21 research outputs found
Ethnic Differences in Mammographic Densities: An Asian Cross-Sectional Study
<div><p>Background</p><p>Mammographic density is a strong risk factor for breast cancer and is highly variable, but, to date, few studies have examined density in Asian women, particularly those in low and middle-income Asian countries where genetic and lifestyle determinants may be significantly different.</p><p>Methods</p><p>A total of 1,240 women who attended an opportunistic mammogram screening programme were eligible for analysis. Mammographic density was estimated using a fully-automated thresholding method and differences across ethnic groups were examined using linear regression in 205 randomly selected Chinese women, 138 Malay and 199 Indian women.</p><p>Results</p><p>Percent density was significantly higher in Chinese women (28.5%; 95% CI 27.0%, 30.0%) compared to Malay (24.2%; 95% CI 22.5%, 26.0%) and Indian (24.3%; 95% CI 22.8%, 25.7%) women (p<0.001), after adjustment for age, BMI, menopausal status, parity and age at first full term pregnancy. Correspondingly, adjusted nondense area was significantly lower in Chinese (72.2cm<sup>2</sup>; 95% CI 67.9cm<sup>2</sup>, 76.5cm<sup>2</sup>) women compared to Malay (92.1cm<sup>2</sup>; 95% CI 86.9cm<sup>2</sup>, 97.2cm<sup>2</sup>) and Indian (97.7cm<sup>2</sup>; 95% CI 93.4cm<sup>2</sup>, 101.9cm<sup>2</sup>) women (p<0.001), but dense area did not differ across the three ethnic groups.</p><p>Conclusions</p><p>Our study shows that higher percent density and lower nondense area reflect the higher incidence of breast cancer in Chinese compared to Malay and Indian women in Malaysia. Known lifestyle determinants of mammographic density do not fully account for the ethnic variations observed in mammographic density in this Asian cohort.</p></div
Unadjusted and adjusted A) mean percent density, B) mean dense area and C) mean nondense area with 95% confidence intervals by ethnicity.
<p>Note: <sup>a</sup>Adjusted for age, BMI, menopausal status, parity and mean adjusted age at first full term pregnancy; <sup>b</sup>Adjusted for age, BMI, menopausal status and parity; <sup>c</sup>Adjusted for age, BMI and menopausal status.</p
Complementary and alternative medicine (CAM) use and delays in presentation and diagnosis of breast cancer patients in public hospitals in Malaysia
<div><p>Complementary and alternative medicine (CAM) is widely used among the breast cancer patients in Malaysia. Delays in presentation, diagnosis and treatment have been shown to impact the disease prognosis. There is considerable use of CAM amongst breast cancer patients. CAM use has been cited as a cause of delay in diagnosis and treatments in qualitative studies, however there had not been any confirmatory study that confirms its impact on delays. The purpose of this study was to evaluate whether the use of CAM among newly diagnosed breast cancer patients was associated with delays in presentation, diagnosis or treatment of breast cancer. This multi-centre cross-sectional study evaluating the time points of the individual breast cancer patients’ journey from first visit, resolution of diagnosis and treatments was conducted in six public hospitals in Malaysia. All newly diagnosed breast cancer patients from 1st January to 31st December 2012 were recruited. Data were collected through medical records review and patient interview by using a structured questionnaire. Complementary and alternative medicine (CAM) was defined as the use of any methods and products not included in conventional allopathic medicine before commencement of treatments. Presentation delay was defined as time taken from symptom discovery to first presentation of more than 3 months. The time points were categorised to diagnosis delay was defined as time taken from first presentation to diagnosis of more than 1 month and treatment delay was defined as time taken from diagnosis to initial treatment of more than 1 month. Multiple logistic regression was used for analysis. A total number of 340 patients participated in this study. The prevalence of CAM use was 46.5% (n = 158). Malay ethnicity (OR 3.32; 95% CI: 1.85, 5.97) and not interpreting symptom as cancerous (OR 1.79; 95% CI: 1.10, 2.92) were significantly associated with CAM use. The use of CAM was associated with delays in presentation (OR 1.65; 95% CI: 1.05, 2.59), diagnosis (OR 2.42; 95% CI: 1.56, 3.77) and treatment of breast cancer (OR 1.74; 95% CI: 1.11, 2.72) on univariate analyses. However, after adjusting with other covariates, CAM use was associated with delays in presentation (OR 1.71; 95% CI: 1.05, 2.78) and diagnosis (OR 2.58; 95% CI: 1.59, 4.17) but not for treatment of breast cancer (OR 1.58; 95% CI: 0.98, 2.55). The prevalence of CAM use among the breast cancer patients was high. Women of Malay ethnicity and not interpreting symptom as cancerous were significantly associated with CAM use. The use of CAM is significantly associated with delay in presentation and resolution of diagnosis. This study suggests further evaluation of access to breast cancer care is needed as poor access may cause the use of CAM. However, since public hospitals in Malaysia are heavily subsidized and readily available to the population, CAM use may impact delays in presentation and diagnosis.</p></div
Univariate analysis of association between CAM use and delays in presentation, diagnosis and treatment among the breast cancer patients (N = 340).
<p>Univariate analysis of association between CAM use and delays in presentation, diagnosis and treatment among the breast cancer patients (N = 340).</p
Types of complementary and alternative medicines (CAM) used by the breast cancer patients (n = 158).
<p>Types of complementary and alternative medicines (CAM) used by the breast cancer patients (n = 158).</p
Characteristic of Non CAM and CAM user among the breast cancer patients (N = 340).
<p>Characteristic of Non CAM and CAM user among the breast cancer patients (N = 340).</p
Multivariate analysis of association between CAM use and other characteristics with delays in presentation, diagnosis and treatment among the breast cancer patients (N = 340).
<p>Multivariate analysis of association between CAM use and other characteristics with delays in presentation, diagnosis and treatment among the breast cancer patients (N = 340).</p
Western blot analysis of protease C1 inhibitor in serum PCA isolates of normal control women and breast cancer patients.
<p>CGB lectin bound proteins of serum PCA isolates were transferred onto nitrocellulose membrane and blotted using rabbit anti-plasma protease C1 inhibitor (a). Intensities of the bands were analysed using the GelAnalyzer software and volume intensity was compared across the three groups of samples analysed (b).</p
List of proteins present in serum PCA isolates.
<p>List of proteins present in serum PCA isolates.</p
Levels of <i>O</i>-glycosylated proteins in serum perchloric acid (PCA) isolates.
<p>(a) The levels of <i>O</i>-glycosylated proteins were estimated using sandwich ELLA with asialoBSM as the standard <i>O</i>-glycosylated protein. (b) <i>O</i>-glycosylated proteins recovery assay was performed by spiking biotinylated-asialoBSM into serum samples and followed by PCA treatment. (●) Biotinylated-asialoBSM spiked into serum samples followed by PCA treatment; (■) Biotinylated-asialoBSM spiked into serum PCA isolates.</p