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Fulltext Association between Healthy Eating Index-2015 and Breast Cancer Risk: A Case-Control Study

Kord-Varkaneh H, Salehi-Sahlabadi A, Zarezade M, Rahmani J, Tan SC, Hekmatdoost A, et al.

Asian Pac J Cancer Prev, 2020 05 01;21(5):1363-1367.
PMID: 32458645 DOI: 10.31557/APJCP.2020.21.5.1363

OBJECTIVE: Diet quality is known to influence cancer risk. The Healthy Eating Index (HEI) is one of the most frequently used measures of diet quality. However, the association between HEI-2015 and breast cancer risk is not known. The present study was undertaken to evaluate the association between HEI-2015 and breast cancer risk.
METHODS: A case-control study comprising 134 breast cancer patients and 265 cancer-free controls were conducted. Dietary intakes were assessed using a validated food frequency questionnaire (FFQ), from which the HEI-2015 score was calculated. Logistic regression was used to derive the odds ratios (ORs) for measuring the association between HEI-2015 scores and breast cancer risk.
RESULTS: Subjects in the top quartile of HEI-2015 had a 46% lower chance of breast cancer compared with subjects in the bottom quartile (OR 0.54; 95% CI 0.30, 0.98). After adjustment for potential confounders such as age, age at menarche, oral contraceptive drug use, menopausal status, marital status, body mass index, smoking and education level, the association between HEI-2015 score and a lower risk of breast cancer was enhanced (OR 0.32; 95% CI 0.16, 0.65).
CONCLUSION: We successfully demonstrated that a higher HEI-2015 score was associated with a reduced breast cancer risk.

Matched MeSH terms: Breast Neoplasms/diet therapy; Breast Neoplasms/pathology; Breast Neoplasms/prevention & control*
Fulltext Clinical Practice Guideline: Management of Breast Cancer, Third Edition

Citation:
Clinical Practice Guidelines: Management of Breast Cancer, Third Edition. Putrajaya: Ministry of Health, Malaysia; 2019
Quick reference: http://www.acadmed.org.my/view_file.cfm?fileid=462
Training manual: http://www.acadmed.org.my/view_file.cfm?fileid=410
Patient information leaflet: http://www.acadmed.org.my/view_file.cfm?fileid=549

Older versions: Second Edition (2010); First Edition (2002)
Keywords: CPG

Matched MeSH terms: Breast Neoplasms
Fulltext The Unique Biology behind the Early Onset of Breast Cancer

Siddig A, Tengku Din TADA, Mohd Nafi SN, Yahya MM, Sulong S, Wan Abdul Rahman WF

Genes (Basel), 2021 03 05;12(3).
PMID: 33807872 DOI: 10.3390/genes12030372

Breast cancer commonly affects women of older age; however, in developing countries, up to 20% of breast cancer cases present in young women (younger than 40 years as defined by oncology literature). Breast cancer in young women is often defined to be aggressive in nature, usually of high histological grade at the time of diagnosis and negative for endocrine receptors with poor overall survival rate. Several researchers have attributed this aggressive nature to a hidden unique biology. However, findings in this aspect remain controversial. Thus, in this article, we aimed to review published work addressing somatic mutations, chromosome copy number variants, single nucleotide polymorphisms, differential gene expression, microRNAs and gene methylation profile of early-onset breast cancer, as well as its altered pathways resulting from those aberrations. Distinct biology behind early-onset of breast cancer was clear among estrogen receptor-positive and sporadic cases. However, further research is needed to determine and validate specific novel markers, which may help in customizing therapy for this group of patients.

Matched MeSH terms: Breast Neoplasms/genetics; Breast Neoplasms/mortality*; Breast Neoplasms/pathology*
Mitotic nuclei analysis in breast cancer histopathology images using deep ensemble classifier

Sohail A, Khan A, Nisar H, Tabassum S, Zameer A

Med Image Anal, 2021 08;72:102121.
PMID: 34139665 DOI: 10.1016/j.media.2021.102121

Mitotic nuclei estimation in breast tumour samples has a prognostic significance in analysing tumour aggressiveness and grading system. The automated assessment of mitotic nuclei is challenging because of their high similarity with non-mitotic nuclei and heteromorphic appearance. In this work, we have proposed a new Deep Convolutional Neural Network (CNN) based Heterogeneous Ensemble technique "DHE-Mit-Classifier" for analysis of mitotic nuclei in breast histopathology images. The proposed technique in the first step detects candidate mitotic patches from the histopathological biopsy regions, whereas, in the second step, these patches are classified into mitotic and non-mitotic nuclei using the proposed DHE-Mit-Classifier. For the development of a heterogeneous ensemble, five different deep CNNs are designed and used as base-classifiers. These deep CNNs have varying architectural designs to capture the structural, textural, and morphological properties of the mitotic nuclei. The developed base-classifiers exploit different ideas, including (i) region homogeneity and feature invariance, (ii) asymmetric split-transform-merge, (iii) dilated convolution based multi-scale transformation, (iv) spatial and channel attention, and (v) residual learning. Multi-layer-perceptron is used as a meta-classifier to develop a robust and accurate classifier for providing the final decision. The performance of the proposed ensemble "DHE-Mit-Classifier" is evaluated against state-of-the-art CNNs. The performance evaluation on the test set suggests the superiority of the proposed ensemble with an F-score (0.77), recall (0.71), precision (0.83), and area under the precision-recall curve (0.80). The good generalisation of the proposed ensemble with a considerably high F-score and precision suggests its potential use in the development of an assistance tool for pathologists.

Matched MeSH terms: Breast
Fulltext The PCA and LDA analysis on the differential expression of proteins in breast cancer

Liang S, Singh M, Dharmaraj S, Gam LH

Dis Markers, 2010;29(5):231-42.
PMID: 21206008 DOI: 10.3233/DMA-2010-0753

Breast cancer is a leading cause of mortality in women. In Malaysia, it is the most common cancer to affect women. The most common form of breast cancer is infiltrating ductal carcinoma (IDC). A proteomic approach was undertaken to identify protein profile changes between cancerous and normal breast tissues from 18 patients. Two protein extracts; aqueous soluble and membrane associated protein extracts were studied. Thirty four differentially expressed proteins were identified. The intensities of the proteins were used as variables in PCA and reduced data of six principal components (PC) were subjected to LDA in order to evaluate the potential of these proteins as collective biomarkers for breast cancer. The protein intensities of SEC13-like 1 (isoform b) and calreticulin contributed the most to the first PC while the protein intensities of fibrinogen beta chain precursor and ATP synthase D chain contributed the most to the second PC. Transthyretin precursor and apolipoprotein A-1 precursor contributed the most to the third PC. The results of LDA indicated good classification of samples into normal and cancerous types when the first 6 PCs were used as the variables. The percentage of correct classification was 91.7% for the originally grouped tissue samples and 88.9% for cross-validated samples.

Matched MeSH terms: Breast Neoplasms/metabolism*; Carcinoma, Ductal, Breast/metabolism*
Impact of chemotherapy schedule modification on breast cancer patients: a single-centre retrospective study

Gunasekaran GH, Hassali MABA, Sabri WMABW, Rahman MTB

Int J Clin Pharm, 2020 Apr;42(2):642-651.
PMID: 32185605 DOI: 10.1007/s11096-020-01011-6

Background Nonconformity to chemotherapy schedules is common in clinical practice. Multiple clinical studies have established the negative prognostic impact of dose delay on survival outcome. Objective This study investigated the prevalence and reason for chemotherapy schedule modifications of breast cancer patients. This study also investigated the impact of schedule modifications on overall survival (OS). Setting This retrospective cohort study was done among breast cancer patient receiving chemotherapy from 2013 to 2017 and patients were followed until 31 Dec 2018. Methods Medical records of patients with cancer were reviewed. Female patients over eighteen years old were included, with primary carcinoma of the breast, who received anthracycline or taxane based chemotherapy regime and completed more than two cycles of chemotherapy. Patients were categorized into three groups of (1) no schedule modification, (2) with schedule modification and (3) incomplete schedule. The Kaplan-Meier was used to test for survival differences in the univariate setting and Cox regression model was used in the multivariate setting. Main outcome measure Prevalence, overall survival rates and hazard ratio of three schedule group Results Among 171 patient who were included in the final analysis, 28 (16.4%) had no schedule modification, 118 (69.0%) with schedule modification and 25 (14.6%) had incomplete schedule with OS of 75.0%, 59.3% and 52.0% respectively. 94% (189) of all cycle rescheduling happened because of constitutional symptoms (70), for non-medical reasons (61) and blood/bone marrow toxicity (58). When compared to patients with no schedule modification, patients with schedule modification had a 2.34-times higher risk of death (HR 2.34, 95% CI 1.03-5.32; p = 0.043). Conclusion Nonconformity to the chemotherapy schedule is common in clinical practice because of treatment complications, patients' social schedule conflicts, and facility administrative reasons. Cumulative delays of ≥ 14 days are likely to have negative prognostic effect on patient survival. Thus, the duration of the delays between cycles should be reduced whenever possible to achieve the maximum chemotherapeutic benefit.

Matched MeSH terms: Breast Neoplasms/diagnosis; Breast Neoplasms/drug therapy*; Breast Neoplasms/mortality*
Clinical Study on Plant Galactagogue Worldwide in Promoting Women's Lactation: a Scoping Review

Kwan SH, Abdul-Rahman PS

Plant Foods Hum Nutr, 2021 Sep;76(3):257-269.
PMID: 34292494 DOI: 10.1007/s11130-021-00901-y

Human milk is recommended by the World Health Organization (WHO) for the general well-being of infants. However, many mothers face an insufficient milk supply to breastfeed their children. Galactagogue, in particular, plant galactagogue, serves as a method to promote lactation. This in-depth review examines the evidence supporting different plants' galactagogic activity through clinical studies around the globe. A scoping review approach was adopted to establish the research questions, and define the findings, selection and analysis of the study. This scoping review highlights and compiles the clinical research performed globally involving plant galactagogue to better inform the medical practitioners, lactation consultants, nursing mothers, communities and relevant personnel on practicing, guidelines, policymaking and research. In general, a total of 1041 research publications were retrieved from different global bibliographic databases, of which only 13 articles were retained for analysis after applying the exclusion criteria. A total of 14 types of plants have undergone clinical studies in the past decade to verify their galactagogic activity. All but two showed a positive effect on promoting milk production. There were 42 articles categorised as excluded studies. The category includes review articles, surveys, case reports, introductory articles of regional plant galactagogue and preclinical studies, which involves animal testing and the studies exploring other issues related to plant galactagogue. The findings demonstrate that there is a significant research gap on the plant galactagogue using clinical studies. More clinical research is necessary to identify and verify the efficacy of various types of plant galactagogue for the benefit of humankind.

Matched MeSH terms: Breast Feeding
Fulltext A comparison of breast cancer survival across different age groups: a multicentric database study in Penang, Malaysia

Tan KF, Adam F, Hussin H, Mohd Mujar NM

Epidemiol Health, 2021;43:e2021038.
PMID: 34044478 DOI: 10.4178/epih.e2021038

This study compared breast cancer survival and the prognostic factors across different age groups of women in Penang, Malaysia. Data on 2,166 women with breast cancer who had been diagnosed between 2010 and 2014 were extracted from the Penang Breast Cancer Registry and stratified into 3 age groups: young (< 40 years old), middle-aged (40-59 years old), and elderly (≥ 60 years). The overall and relative survival rates were calculated using the life table method, median survival time was calculated using the Kaplan-Meier method, and comparisons between groups were conducted using the log-rank test. Prognostic factors were analyzed using a Cox proportional hazards model. The 5-year overall and breast cancer-specific survival rates for women with breast cancer in Penang were 72.9% and 75.2%, with a mean survival time of 92.5 months and 95.1 months, respectively. The 5-year breast cancer-specific survival rates for young, middle-aged, and elderly women were 74.9%, 77.8%, and 71.4%, respectively, with a mean survival time of 95.7 months, 97.5 months, and 91.2 months. There was a significant difference in breast cancer survival between age groups, with elderly women showing the lowest survival rate, followed by young and middle-aged women. Disease stage was the most prominent prognostic factor for all age groups. Survival rates and prognostic factors differed according to age group. Treatment planning for breast cancer patients should be age-specific to promote better cancer care and survival.

Matched MeSH terms: Breast Neoplasms/mortality*; Breast Neoplasms/pathology; Breast Neoplasms/therapy*
The Immunomodulatory Potential of Selected Bioactive Plant-Based Compounds in Breast Cancer: A Review

Baraya YS, Wong KK, Yaacob NS

Anticancer Agents Med Chem, 2017;17(6):770-783.
PMID: 27539316 DOI: 10.2174/1871520616666160817111242

Breast cancer has continued to cause high cancer death rates among women worldwide. The use of plants' natural products in breast cancer treatment has received more attention in recent years due to their potentially wider safety margin and the potential to complement conventional chemotherapeutic drugs. Plantbased products have demonstrated anticancer potential through different biological pathways including modulation of the immune system. Immunomodulatory properties of medicinal plants have been shown to mitigate breast cancer cell growth. Different immune cell types participate in this process especially cytotoxic T cells and natural killer cells, and cytokines including chemokines and tumor necrosis factor-α. Medicinal plants such as Glycyrrhiza glabra, Uncaria tomentosa, Camellia sinensis, Panax ginseng, Prunus armenaica (apricot), Allium sativum, Arctium lappa and Curcuma longa were reported to hold strong potential in breast cancer treatment in various parts of the world. Interestingly, research findings have shown that these plants possess bioactive immunomodulators as their main constituents producing the anticancer effects. These immunomodulatory compounds include ajoene, arctigenin, β-carotene, curcumin, epigallocatechin-3-gallate, ginsan, glabridin and quinic acid. In this review, we discussed the ability of these eight immunomodulators in regulating the immune system potentially applicable in breast cancer treatment via anti-inflammatory (curcumin, arctigenin, glabridin and ajoene) and lymphocytes activation (β-carotene, epigallocatechin-3-gallate, quinic acid and ginsan) properties, as well as future research direction in their use for breast cancer treatment.

Matched MeSH terms: Breast Neoplasms/drug therapy*; Breast Neoplasms/immunology; Breast Neoplasms/pathology
Palliation and breast cancer

Yip CH

J Surg Oncol, 2017 Apr;115(5):538-543.
PMID: 28097656 DOI: 10.1002/jso.24560

Metastatic breast cancer is an incurable disease. With improvement in systemic therapy, survival has improved over the past few years. Removing the primary tumor has shown improved survival in retrospective studies, but this may be due to selection bias. The first reported randomized controlled trial (RCT) from India showed no difference in survival with surgery. However another RCT from Turkey showed that a select group of patient with bone-only metastases have a survival benefit.

Matched MeSH terms: Breast Neoplasms/mortality; Breast Neoplasms/pathology*; Breast Neoplasms/surgery*
Fulltext Image quality of two full field digital mammography using a female breast phantom

Chelliah, Kanaga Kumari, Ang, Wee Chin, Abd Aziz Tajuddin, Arasaratnam, Shantini A., Suraya Aziz, Laila Suryani Elias

Jurnal Sains Kesihatan Malaysia, 2009;7(1):65-72.
MyJurnal

Digital mammography has been progressively introduced in screening centers and the concern is to achieve an image of diagnostic value which would be able to detect early changes in the breast tissue. The aim of this study was to evaluate the image quality of mammograms using quantitative and qualitative methods of two FFDM systems with variations in breast thickness and anode/filter combination. This study was done from January to April 2008 with two FFDM systems; Siemens Mammomat NovationDR at Diagnostic Imaging Department, Hospital Kuala Lumpur and Hologic Lorad Selenia at Breast Clinic, National Cancer Society. A CIRS012A tissue equivalent breast phantom (4, 5 and 6 cm) thickness was used to obtain images in the craniocaudal plane with 26-32 kVp and a combination of molybdenum/molybdenum (Mo/Mo) and molybdenum/rhodium (Mo/Rh) anode/filter. For the qualitative evaluation, two independent radiologist with a minimum of five years experience was used to score the images. Wilcoxon Sign Rank Test showed that there are no significant differences (p > 0.05) in image quality between both the FFDM systems. Kappa analysis had a poor agreement between the scores given by the two radiologists. The quantitative analysis using Mann-Whitney test showed that there are significant differences (p < 0.05) between the SNR values of both FFDM systems. Although the qualitative evaluation was similar, the study showed that Lorad Selenia had a significantly superior SNR value, hence would be a better tool to detect early changes in the breast tissue. This study also demonstrated that a lower kVp is more suitable with molybdenum filter and as the breast thickness is increased rhodium filter with higher kVp displayed better quality images.

Matched MeSH terms: Breast
Fulltext Uncommon presentation of a common aesthetic procedure: late infection of a ruptured silicone breast implant

Kosai, N.R., Aznan, M., Taher, M.M., Reynu, R.

Medicine & Health, 2014;9(1):85-88.
MyJurnal

Breast augmentation using silicone implant is a common and popular aesthetic procedure with a high safety profile. Infection of silicone breast implants is a rare clinical entity, with skin commensal organisms often implicated as causative pathogen. Surgical treatment often involves removal of the implant with salvage procedures limited to selected cases. This case highlights a delayed presentation of an infected silicone breast implant presenting as a chest wall abscess 15 years after initial surgery.

Matched MeSH terms: Breast Implants
Fulltext A study on the morphometric asymmetry of atlas vertebrae

Shahrun Niza AS, Nani Harlina ML, Razrim R, Ussof Eskaandar MH, Rohaizak M

Journal of Surgical Academia, 2016;6(1):25-31.
MyJurnal

A surgeon’s experience plays an important role in breast conserving surgery (BCS). The common conception is that, the more junior is the operating surgeon, the surgical margin will be wider or closer to the tumour edge. Thus the aim of this study is to look into the adequacy of surgical margin performed by different level of surgeons’ experience in patients whom underwent wide local excision (WLE) and hook-wire localization (HWL) in our surgical unit. The surgical experience of the operating surgeon and their surgical margins will be analyzed. This is a retrospective study from January 2000 to December 2012. Eighty-eight patients with early breast cancer underwent WLE and HWL by 3 different groups of surgeons (breast surgeons, junior surgeons and surgical registrars) were included. The surgical margins were analyzed for involved-margin, closed-margin or excessed-margin.The incidence of involved-margin, closed-margin and excessed-margin is the lowest among breast surgeons compared to other groups. However, the results were not statistically significant. The incidence of involved surgical margin is significantly higher within junior surgeons for HWL compared to the breast surgeons. The incidence of involved, closed or excessed surgical margin were lowest when performed by breast surgeon but not significantly different between the three groups. However, for HWL the breast surgeons significantly better compared to the other groups.

Matched MeSH terms: Breast Neoplasms
Fulltext Imaging and histopathology correlation of solid papillary carcinoma of the breast : a review of four cases.

Sharifah, M.I.A.

International Medical Journal Malaysia, 2015;14(1):93-97.
MyJurnal

Solid papillary breast carcinoma is a rare type of breast carcinoma. We present four cases which highlight the radiological and histological findings of solid papillary carcinoma. Mammogram supplemented with ultrasound played an important role in detecting solid papillary carcinomas which usually presents as intraductal lesions or intracystic mass with Doppler signal. Excision biopsy is a better option than core biopsy as the latter modality may not be representative and the diagnosis of solid papillary breast carcinoma may be missed.

Matched MeSH terms: Breast Neoplasms
Fulltext Effects of image processing techniques on mammographic phantom images: a pilot study

Langarizadeh, Mostafa, Rozi Mahmud, Abd. Rahman Ramli, Suhaimi Napis, Mohammad Reza Beikzadeh, Wan Eny Zarina Wan Abdul Rahman

Pertanika Journal of Science & Technology, 2011;19(1):67-76.
MyJurnal

Breast cancer is one of the most important diseases among females. According to the Malaysian Oncological Society (Wahid, 2007), about 4% of women who are 40 years old and above are suffering from breast cancer. Masses and microcalcifications are two important signs for breast cancer diagnosis on mammography. In this research, the effects of different image processing techniques which include enhancement, restoration, segmentation, and hybrid methods on phantom images were studied. Three different phantom images, which were obtained at 25kv (63.2 MAS), 28kv (29.8 MAS) and 35kv (9.5 MAS), were manipulated using image processing methods. The images were scored by two expert radiologists and the results were compared to explore any significant improvements. Meanwhile, the Wilcoxen Rank test was used to compare the quality of the manipulated images with the original one (alpha=0.05). Each image processing method was found to be effective on some particular criteria for image quality. Some methods were effective on just one criterion while some others were effective on a few criteria. The statistical test showed that there was an average improvement of 41 percent when the images were manipulated using the histogram modification methods. It could be concluded that different image processing methods have different effects on phantom images which generally improve radiologists’ visualization. The results confirm that the histogram stretching and histogram equation methods lead to higher improvement in image quality as compared to the original image (p < 0.05).

Matched MeSH terms: Breast Neoplasms
Fulltext Case report: massive ruptured malignant phyllodes tumour

Ong, E.C.W., Kong, C.K.

JUMMEC, 2017;20(1):8-10.
MyJurnal

Phyllodes tumour is a rare entity, affecting mainly middle aged women. It consists of a spectrum of disease
from benign tumour to highly aggressive malignant form. We present a case of massive ruptured malignant
Phyllodes tumour, and its subsequent management.

Matched MeSH terms: Breast Neoplasms
The Role of MicroRNAs in Diagnosis, Prognosis, Metastasis and Resistant Cases in Breast Cancer

Teoh SL, Das S

Curr Pharm Des, 2017;23(12):1845-1859.
PMID: 28231756 DOI: 10.2174/1381612822666161027120043

The incidence and mortality due to breast cancer is increasing worldwide. There is a constant quest to know the underlying molecular biology of breast cancer in order to arrive at diagnosis and plan better treatment options. MicroRNAs (miRNAs) are small non-coding and single stranded RNAs which influence the gene expression and physiological condition in any tumor. The miRNAs may act on different pathways in various cancers. Recently, there are research reports on various miRNAs being linked to breast cancers. The important miRNAs associated with breast cancers include miR-21, miR-155, miR-27a, miR-205, miR-145 and miR-320a. In the present review we discuss the role of miRNAs in breast cancer, its importance as diagnostic markers, prognosis and metastasis markers. We also highlight the role of miRNAs with regard to resistance to few anticancerous drugs such as Tamoxifen and Trastuzumab. The role of miRNA in resistance to treatment is one of the core issues discussed in the present review. Much information on the miRNA roles is available particularly in the neoadjuvant chemotherapy setting, because this protocol allows the rapid association of miRNA expression with the treatment response. This review opens the door for designing better therapeutic options in drug resistance cases in breast cancer.

Matched MeSH terms: Breast Neoplasms/diagnosis*; Breast Neoplasms/genetics*; Breast Neoplasms/pathology
Fulltext Targeting HER4 in overcoming resistance to breast cancer targeted therapy

Siti Norasikin Mohd Nafi

Buletin Persatuan Genetik Malaysia, 2015;21(1):26-31.
MyJurnal

Resistance to anti-HER2 targeted therapy imposes a crucial limitation to the successful treatment of HER2 positive breast cancer. The expression of HER4 and its prognostic value is controversial in breast cancer. The role of HER4 in trastuzumab treatment and resistance in HER2-positive breast cancer has been recently studied. HER4 activation, cleavage and nuclear translocation have been demonstrated mediate trastuzumab resistance in HER2 positive breast cancer. In addition, nuclear HER4 is suggested could be a novel predictive and prognostic biomarker in HER2 positive breast cancer patients. Understanding the role of HER4 may offer useful insights to cancer treatment in HER2-positive breast cancer and other cancers.

Matched MeSH terms: Breast Neoplasms
Fulltext Time-dependent risk and predictors of venous thromboembolism in breast cancer patients: A population-based cohort study

Brand JS, Hedayati E, Bhoo-Pathy N, Bergh J, Hall P, Humphreys K, et al.

Cancer, 2017 02 01;123(3):468-475.
PMID: 27727456 DOI: 10.1002/cncr.30364

BACKGROUND: Venous thromboembolism (VTE) is a serious complication of cancer and its treatment. The current study assessed the risk and clinical predictors of VTE in breast cancer patients by time since diagnosis.
METHODS: This Swedish population-based study included 8338 breast cancer patients diagnosed from 2001 to 2008 in the Stockholm-Gotland region with complete follow-up until 2012. Their incidence of VTE was compared with the incidence among 39,013 age-matched reference individuals from the general population. Cox and flexible parametric models were used to examine associations with patient, tumor, and treatment characteristics, accounting for time-dependent effects.
RESULTS: Over a median follow-up of 7.2 years, 426 breast cancer patients experienced a VTE event (cumulative incidence, 5.1%). The VTE incidence was 3-fold increased (hazard ratio [HR], 3.28; 95% confidence interval [CI], 2.87-3.74) in comparison with the incidence in the general population and was highest 6 months after diagnosis (HR, 8.62; 95% CI, 6.56-11.33) with a sustained increase in risk thereafter (HR at 5 years, 2.19; 95% CI, 1.80-2.67). Independent predictors of VTE included the following: older age, being overweight, preexisting VTE, comorbid disease, tumor size > 40 mm, progesterone receptor (PR)-negative status, more than 4 affected lymph nodes, and receipt of chemo- and endocrine therapy. The impact of chemotherapy was limited to early-onset VTE, whereas comorbid disease and PR-negative status were more strongly associated with late-onset events.
CONCLUSIONS: This study confirms the long-term risk of VTE in breast cancer patients and identifies a comprehensive set of clinical risk predictors. Temporal associations with patient, tumor, and treatment characteristics provide insight into the time-dependent etiology of VTE. Cancer 2017;123:468-475. © 2016 American Cancer Society.

Matched MeSH terms: Breast Neoplasms/complications*; Breast Neoplasms/drug therapy*; Breast Neoplasms/pathology
Fulltext The influence of religious belief and sociocultural on breastfeeding practice: a literature review

Nurul Akma Jamil

The Malaysian Journal of Nursing, 2018;9(4):79-85.
MyJurnal

Socio-cultural poses as the enabler and barrier in breastfeeding practice. A review of published literature
was conducted and a total of 25 articles were reviewed to seek the answer: How religious belief and
sociocultural influence breastfeeding practice? Published articles were identified through electronic
searches of PubMed/MEDLINE, Scopus, Google scholars and IIUM Repository within timeframe of 2011
to 2017. Through this searching, three key themes were identified: religious views on breastfeeding,
sociocultural perspectives and challenges. A comprehensive understanding on religious recommendation
and cultural influence would benefit in the reconstruction of breastfeeding promotion and education
program.

Matched MeSH terms: Breast Feeding

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