• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.895-904
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• 2016

Breast cancer is the most commonly diagnosed invasive cancer among women. Many factors, both genetic and non-genetic, determine a woman's risk of developing breast cancer and several breast cancer risk prediction models have been proposed. It is vitally important to risk stratify patients as there are now effective preventive strategies available. All women need to be counseled regarding healthy lifestyle recommendations to decrease breast cancer risk. As such, management of these women requires healthcare professionals to be familiar with additional risk factors so that timely recommendations can be made on surveillance/risk-reducing strategies. Breast cancer risk reduction strategies can be better understood by encouraging the women at risk to participate in clinical trials to test new strategies for decreasing the risk. This article reviews the advances in the identification of women at high risk of developing breast cancer and also reviews the strategies available for breast cancer prevention.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.1737-1742
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• 2013

Early diagnosis has a major role in improving prognosis of breast cancer. The purpose of this study was to assess the risk status of women 35-69 years of age using risk assessment models and the prevalence of mammography in a community setting. The sample of this cross sectional study consisted of 227 women, 35-69 years of age residing in Izmir, a city located in western region of Turkey. A questionnaire was used to collect data and the Gail and Cuzick-Tyrer models were applied to assess the risk of breast cancer. In this study, 52.7% of women had mammography at least once, and 41.3% of the women over the age of 40 had mammography screening in the last two years. The five years risk for breast cancer was high in 15.8% of women according to the Gail model and ten years risk was high in 21.7% with the Cuzick-Tyrer model. In the present study, the breast cancer risk levels were assessed in a population setting for the first time in Turkey using breast cancer risk level assessment models. Being in 60-69 age group, having low education and not being in menopause were significant risk factors for not having mammography according to logistic regression analysis. Mammography utilization rate was low. Women must be educated about breast cancer screening methods and early diagnosis. The women in the high risk group should be informed on their risk status which may increase their attendance at breast cancer screening.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.563-568
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• 2016

Background: Breast cancer is the most prevalent cancer in women worldwide and its frequency is increasing gradually in many countries. Over the last three decades an increase in the breast cancer has been witnessed in the earlier low-risk Asian countries including Pakistan. Purpose: The objective of the current study was to assess the prevalence of known risk factors like early menarche, late menopause, socio economic, reproductive and demographic factors, among women diagnosed with breast cancer at INMOL hospital, Lahore, Punjab, as little information exists in this regard. Materials and Methods: A survey study was conducted on 200 women diagnosed with breast cancer who were seen at Institute of Nuclear Medicine and Oncology (INMOL) hospital, Lahore. A structured questionnaire was administered to these patients regarding the known risk factors through face to face interviews after obtaining appropriate consent. Results: Regarding non-modifiable risk factors, our study showed that majority of the breast cancer patients were diagnosed at 35-45 years (32.5%) or at older age (${\leq}46$) and experienced menarche at 12 years or older (66 %). Likewise, a large number of patients reached menopause at the age of 45 years (60%), had no family and personal history of breast cancer (80%) and hence fell in a low risk category. Regarding modifiable risk factors in women diagnosed with breast cancer, most of the patients fell in low risk strata as the majority were married (98%) at young age, breastfed their children for 12 months or more (88%) and bore two to three children (80%). Considering income criteria, the majority of the patients had a low risk profile as they belonged to middle class (70%), urban area (60%) and were house wives (80%). However, it was noted that a considerable number of women (34%) diagnosed with breast cancer experienced menarche at an early age (<12) and reached menopause after the age of 45 years. This situation is further augmented by environmental changes and dietary habits and places them in a high risk category.

• Research in Community and Public Health Nursing
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• v.8 no.1
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• pp.89-101
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• 1997

Breast cancer ranks as one of the major health problems in adult women. The purpose of this study is to determine relationships among the practice of Breast Self-Examination(BSE) and the variables of cancer risk and other genernal factors. This knowledge may be helpful in designing a BSE educational program to promote breast self-examination on a regular basis. The study population included 205 women who live in K city. Personal interviews were conducted to determine the individual's breast self-examination behavior, the level of Breast Cancer Risk according to general factors as well as her reasons for not doing a breast self-examination. The collected data was analyzed with an SAS program The results were summarized as follows : 1. The level of Breast Cancer Risk of the subjects is as follows: high risk(9%), moderate risk(11%), boderline risk(12%), no increased risk (68%). 2. There was no difference in the practice of BSE between women who were at high cancer risk and at no increased cancer risk. 3. BSE practice levels according to general foctors were significantly related to the residence and the level of education of the subjects. The performing of regular breast self-examination in urban areas was 7% and in rural areas was 0%. Regularly practiced breast self-examination in women with a low education was 5% and in college educated women, it was 29%. 4. BSE education was significantly related to the residence and the level of education of the subjects. The majority learned BSE through 'a magazine or journal'. 5. The reason of the majority of women did not perform a regular breast self-examination was, 'Didn't know the BSE technique'. On the basis of this study it can be concluded that the development of a BSE education program is needed to help women perform the examination correctly.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7485-7489
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• 2015

Background: Breast cancer is the most common type of cancer in women throughout the world. However, in comparison with Western women, it presents relatively early in women of Asian ethnicity. Early menarche, late menopause, use of OCP's, family history of benign or malignant breast disease, exposure to radiation and BMI in the under-weight range are well known risk factors for the development of breast cancer in premenopausal women. Early detection with the use of breast self-examination (BSE) and breast cancer screening programs can lead to a reduction in the mortality rates due to breast cancer. The aim of our study was to assess the risk factors for breast cancer among young women and to emphasize the importance of early screening among them. Materials and Methods: We conducted a cross-sectional study among women aged 18 to 25 using a self-administered questionnaire. Data was collected over a period of 6 months from June to December, 2014. A total of 300 young women selected randomly from Dow Medical College and various departments of Karachi University successfully completed the survey. Results: Respondents were 18-25 years of age (mean age=21.5). Out of the 300 young females, 90 (30%) had at least one risk factor, 90 (30%) had two, 40 (13%) had three, 8 (2.7%) had four, 2 (0.7%) had five while one female was found to have six positive risk factors for breast cancer. Some 66 women (22%) experienced symptoms of breast cancer such as non-cyclical pain and lumps. While 222 women (74%) had never performed breast self-examination, 22 (7.3%) had had a breast examination done by a health professional while 32 (10.7%) had participated in breast screening programs. A total of 223 (74.3%) women considered breast cancer screening important for young women. Conclusions: The percentage of young women with risk factors for breast cancer was found to be alarmingly high. Therefore, screening for breast cancer should start at an early age especially in high risk groups. Awareness about breast self-examination should be emphasized. Moreover, screening programs should be started to ensure early detection and reduction of mortality rates caused by breast cancer also in young Pakistani females.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.7023-7027
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• 2013

To evaluate the relationship between obesity, diet, physical activity and breast cancer in Thai women, we conducted a case control study with 1,130 cases and 1,142 controls. Informed consent was obtained from all participants and a structured questionnaire was performed by trained interviewers to collect information on demographic and anthropometric data, reproductive and medical history, residential history, physical activity and occupation as well as dietary habits. A significant positive association with an increased risk of breast cancer was observed in women body mass index (BMI) of ${\geq}25mg/m^2$ (OR=1.33, 95%CI 1.07-1.65), the risk being higher in postmenopausal women (OR=1.67, 95%CI 1.24-2.25). In addition, underweight BMI at ages 10 and 20 years showed an inverse association in all women (OR=0.70, 95%CI 0.56-0.88 and OR=0.74, 95%CI 0.59-0.93, respectively) and in those with a premenopausal status (OR=0.69, 95%CI 0.51-0.93 and OR=0.76, 95%CI 0.56-0.99, respectively). Regular exercise was associated with a decreased risk of breast cancer (OR=0.78, 95%CI 0.68-0.98). Interestingly, analysis by type of activity revealed significant protective effects for women who reported the highest levels of walking for shopping (OR=0.58, 95%CI 0.38-0.88). High consumption of vegetables and fruit were associated with a decreased risk of breast cancer, while high consumption of animal fat showed an increased risk in postmenopausal women. In conclusion, our results indicate that obesity and high consumption of animal fat are associated with breast cancer risk, particularly in postmenopausal women, while recreational physical activity has protective effects. It seems that primary prevention of breast cancer should be promoted in an integrated manner. Effective strategies need to be identified to engage women in healthy lifestyles.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.723-726
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• 2013

Background: Breast cancer is worldwide the most common cancer in women and is a major public health problem. Genes with high or low penetrance are now clearly implicated in the onset of breast cancer, mostly the BRCA genes. All women in families at high risk of breast cancer do not develop tumours, even when they carry the familial mutation, suggesting the existence of genetic and environmental protective factors. Several studies have shown that consanguinity is linked to a decreased or an increased risk of breast cancer, but to the best of our knowledge, there is no study concerning the association between consanguinity and the occurrence of tumours in women with high risk of breast cancer. The objective of this study was to examine whether parental consanguinity in families with genetic predisposition to breast cancer affect the risk of siblings for having this cancer. Materials and Methods: Over a six-year period, 72 different patients with a histological diagnosis of breast or ovarian cancer from 42 families were recruited for genetic counselling to the Department of Medical Genetics, Rabat. Consanguinity rate was determined in cases and compared to the consanguinity rate in the Moroccan general population. Results: Consanguinity rates were 9.72% in patients and 15.3% in controls, but the difference was statistically not significant (p>0.001) and the mean coefficient of consanguinity was lower in breast cancer patients (0.0034) than in controls (0.0065). Conclusions: Despite the relatively small sample size of the current study, our results suggest that parental consanguinity in Moroccan women might not be associated with an altered risk of breast cancer. Large scale studies should be carried out to confirm our results and to develop public health programs.

• Journal of Nutrition and Health
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• v.36 no.1
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• pp.40-48
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• 2003

This study was conducted to investigate the relationship between alcohol consumption, physical activity and breast cancer risk in Korean women. Newly histologically identified cases (N = 108) were selected at Hanyang and Soonchunhyang University Hospitals in Seoul, from January 1998 to August 1999. Hospital-based controls (n = 121) were the patients who visited at the same hospital in the department of plastic surgery, general surgery and opthalmology. Subjects were asked informations on demographic, reproductive, and history of breast feeding as well as physical activity, exercise habit, alcohol consumption by individual interview. Odds ratio (OR) and 95% Confidence Intervals (CI) were calculated by using unconditional logistic regression after adjusted for confounding factors. Among postmenopausal women, the risk of breast cancer increased with increasing alcohol drinking: relative risk for the highest group ( $\geq$ 150 g per week) compared with the lowest group (never drinking) was 2.05 (CI=1.74-3.79). Association of exercise and high physical activity for breast cancer appeared to be limited to women with high physical index among postmenopausal women. We observed decreasing risk of breast cancer with increasing physical activity index among postmenopausal women (OR=0.49,95% CI=0.56-0.92). Results of this study support a protective effects of physical activity during adulthood for breast cancer. (Korean J Nutrition 36(1): 40-48, 2003)

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.8
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• pp.3741-3745
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• 2016

Background: This study was carried out to examine breast cancer risk and its fertility predictors in women aged ${\geq}35$. Materials and Methods: This cross-sectional study was conducted on 560 healthy women referred to health centers of Tabriz-Iran, 2013-2014. Five-year and lifetime risk of developing breast cancer were determined using the Gail model. General linear modeling was applied to determine breast cancer predictors. Results: The mean age of the subjects was 42.7 (SD: 7.7) years. Mean 5-year and lifetime risks of developing breast cancer were determined to be 0.6% (SD: 0.2%) and 8.9% (SD: 2.5%), respectively. Variables of family history of breast cancer, age, age at menarche, parity, age at first childbirth, breastfeeding history, frequency of breastfeeding, method of contraception, marital status and education were all found to be predictors of breast cancer risk. Conclusions: According to the results of this study, screening programs based on the Gail model should be implemented for Iranian people who have a high risk for breast cancer in order to facilitate early detection and better plan for possible malignancies.

• Asian Oncology Nursing
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• v.5 no.2
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• pp.146-158
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• 2005

Purpose: This study was to obtain a understanding of breast cancer women with high risk for hereditary cancer syndrome. Method: A micro-ethnography was used, including participation observation, open-ended in-depth interviews. Results: Two major arguments were derived. First, When Korean women at high risk to hereditary breast cancer make a decision about whether to take a genetic test, they are strongly motivated by a desire to preserve close kinship bonds and "family love" among their siblings, parents and children. Second, Even after genetic risk assessment and counseling services, Korean women at high-risk for developing a hereditary breast cancer who have been informed that they are mutation carriers, still hold onto previous beliefs about cancer causation. Their cancer prevention strategies are constructed according to their unchanged perceptions and beliefs about cancer causation. Conclusion: More sensitive genetic counseling program needs to be developed. Referral programs and clinical services must be attentive to cultural values and beliefs otherwise cultural attitudes and practices toward genetic counseling will not change.