The relationship between gut microbiome estrobolome and breast cancer: A systematic review of current evidences

Breast cancer is the most frequent kind of cancer and the second leading cause of mortality worldwide, behind heart disease. Next-generation sequencing technologies enables for unprecedented enumeration of human resident gut microorganisms, conferring novel insights into the role of the microbiota in health and individuals with breast cancer. A growing body of research on microbial dysbiosis seems to indicate an elevated risk of health complications including cancer. Although several dysbiosis indices have been proposed, their underlying methodology, as well as the cohorts and conditions of breast cancer patients are significantly different. To date, these indices have not yet been thoroughly reviewed especially when it comes to researching the estrogen-gut microbiota axis. Instead of providing a thorough rating of the most effective diversity measurements, the current work aims to be used to assess the relevance of each study's findings across the demographic data, different subtypes, and stages of breast cancer, and tie them to the estrobolome, which controls the amount of oestrogen that circulates through humans. This review will cover 11 studies which will go into a detailed discussion for the microbiome results of the mentioned studies, leaving to the user the final choice of the most suited indices as well as highlight the observed bacteria found to be related to the estrobolome in hopes of giving the reader a better understanding for the biological cross-talk between gut microbiome and breast cancer progression

The relationship between gut microbiome estrobolome and breast cancer: a systematic review of current evidences

Breast cancer is the most frequent kind of cancer and the second leading cause of mortality worldwide, behind heart disease. Next-generation sequencing technologies enables for unprecedented enumeration of human resident gut microorganisms, conferring novel insights into the role of the microbiota in health and individuals with breast cancer. A growing body of research on microbial dysbiosis seems to indicate an elevated risk of health complications including cancer. Although several dysbiosis indices have been proposed, their underlying methodology, as well as the cohorts and conditions of breast cancer patients are significantly different. To date, these indices have not yet been thoroughly reviewed especially when it comes to researching the estrogen-gut microbiota axis. Instead of providing a thorough rating of the most effective diversity measurements the current work aims to be used to assess the relevance of each study’s findings across the demographic data, different subtypes, and stages of breast cancer, and tie them to the estrobolome, which controls the amount of oestrogen that circulates through humans. This review will cover 11 studies which will go into a detailed discussion for the microbiome results of the mentioned studies, leaving to the user the final choice of the most suited indices as well as highlight the observed bacteria found to be related to the estrobolome in hopes of giving the reader a better understanding for the biological cross-talk between gut microbiome and breast cancer progression

Prevalence of breast cancer and its associated factors for recurrence in Hospital Tengku Ampuan Afzan from 2008 to 2012

INTRODUCTION: Breast cancer is the commonest malignancy in Malaysian women. Cancer recurrence commonly seen in the first 2 years can be detrimental. Thus, identifying its prognostic factors is important. MATERIALS AND METHODS: We have retrospectively analyzed 179 women with breast cancer based on 5 years single center database with minimum follow up of 2 years. The demographic and clinico-pathological characteristics were determined using descriptive statistics. Survival was calculated based on Kaplan-Meier method. Multivariate analysis by Cox proportional hazards was performed to evaluate the potential factors affecting breast cancer recurrence. RESULTS: Mean follow up was 42 months, with mean age 52 years and 60.9% presented in Stage II disease. Overall recurrence was 41.9% with local recurrence 2.1%, regional recurrence 12.3% and distant recurrence 27.4%. 50% of our patients developed recurrence at 25 months. On univariate analysis, time to first presentation was significantly correlated with recurrence. In multivariate analysis, the tumor size, lymph node positivity and lympho-vascular invasion were independently associated with recurrence. Discussion: To date, local studies on prognostic factors in breast cancer recurrence remained sparse. Based on this study, factors associated with breast cancer recurrence identified and coincides with the previous evidence. Furthermore, this would provide evidence to improve the survival for patients with breast cancer in local settings. CONCLUSION: Further studies also need to be done on the non-compliant patients with advanced disease at presentation to determine factors towards their perception of surgical care in breast oncology

Correlation between severity of erosive reflux esophagitis and its manometric findings in a tertiary hospital at East Coast, Peninsular Malaysia

The burden of Gastroesophageal Reflux Disease, GERD in Asia-Pacific region is increasing. Objectives: To evaluate the manometric finding in erosive reflux esophagitis and its correlation with severity among patients who were seen at Surgical Department, Hospital Tengku Ampuan Afzan (HTAA), Kuantan. Methodology: This was a cross sectional study which involved 60 patients seen from September 2012 until January 2014. Patients were required to fill up the Reflux Disease Specific Questionaire and subsequently underwent manometric evaluation. Descriptive statistics and Pearson’s correlation were applied using SPSS version 18.0. Results: There was no correlation between the severity of Erosive Reflux Disease with the Lower Esophageal Sphincter Pressure or esophageal motility. There was positive correlation (r = + 0.54) between severity of Erosive Reflux Disease and velocity variables of esophageal motility but it was not statistically significant. Discussion: Few experts opined that Erosive Reflux Disease is associated with esophageal dysmotility but there was no specific pattern of esophageal mean wave amplitude in our study sample. The limitation of this study was the sample’s selection and size. Thus, we need further study with better methodology and sample size. Conclusion: In conclusion, there was no significant correlation between the severity of Erosive Reflux Esophagitis on the Lower Esophageal Sphincter pressure and the esophageal motilit

Primary patency rate of Arteriovenous Fistula (AVF) and factors affecting its patency among Malaysian

The purpose of this study was to compare the maturity and patency rate of AVF being created at our centre in comparison to those being published elsewhere in the world. We are also analyzing different factors identified previously that may have affected this maturity and patency rate. This is an observational cross sectional study including all patients underwent AVF creation between 1st of January 2013 to 31st December 2013. We analysed non-modifiable factors including age, gender, presence of diabetes, presence of peripheral vascular disease and venous and artery diameter, and modifiable factors including smoking status, BMI index, anti-platelets and statin therapy and the site and side of AVF created, against the maturity and patency rate using a multi variates analysis. Our maturity rate at 6 weeks is 89% and patency rate at 6 months is 61% and at 12 months is 57%. Although there was a positive trends towards a better maturity rate in those who were treated with statin and with a bigger venous diameter, this was not statistically significant and these trends fail to sustain towards patency rates at both 6 and 12 months. In conclusion, our centre’s autologous AVF creation has been equally successful in comparison to other published results worldwide. Our study population failed to show any relationship between some known risk factors that has been shown by earlier study to have an effect on autologous AVF maturity and patenc

Analysis of diagnosis and treatment interval of breast cancer patients attending Sultan Ahmad Shah Medical Centre @IIUM

Introduction: Breast cancer is an ongoing issue that is plaguing many women worldwide. Early detection of breast cancer improve survival. In Malaysia, there is scanty data available to evaluate the acceptable time interval of diagnosis and treatment. This study aimed to analyze the diagnosis and treatment time interval of breast cancer patients attending SASMEC@IIUM. Materials and Methodss: A total of 87 participants were recruited in this retrospective cross-sectional study, conducted at SASMEC@IIUM, from January 2017 to December 2021. Those with recurrent breast cancer or known to have other cancers were excluded. Patients’ data were collected from clinical records and telephone interviews. Waiting times for presentation, referral, assessment, and initial treatment were documented. Results: From 87 participants, 99 % were female with a mean age of 57 years old (SD+11 years old). Majority were at the later stage of disease with 27% of patient were in stage III cancer and 30% had metastatic disease. The diagnostic interval was 13 days for stage IV, 14 days for stage III, 24.5 days for stage II and 70.5 days for stage I. In contrast, the treatment interval was 32 days for stage IV, 28 days for stage III, 23 days for stage II and 19 days for stage I. Statistically both diagnosis and treatment interval according to cancer staging was p = 0.082 and p = 0.273 which were statistically not significant. Conclusion: Adherent to standard international level treatment interval will provide the best oncological outcome. Our diagnosis and treatment interval were within the acceptable international standard of 28 days interval for diagnosis and treatment of breast cancer patients

Multiple Endoscopic Biopsy Sites increase detection of Helicobacter Pylori infection: a multi-centre study

Background: Helicobacter pylori infection affects almost half of the population and remains clinically significant in chronic gastritis and gastric malignancy. However, its prevalence is found to be low in Pahang, Malaysia population where the practice of single antral biopsy during endoscopy has been advocated. Our aim for this research is to determine the role of multiple gastric biopsy sites during endoscopy (OGDS) to increase the detection of Helicobacter pylori infection. The recommended 5 biopsy sites in the Updated Sydney System in which includes antrum, incisura angularis and body of stomach. Methodology: This is a cross sectional study of 141 patients with clinical diagnosis of gastritis or dyspepsia who underwent OGDS in 2 tertiary hospital in Pahang, Malaysia from January 2016 to December 2016. Five biopsy sites have been obtained and tested with CLO test and send for histology. The positive result for Helicobacter pylori infection by CLO test and/ or histology together with sociodemographic data, endoscopic diagnosis and histology characteristics were recorded and analyzed using IBM SPSS Statistic version 23. Results: Total of 17 patients were diagnosed with Helicobacter pylori infection, making the prevalence of the infection to 12%. No significant difference seen in most of the parameters identified. However, we found out that single antral biopsy can missed the infection rate up to 35%. Conclusion: Multiple biopsy sites during endoscopy can increase detection of Helicobacter pylori infection

Gut microbiome of women diagnosed with breast cancer within Pahang, Malaysia

Background Breast cancer is an ongoing issue that is plaguing many young women especially within the regions of Asia. Many factors have been studied thoroughly and have been ruled out over the years. Nevertheless, emergent studies towards the gut microbiome suggest its potential as another cause or treatment to the current predicament. This study aims to elucidate the role of the microbiome in relation to breast cancer by comparing the observed gut flora within healthy individuals to those afflicted with breast cancer in Pahang, Malaysia. Methods Stool samples were collected from all 69 participants. 36 subjects were of newly diagnosed breast cancer patients, pre-treatment while 33 subjects were control group. Samples were homogenized with water prior to performing DNA extraction using standard protocols of QIAamp® PowerFecal® Pro Kit. Metagenome sequencing of V3 variable region of 16S rRNA gene was conducted on a NovaSEQ6000 (Illumina, San Diego, CA) using standard protocols. Data analysis was conducted on the MicrobiomeAnalyst platform using default settings. Results We report a total of 114 695 read counts generated which represents 704 operational taxonomic units (OTUs) from the raw data. IDDF2022-ABS-0263 Figure 1 shows the top 30 features observed among the groups at genus level where it was shown that Holdemanella and Akkermansia were more abundant within the cancer group. Significant beta-diversity results from IDDF2022-ABS-0263 Figure 2 (p-value ≤ 0.001) suggest that the composition between breast cancer patients and healthy individuals are distinct from each other. Furthermore, IDDF2022-ABS-0263 Figure 3A indicates that Holdemanella is significant to the study whereas IDDF2022-ABS-0263 Figure 3B shows that Akkermansia has positive correlations towards breast cancer patients.Conclusions This study found that the microbiome observed within breast cancer patients is indeed different from healthy individuals at least within Pahang, Malaysia. Genera of interest are Holdemanella and Akkermansia which are found to be more abundant within the cancer group. Further studies are warranted to better understand the roles of these features towards breast cancer development or treatment