI: 1.016-1.168) and had higher confidence of BSE (OR=1.076, 95%CI: 1.028-1.126) were more likely to perform the screening.

    CONCLUSIONS: The findings show that Malaysian young female's perception regarding breast cancer and the practice of BSE is low. Targeted education should be implemented to improve early detection of breast cancer.
    Matched MeSH terms: Breast Neoplasms/diagnosis*
  14. Dietary changes among breast cancer patients in Malaysia
    Shaharudin SH, Sulaiman S, Shahril MR, Emran NA, Akmal SN
    Cancer Nurs, 2013 Mar-Apr;36(2):131-8.
    PMID: 22293157 DOI: 10.1097/NCC.0b013e31824062d1
    BACKGROUND: Breast cancer patients often show an interest in making dietary changes after diagnosis of breast cancer to improve their health condition and prevent cancer recurrence.
    OBJECTIVE: The objective of the study was to determine changes in dietary intake 2 years after diagnosis among breast cancer patients.
    METHODS: One hundred sixteen subjects were asked to complete a semiquantitative food frequency questionnaire, diet recalls, and dietary changes questionnaire to assess dietary intake before and after diagnosis. The information on sociodemographic background, cancer treatment history, and anthropometric indices was also collected.
    RESULTS: Seventy-two subjects considered diet as a contributing factor to breast cancer, and 67 subjects changed their dietary habits after breast cancer diagnosis. The reasons for changes in diet were physician and dietitian advice and desire to cure cancer. The sources of information were derived from their physician, mass media, and family members. Total energy, protein, total fat, fatty acids, and vitamin E intake were significantly decreased after diagnosis. Meanwhile, the intake of β-carotene and vitamin C increased significantly after diagnosis. The changes included reduction in red meat, seafood, noodles, and poultry intake. An increased consumption of fruits, vegetables, fish, low-fat milk, and soy products was observed. The subjects tended to lower high-fat foods intake and started to eat more fruits and vegetables.
    CONCLUSION: Breast cancer patients had changed to a healthier diet after breast cancer diagnosis, although the changes made were small.
    IMPLICATIONS FOR PRACTICE: This will be helpful to dietitians in providing a better understanding of good eating habits that will maintain patients' health after breast cancer diagnosis.
    Matched MeSH terms: Breast Neoplasms/diagnosis
  15. Breast screening and health issues among rural females in Malaysia: how much do they know and practice?
    Dahlui M, Gan DE, Taib NA, Lim JN
    Prev Med, 2013;57 Suppl:S18-20.
    PMID: 23276776 DOI: 10.1016/j.ypmed.2012.12.010
    OBJECTIVE:
    This study investigated rural women's knowledge of breast cancer and screening methods by ethnicity and examined the predictors of breast screening methods.

    METHODS:
    A cross-sectional survey was conducted in 2011 in five rural districts of Perak; 959 women were interviewed using a semi-structured questionnaire. ANOVA and regression analysis were used in data analysis.

    RESULTS:
    Women below 50 years old, of Malay ethnicity and who had secondary education scored better than those older, of Chinese ethnicity and had primary education (p<0.001). The uptake of breast self-examination (BSE), clinical breast examination (CBE) and mammogram was 59%, 51% and 6.8%, respectively. Multivariate analysis revealed knowledge of breast cancer and CBE as top predictors of BSE, being married and knowledge of breast cancer as top predictors for CBE; and CBE as the top predictor of mammography uptake. Support from husbands and family members for breast cancer screening was a predictor for CBE and BSE.

    CONCLUSION:
    Knowledge of breast cancer and its screening uptake varies by ethnicity, location and the type of support received. Efforts and approaches to improve the women's knowledge of breast cancer and its screening uptake therefore should be customized to address the different influencing factors.
    Matched MeSH terms: Breast Neoplasms/diagnosis
  16. Challenges in the management of breast cancer in low- and middle-income countries
    Yip CH, Taib NA
    Future Oncol, 2012 Dec;8(12):1575-83.
    PMID: 23231519 DOI: 10.2217/fon.12.141
    The incidence of breast cancer is rising in low- and middle-income countries (LMICs) due to 'westernization' of risk factors for developing breast cancer. However, survival remains low because of barriers in early detection and optimal access to treatment, which are the two main determinants of breast cancer outcome. A multidisciplinary approach to treatment gives the best results. An accurate diagnosis is dependent on a reliable pathology service, which will provide an adequate pathology report with prognostic and predictor information to allow optimal oncological treatment. Stratification of clinical practice guidelines based on resource level will ensure that women will have access to treatment even in a low-resource setting. Advocacy and civil society play a role in galvanizing the political will required to meet the challenge of providing opportunities for breast cancer control in LMICs. Collaboration between high-income countries and LMICs could be a strategy in facing these challenges.
    Matched MeSH terms: Breast Neoplasms/diagnosis*
  17. Fulltext Synchronous unilateral infiltrating ductal and lobular breast carcinoma
    Kaur S, Rahmat K, Chandran PA, Alli K, Aziz YF
    Singapore Med J, 2012 Nov;53(11):e240-3.
    PMID: 23192514
    The incidence of synchronous bilateral infiltrating breast cancer has been reported to be 2%. However, synchronous unilateral infiltrating ductal carcinoma and infiltrating lobular carcinoma (ILC) are very rarely reported. We present a woman with palpable ILC who was later found to have synchronous well-circumscribed ductal carcinoma on further imaging. We also discuss the use of diagnostic approaches such as ultrasonography, mammography and histopathology. This case highlights the importance of careful assessment of concurrent lesions in the breast in the presence of an existing carcinoma.
    Matched MeSH terms: Breast Neoplasms/diagnosis*
  18. Fulltext Gradually implemented new biomarkers for prognostication of breast cancer: complete case analysis may introduce bias
    Bhoo Pathy N, Uiterwaal CS, Taib NA, Verkooijen HM, Yip CH
    J Clin Epidemiol, 2012 May;65(5):568-71.
    PMID: 22269329 DOI: 10.1016/j.jclinepi.2011.09.013
    Many recent studies investigated the prognostic value of new biomarkers in breast cancer using data from cancer registries. Some of these studies were conducted using only patients for whom biomarker status was available (or tested). Using human epidermal growth factor receptor 2 (HER2) as an example, we determined whether testing for a recently introduced biomarker was associated with the outcome of women with breast cancer.
    Matched MeSH terms: Breast Neoplasms/diagnosis*
  19. Standardisation of clinical breast-density measurement
    Ng KH, Yip CH, Taib NA
    Lancet Oncol, 2012 Apr;13(4):334-6.
    PMID: 22469115 DOI: 10.1016/S1470-2045(12)70093-1
    Matched MeSH terms: Breast Neoplasms/diagnosis*
  20. Fulltext Psychometric properties of the Malay version of the Breast Module (BR23)
    Yusoff N, Low WY, Yip CH
    Singapore Med J, 2012 Jan;53(1):36-9.
    PMID: 22252181
    The Breast Module (BR23) is increasingly being used worldwide in breast cancer research. This study evaluates the appropriateness of the translated version (i.e. BR23-Malay version) as a useful tool for the Malaysian population who could understand Malay, and examines the reliability and validity of the BR23-Malay version.
    Matched MeSH terms: Breast Neoplasms/diagnosis*
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