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Roles of Ki67 in Breast Cancer - Important for Management?

  • Yip, CH;Bhoo-Pathy, N;Daniel, JM;Foo, YC;Mohamed, AK;Abdullah, MM;Ng, YS;Yap, BK;Pathmanathan, R
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권3호
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    • pp.1077-1082
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    • 2016
  • Background: The three standard biomarkers used in breast cancer are the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). The Ki-67 index, a proliferative marker, has been shown to be associated with a poorer outcome, and despite absence of standardization of pathological assessment, is widely used for therapy decision making. We aim to study the role of the Ki-67 index in a group of Asian women with breast cancer. Materials and Methods: A total of 450 women newly diagnosed with Stage 1 to 3 invasive breast cancer in a single centre from July 2013 to Dec 2014 were included in this study. Univariable and multivariable logistic regression was used to determine the association between Ki-67 (positive defined as 14% and above) and age, ethnicity, grade, mitotic index, ER, PR, HER2, lymph node status and size. All analyses were performed using SPSS Version 22. Results: In univariable analysis, Ki -67 index was associated with younger age, higher grade, ER and PR negativity, HER2 positivity, high mitotic index and positive lymph nodes. However on multivariable analysis only tumour size, grade, PR and HER2 remained significant. Out of 102 stage 1 patients who had ER positive/PR positive/HER2 negative tumours and non-grade 3, only 5 (4.9%) had a positive Ki-67 index and may have been offered chemotherapy. However, it is interesting to note that none of these patients received chemotherapy. Conclusions: Information on Ki67 would have potentially changed management in an insignificant proportion of patients with stage 1 breast cancer.

Oral Contraceptives, Abortion and Breast Cancer Risk: a Case Control Study in Saudi Arabia

  • Karim, Syed Mustafa;Baeshen, Wijdan;Neamatullah, Syed Nehal;Bin, Bakr
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권9호
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    • pp.3957-3960
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    • 2015
  • Background: Several studies have examined the relationship between oral contraceptive pill (OCP) use, abortions and breast cancer, with mixed results. Hormonal changes associated with OCP use and abortion may increase risk of breast cancer over time, but there is a lack of studies studying this association in Saudi Arabian women. Materials and Methods: We thererfore conducted a case control study in 192 women (92 as cases and 100 as controls), aged 30 to 65, and collected information on variables including examples related to study objectives and those which may confound findings. The Chi square test was used to detect associations between various factors and risk of breast cancer. Results: We found no evidence of interaction between history of abortion or frequency of abortion and breast cancer risk (Chi square=0.422, p =0.420 and 1, p =0.169) respectively. Oral contraceptives did not confer risk for breast cancer overall (OR=0.276, 95%CI 0.092-0.829, p=0.524), while long term use of OCP was associated with increased risk of breast cancer (OR=0.297, 95%CI 0.158-0.557, p=0.001), with higher association for those who used 10 years or more of OCPs (OR=0.282, 95%CI 0.095-0.835, p=0.02). Age at first use of OCPs had no effect on breast cancer risk (p=0.452) or age at diagnosis (p=0.074). Conclusions: Prolonged use of OC (more than 10 years) may be associated with increased risk of breast cancer in Saudi women. Larger population based studies are needed to confirm this finding in this population.

Characteristic Trend Analysis of Cancer Patients Hospitalized in Shanxi Tumor Hospital for the First Time during 2001 and 2010

  • Zhang, Wen-Li;Wang, Yan;Han, Cun-Zhi
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권9호
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    • pp.3673-3676
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    • 2015
  • To observe and analyze the characteristic trend of cancer patients hospitalized for the first time in Shanxi Tumor Hospital from 2001 to 2010, clinical data including case number, age, gender, and frequency of different tumor occurrences were collected and statistically analyzed. Results: (i) From 2001 to 2010, the number of cancer patients hospitalized for the first time increased by 1.3-fold; (ii) The patient overall average age also increased from 51.8 to 54.4, for males from 55.5 to 58.7 and females from 48.4 to 51.1, respectively. (iii) Male patients accounted for 43-48% and females accounted for 52-57% of the total. The percentage of female patients was higher than that of male patients in every year and showed an upward trend over the years, while that of the males showed a downward trend (${\chi}^2=7.031$, p=0.008); (iv) Among the top 6 most common cancers, lung, cervical, esophageal, colorectal and breast cancers tended to increase over the years (p<0.05), but not gastric cancer (p=0.423). Conclusions: (i) The number of cancer patients hospitalized for the first time during the past 10 years increased year by year, and was higher for female than male; (ii) the average age of patients increased year after year and was greater for male than female; (iii) the number of patients with lung cancer, cervical cancer, esophageal cancer, colorectal cancer and breast cancer increased over years.

Survival Prognostic Factors of Male Breast Cancer in Southern Iran: a LASSO-Cox Regression Approach

  • Shahraki, Hadi Raeisi;Salehi, Alireza;Zare, Najaf
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권15호
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    • pp.6773-6777
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    • 2015
  • We used to LASSO-Cox method for determining prognostic factors of male breast cancer survival and showed the superiority of this method compared to Cox proportional hazard model in low sample size setting. In order to identify and estimate exactly the relative hazard of the most important factors effective for the survival duration of male breast cancer, the LASSO-Cox method has been used. Our data includes the information of male breast cancer patients in Fars province, south of Iran, from 1989 to 2008. Cox proportional hazard and LASSO-Cox models were fitted for 20 classified variables. To reduce the impact of missing data, the multiple imputation method was used 20 times through the Markov chain Mont Carlo method and the results were combined with Rubin's rules. In 50 patients, the age at diagnosis was 59.6 (SD=12.8) years with a minimum of 34 and maximum of 84 years and the mean of survival time was 62 months. Three, 5 and 10 year survival were 92%, 77% and 26%, respectively. Using the LASSO-Cox method led to eliminating 8 low effect variables and also decreased the standard error by 2.5 to 7 times. The relative efficiency of LASSO-Cox method compared with the Cox proportional hazard method was calculated as 22.39. The19 years follow of male breast cancer patients show that the age, having a history of alcohol use, nipple discharge, laterality, histological grade and duration of symptoms were the most important variables that have played an effective role in the patient's survival. In such situations, estimating the coefficients by LASSO-Cox method will be more efficient than the Cox's proportional hazard method.

Religious Coping and Quality of Life in Women with Breast Cancer

  • Zamanian, Hadi;Eftekhar-Ardebili, Hasan;Eftekhar-Ardebili, Mehrdad;Shojaeizadeh, Davood;Nedjat, Saharnaz;Taheri-Kharameh, Zahra;Daryaafzoon, Mona
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7721-7725
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    • 2015
  • Background: The aim of this study was to assess the predictive role of religious coping in quality of life of breast cancer patients. Materials and Methods: This multi-center cross-sectional study was conducted in Tehran, Iran, from October 2014 to May 2015. A total of 224 women with breast cancer completed measures of socio-demographic information, religious coping (brief RCOPE), and quality of life (FACT-B). Data were analyzed using descriptive statistics and the t-test, ANOVA, and linear regression analysis. Results: The mean age was 47.1 (SD=9.07) years and the majority were married (81.3%). The mean score for positive religious coping was 22.98 (SD=4.09) while it was 10.13 (SD=3.90) for negative religious coping. Multiple linear regression showed positive and negative religious coping as predictor variables explained a significant amount of variance in overall QOL score ($R^2=.22$, P=.001) after controlling for socio-demographic, and clinical variables. Positive religious coping was associated with improved QOL (${\beta}=0.29$; p=0.001). In contrast, negative religious coping was significantly associated with worse QOL (${\beta}=-0.26$; p=0.005). Conclusions: The results indicated the used types of religious coping strategies are related to better or poorer QOL and highlight the importance of religious support in breast cancer care.

Intention to Quit Smoking among Intermediate and Secondary School Students in Saudi Arabia

  • Abdulmohsen Hamdan, Al-Zalabani;Ayat Roushdy, Abdallah;Reem Ibrahim, Alqabshawi
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권15호
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    • pp.6741-6747
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    • 2015
  • Background: Smoking is one of the most preventable causes of disease and death, including cancer, and quitting at an early age can reduce smoking-related morbidity and mortality. This study aimed to estimate the prevalence and to identify factors affecting the "intention to quit" among intermediate and secondary school current cigarette smoker students in Al Madinah city, Saudi Arabia. Materials and Methods: This study cohort included 307 current smoker students in a school-based survey. The intention to quit and its related determinants were assessed using a self-administered questionnaire. Results: More than half of the participants were ${\geq}17$ years, and of male gender (54.7%, 77.9% respectively). An intention to quit smoking was reported in 71.7% of participants, and was been significantly associated with: male gender (OR=3.25, 95% CI=1.65-6.41): age at 1st trial of smoking. 10-15 years (OR=2.11, 95% CI=1.03-4.32) along with age of ${\geq}15$ years (OR=3.10, 95% CI=1.20-7.88); days of smoking in the past 30 days (days <10 (OR=2.31, 95% CI=1.23-4.35) along with days ranging from 10-19 days (OR= 3.42, 95% CI=1.18-9.91); knowing that smoking is hazardous to health (OR=3.04, 95% CI=1.42-6.47); and finally, supporting smoking bans in public places (OR=1.89, 95% CI=1.11-3.25). Conclusions: A substantial number of participants were willing to quit smoking. Effective interventions focusing on providing information about the hazards of smoking and prohibiting smoking in public places could help initiate the intention to quit among youth smokers.

The Carcinogenic Liver Fluke Opisthorchis viverrini among Rural Community People in Northeast Thailand: a Cross-Sectional Descriptive Study using Multistage Sampling Technique

  • Kaewpitoon, Soraya J;Kaewpitoon, Natthawut;Rujirakul, Ratana;Ueng-arporn, Naporn;Matrakool, Likit;Tongtawee, Taweesak
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7803-7807
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    • 2015
  • Opisthorchis viverrini infection is a serious public health problem in Southeast Asia especially in the northeast and north of Thailand. Therefore, a cross-sectional survey using multistage sampling was conducted from the rural communities of Surin province, Thailand, during September 2013 to July 2014. O. viverrini infection was determined using Kato's thick smear technique. Socio-demographic, information resources, and history data were collected using predesigned semi-structured questionnaires. A total of 510 participants completed interviews and had stools collected. Some 32 (6.47%) participants were infected with O. viverrini. The rate was slightly higehr in males (6.61%) than females (6.32%). High frequencies were found in the age groups 61-70 (19.4%) and 71-80 years (19.4%), those involved in agriculture (10.5%), and in primary school (10.3%). The distribution of high infection was found in Tha Tum (16.7%) and Sankha district (16.7%), followed by Samrong Thap (13.3%), Si Narong (13.33%), and Buachet district (13.33%). Chi-square testing indicated that age (61-70 and 71-80 year old), education (primary school) and occupation (agriculture), were significantly associated with O. viverrini infection (p-value<0.05). Of 72.6% participants who had past histories with stool examination, 17.0% of them had been infected with O. viverrini and 43.2% treated with praziquantel. This finding confirmed that O. viverrini is still a problem in Surin province, Thailand, and therefore, interventions are urgently required for mass treatment and health education implementation.

Differences in Prognostic Factors between Early and Late Recurrence Breast Cancers

  • Payandeh, Mehrdad;Sadeghi, Masoud;Sadeghi, Edris
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권15호
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    • pp.6575-6579
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    • 2015
  • Background: Breast cancer (BC) is the most frequent malignancy among females and is a leading cause of death of middle-aged women. Herein, we evaluated baseline characteristics for BC patients and also compared these variables across ealry and late recurrence groups. Materials and Methods: Between 1995 to 2014, among female breast cancer patients referred to our oncology clinic, eighty-six were entered into our study. All had distant metastasis. Early recurrence was defined as initial recurrence within 5 years following curative surgery irrespective of site. Likewise, late recurrence was defined as initial recurrence after 5 years. No recurrence was defined for survivors to a complete minimum of 10 years follow-up. Significant prognostic factors associated with early or late recurrence were selected according to the Akaike Information Criterion. Results: The median follow-up was 9 years (range, 1-18 years). During follow-up period, 51 recurrences occurred (distant metastasis), 31 early and 20 late. According to the site of recurrence, there were 51 distant. In this follow-up period, 19 patients died. Compared with the early recurrence group, the no recurrence group had lower lymph node involvement and more p53 positive lesions but the late recurrence group had lower tumor size. In comparison to no recurrence, p53 (odds ratio [OR] 6.94, 95% CI 1.49-32.16) was a significant prognostic factor for early recurrence within 5 years. Conclusions: Tumor size, p53 and LN metastasis are the most important risk factors for distance recurrence especially in early recurrence and also between of them, p53 is significant prognostic factor for early recurrence.

Oncology Nurses Knowledge and Attitudes Regarding Cancer Pain Management

  • Shahriary, Shahdad;Shiryazdi, Seyed Mostafa;Shiryazdi, Seyed Ali;Arjomandi, Amir;Haghighi, Fatemeh;Vakili, Fariba Mir;Mostafaie, Naiemeh
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7501-7506
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    • 2015
  • Background: Oncology nurses play a crucial role in cancer pain management and must be highly informed to ensure their effective practice in the cancer setting. The aim of this study was to determine the baseline level of knowledge and attitudes of oncology nurses regarding cancer pain management. Materials and Methods: A cross-sectional survey research design was employed. The sample comprised 58 cancer nurses working in Shahid Sadoughi hospital, Yazd, Iran. The "Nurses Knowledge and Attitudes Survey Regarding Pain" (NKAS) tool and a demographic form were utilized to ascertain the knowledge and attitudes of oncology nurses working in oncology settings. Results: The average correct response rate for oncology nurses was 66.6%, ranging from 12.1% to 94.8%. The nurses mean score on the knowledge and attitudes survey regarding pain management was 28.5%. Results revealed that the mean percentage score overall was 65.7%. Only 8.6% of nurse participants obtained a passing score of 75% or greater. Widespread knowledge deficits and poor attitudes were noted in this study, particularly regard pharmacological management of pain. Conclusions: The present study provides important information about knowledge deficits in pain management among oncology nurses and limited training regarding pain management. Our results support the universal concern of inadequate knowledge and attitudes of nurses regarding cancer pain. It is suggested educational and quality improvement initiatives in pain management could enhance nurses knowledge in the area of pain and possibly improve practice.

Poor Knowledge and Practice Towards Breast Cancer among Women in Baghdad City, Iraq

  • Hasan, Tiba Nezar;Shah, Shamsul Azhar;Hassan, Mohd Rohaizat;Safian, Nazarudin;Azhar, Zahir Izuan;Syed Abdul Rahim, Syed Sharizman;Ghazi, Hasanain Faisal
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권15호
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    • pp.6669-6672
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    • 2015
  • Background: Breast cancer is one of the most common cancers among females worldwide. The aim of this study was to assess the knowledge and practice about breast cancer and its related factors among women in Baghdad city, Iraq. Materials and Methods: A cross-sectional study was conducted among 508 women aged 18 to 55 years from four non-governmental organizations (NGO) in Baghdad city, Iraq. A self-administered questionnaire on breast cancer knowledge and practice was distributed to participants during weekly activity of the NGO. Results: A total of 61.2% of the respondents had poor knowledge, only 30.3% performed breast self-examination (BSE) and 41.8% said that they did not know the technique to perform BSE. Associations between knowledge and marital status and age were significant. For practice, working status, education, age and family income were significant. After controlling for cofounders, the most important contributing factors for poor knowledge among respondents were marital status and not performing BSE, with adjusted odds ratio of 1.6 and 1.8 respectively. Conclusions: Breast cancer knowledge and practice of BSE are poor among women in Baghdad city, Iraq. More promotion regarding breast cancer signs and symptoms and also how to perform BSE should be conducted using media such as television and internet as these constituted the main sources of information for most women in our study.