• Journal of Korean Academy of Nursing
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• v.33 no.8
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• pp.1119-1126
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• 2003

Background. Breast cancer is the most common form of cancer among Korean women. Only 14 % of urban women and 10% of rural women in Korea, however, participated in breast cancer screening behavior in 1998 (Korean Ministry of Health & Welfare, 1999). Purpose. The aim of this study was to evaluate the effect of community-based breast self-examination (BSE) education programs in Korea. Methods. First, breast cancer risk appraisals were done with 1,977 rural women. Of the 1,977 women, nearly 30% (n=494) had a higher or equal to borderline risk of developing breast cancer. This quasi-experimental study was conducted to target these women with a high or equal to borderline risk of breast cancer. The risk appraisal feedback and breast self-examination education were used as an intervention for breast cancer prevention and early detection. Results. After a 3-month follow-up, 30.5% of the women in the intervention group performed regular BSE compared to 10.2 % of women in the control group. The mean knowledge score related to breast cancer and BSE was significantly higher for the women in the intervention group than that in the control group.

• Journal of Preventive Medicine and Public Health
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• v.49 no.6
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• pp.367-375
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• 2016

Objectives: The established theory that breast density is an independent predictor of breast cancer risk is based on studies targeting white women in the West. More Asian women than Western women have dense breasts, but the incidence of breast cancer is lower among Asian women. This meta-analysis investigated the association between breast density in mammography and breast cancer risk in Asian women. Methods: PubMed and Scopus were searched, and the final date of publication was set as December 31, 2015. The effect size in each article was calculated using the interval-collapse method. Summary effect sizes (sESs) and 95% confidence intervals (CIs) were calculated by conducting a meta-analysis applying a random effect model. To investigate the dose-response relationship, random effect dose-response meta-regression (RE-DRMR) was conducted. Results: Six analytical epidemiology studies in total were selected, including one cohort study and five case-control studies. A total of 17 datasets were constructed by type of breast density index and menopausal status. In analyzing the subgroups of premenopausal vs. postmenopausal women, the percent density (PD) index was confirmed to be associated with a significantly elevated risk for breast cancer (sES, 2.21; 95% CI, 1.52 to 3.21; $I^2=50.0%$). The RE-DRMR results showed that the risk of breast cancer increased 1.73 times for each 25% increase in PD in postmenopausal women (95% CI, 1.20 to 2.47). Conclusions: In Asian women, breast cancer risk increased with breast density measured using the PD index, regardless of menopausal status. We propose the further development of a breast cancer risk prediction model based on the application of PD in Asian women.

• Nutritional Sciences
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• v.3 no.2
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• pp.77-82
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• 2000

We carried out a case-control study to investigate protective effect of lactating against breast cancer in Korea. Cases (n=108) were the newly histologically identified breast cancer between December 1997 and August 1999. Hospital-based controls were selected by frequency matching method with age ($\pm$4 age) and menopausal status from the patients at the same hospital in the plastic surgery, general surgery and opthalmology department. Interviews included information on general characteristics of subjects, disease history, family history of breast cancer, vitamin supplementation, alcohol intake, food intake, and reproductive factors as well as lactation history. Odds ratio (OR) and 95% Confidence Intervals (CI) were calculated by using unconditional logistic regression. Age distribution of case control subjects were similar. Late menarche age $\geq$ 17 in premenopausal women was related to the lower risk of breast cancer OR = 0.41, 95% CI = 0.28-0.91. Family history of breast cancer was related to the higher risk of breast cancer only in premenopausal women (OR = 2.07, 95% CI = 1.35-2.71). Higher body mass index mass index (> 30) were associated with higher risk of breast cancer in postmenopausal women. For premenopausal women, women who had lactated $\geq$ 12 months to the first child had a significantly lower risk (OR = 0.53, 95% CI = 0.24-0.97) than the women had no breast feeding experience. However, results from postmenopausal women did not show an association with decreased breast cancer risk. These findings suggest that lactation may be a protective factor of breast cancer in Korean women.

• 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.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4307-4312
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• 2016

Background: Breast cancer is the most common female malignancy worldwide and its incidence is on the rise in Pakistan. The aim of this case-control study was to quantify the association of various risk factors with breast cancer risk among Pakistani women. Materials and Methods: A total of 2,246 women were studied, including 1,238 women with histologically confirmed breast cancer patients and age matched control subjects (N=1008) without breast cancer and other chronic diseases. Subjects were interviewed using a specifically designed questionnaire. Unconditional logistic regression was applied. Subsequent disease-specific mortality was also measured. Results: In this study, majority of the breast cancer patients (69.59%) were in age ranges of 40s and 50s. BMI greater than 25kg/m2 (OR=1.57; 95%CI, 1.26-1.90 and OR=1.60; 95%CI, 1.26-2.03), marital status of unmarried (OR=2.03; 95%CI, 1.69-2.44), lack of breast feeding, smoking (current or ever), lack of physical activity and post-menopausal status were found to have significant positive associations with breast cancer. It was also observed that increased parity reduced the disease risk. A larger number of cases (58.1%) had their right breast affected while 22.8% had other complications as well. Conclusions: This exploratory analysis indicated a number of risk factors to be associated with increased risk of breast cancer. It was also observed that mean age at diagnosis is a decade earlier than in western countries. It is hoped that our findings will facilitate establishment of adequate evidence-based awareness and preventive measures for Pakistani women.

• 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.7
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• pp.2857-2870
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• 2015

Although the incidence of breast cancer in Asia remains lower than in North America, Western Europe, and Oceania, rates have been increasing rapidly during the past few decades, and Asian countries now account for 40% of breast cancer cases diagnosed worldwide. Breast cancer mortality has also increased among Asian women, in contrast to decreased mortality in Northern America, Western Europe, and Oceania. These increased rates are associated with higher prevalence of breast cancer risk factors (e.g., reduced parity, delayed childbirth, increased obesity) that have accompanied economic development throughout the region. However, Asian regions (western, south-central, south-eastern, and eastern) and countries differ in the types and magnitude of changes in breast cancer risk factors, and cannot be viewed as a single homogeneous group. The objective of this paper was to contrast the heterogeneous epidemiology of breast cancer by Asian regions and countries, and to suggest potential avenues for future research.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.12
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• pp.5125-5135
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• 2015

Background: Total fat intake may be associated with increased risk of breast cancer, and fish oil has been suggested as a protection factor to breast cancer. But the effect of vegetable oils is inconclusive. We aimed to investigate the association with high vegetable oils consumption and breast cancer risk, and evaluated their dose-response relationship. Design: We systematically searched the MEDLINE, EMBASE, Cochrane databases, and CNKI updated to December 2014, and identified all observational studies providing quantitative estimates between breast cancer risk and different vegetable oils consumption. Fixed or random effect models were used to estimate summary odds ratios for the highest vs. lowest intake, and dose-response relationship was assessed by restricted cubic spline model and generalized least-squares trend (GLST) model. Results: Five prospective cohort studies and 11 retrospective case-control studies, involving 11,161 breast cancer events from more than 150,000 females, met the inclusion criteria. Compared with the lowest vegetable oils consumption, higher intake didn't increased the risk of breast cancer with pooled OR of 0.88 (95% CIs:0.77-1.01), and the result from dose-response analyses didn't show a significant positive or negative trend on the breast cancer risk for each 10g vegetable oil/day increment (OR=0.98, 95% CIs: 0.95-1.01). In the subgroup analyses, the oils might impact on females with different strata of BMI. Higher olive oil intake showed a protective effect against breast cancer with OR of 0.74 (95% CIs: 0.60-0.92), which was not significant among the three cohort studies. Conclusions: This meta-analyses suggested that higher intake of vegetable oils is not associated with the higher risk of breast cancer. Olive oil might be a protective factor for the cancer occurrence among case-control studies and from the whole. Recall bias and imbalance in study location and vegetable oils subtypes shouldn't be ignored. More prospective cohort studies are required to confirm the interaction of the impact of vegetable oils on different population and various cancer characteristic, and further investigate the relationship between different subtype oils and breast cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.9579-9586
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• 2014

There is growing scientific evidence linking excess body weight to breast cancer risk. However, there is no common consensus on this relation due partly to methodologies used, populations studied and the cancer subtype. We report here a summary of the present state of knowledge on the role of overweight and obesity in pathogenesis of breast cancer and possible mechanisms through which excess body weight might influence the risk, focusing on the role of oxidative stress in breast cancer etiology. The findings demonstrate duality of excess body weight action in dependence on menopausal status: a statistically significant increased risk in postmenopausal overweight/ obese women and non-significant preventive effect among premenopausal women. Due to several gaps in the literature on this topic, additional studies are needed. Future research should address factors influencing the excess body weight - breast cancer relationship, such as race/ethnicity, tumor subtype, receptor status, the most appropriate measure of adiposity, reproductive characteristics, and lifestyle components.

• 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.