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Breast cancer hla


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Public webinar presentation on breast cancer. This presentation gives an overview of breast cancer in Malaysia, the risk factors and ways to reduce risk of breast cancer, early detection and its importance on survivorship besides exploring treatment options.

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Breast cancer hla

  1. 1. Breast cancer Dr Chea Chan Hooi General & Laparoscopic Surgeon Borneo Medical Centre (Miri) 11th November 2020
  2. 2. Content • Introduction • Basics • Risk factors • Symptoms • Investigations • Treatment • Conclusion
  3. 3. Introduction • Cancer arising from breast tissue • The most common cancer in Malaysia • 1 in 20 Malaysian women will develop breast cancer in their lifetimes • 48% of patients present in stages 3 and 4, only 1/2 survive >5 years after diagnosis
  4. 4. Cancer cases in Malaysia
  5. 5. Basics
  6. 6. Progression to cancer basement membrane
  7. 7. basement membrane
  8. 8. Risk factors • Sedentary lifestyle • Poor dietary habits high in sugar and fat besides processed meat • Obesity
  9. 9. • Never had full-term pregnancy • Never breast-fed >6 months • First childbirth >35 year-old
  10. 10. • Oral contraceptive pills >10 years • Post-menopausal hormone replacement therapy >4 years
  11. 11. • Smoking • Excessive alcohol consumption
  12. 12. • Radiotherapy to chest <30 year-old
  13. 13. • Gender • Vast majority of patients are women • Men can also develop breast cancer (0.1%)
  14. 14. • Race
  15. 15. • Age >40 years old
  16. 16. • Genetics & family history of breast or ovarian cancers
  17. 17. • Started menstruating <10 year-old and stopped >55 year-old
  18. 18. Symptoms *retrieved from
  19. 19. Peau d'orange
  20. 20. 0.1% of breast cancer patients are men
  21. 21. Investigations Ultrasonography Mammography
  22. 22. • Fine needle aspiration • Obtain cells for microscopic examination • Less reliable • Biopsy • Obtain tissue sample for microscopic examination • “...diagnosed upon the basis of a microscopic examination of the fixed tissue, supported by a biopsy result.”
  23. 23. • CT scan • To assess distant spread
  24. 24. Treatment options • Surgery • Chemotherapy • Radiotherapy • Hormonal therapy • Targeted therapy
  25. 25. Breast surgery Mastectomy Lumpectomy/Breast-conserving surgery
  26. 26. Quadrantectomy
  27. 27. Axillary (armpit) surgery Axillary dissection Sentinel lymph node biopsy
  28. 28. Treatment options • Surgery • Chemotherapy • Radiotherapy • Hormonal therapy • Targeted therapy Oncologist
  29. 29. Survival
  30. 30. Conclusion • Breast cancer is very common • Early detection saves lives • Various modalities available for early detection • Everyone associated with healthcare has a role to play to reduce its incidence
  31. 31. References • 1 Worldwide cancer data global cancer statistics for the most common cancers. World Cancer Reserach Fund International. Available: data#:~:text=Lung%20and%20breast%20cancers%20were,million%20new%20cases%20in%202018. • 2 Azizah Ab M, Nor Saleha IT, Noor Hashimah A, Asmah ZA, Mastulu W. Malaysian National Cancer Registry Report 2007 - 2011 Malaysia cancer statistics, data & figure. National Cancer Institute, Ministry of Health Malaysia • 3 Yip CH, Nur Aishah MT, Ibraham M. Epidemiology of breast cancer in Malaysia. Asian Pac J Cancer Prev 2006;7(3):369-74. • 4 Nor Aini, Wan Rozita WM, Nor Asiah M, et al. Survival rate of breast cancer patients in Malaysia: a population-based study. Asian Pac J Cancer Prev 2013;14(8):4591-4. • 5 Cui X, Dai Q, Tseng M, et al. Dietary patterns and breast cancer risk in The Shanghai Breast Cancer Study. Cancer Epidemiol Biomarkers 2007;16:1443-8. • 6 Sun YS, Zhao Z, Yang ZN, et al. Risk factors and preventions of breast cancer. Int J Biol Sci 2017;13(11):1387-1397 • 7 Horn J, Asvold BO, Opdahl S. et al. Reproductive factors and the risk of breast cancer in old age: a Norwegian cohort study. Breast Cancer Res Treat 2013;139:237–43. • 8 Soroush A, Farshchian N, Komasi S. et al. The role of oral contraceptive pills on increased risk of breast cancer in Iranian populations: a meta-analysis. J Can Prev 2016;21:294–301. • 9L iu JY, Chen TJ, Hwang SJ. The risk of breast casncer in women using menopausal hormone replacement therapy in Taiwan. Int J Environ Res Pub Health 2016;13:482. • 10 Hamajima N, Hirose K, Tajima K, et al. Alcohol, tobacco and breast cancer-collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 women without the disease. Br J Cancer 2002;87:1234–45. • 11 Brewer HR, Jones ME, Schoemaker MJ, Ashworth A, Swerdlow AJ. Family history and risk of breast cancer: an analysis accounting for family structure. Breast Cancer Rest Treat 2017;165(1):193-200. • 12 American Cancer Society. Radiation therapy for Hodgkin lymphoma. Available: lymphoma/treating/radiation.html#:~:text=Radiation%20therapy%20uses%20high%2Denergy,one%20part%20of%20the%20body. • 13 Dai Q, Shu XO, Jin F, Gao YT, Ruan ZX, Zheng W. Consumption of animal foods, cooking methods, and risk of breast cancer. Cancer Epidemiol Biomarkers Prev 2002;11:801–8 • 14 Fu Z, Deming SL, Fair AM, et al. Well-done meat intake and meat-derived mutagen exposures in relation to breast cancer risk: the Nashville Breast Health Study. Breast Cancer Res Treat 2011;129:919–28
  32. 32. • 15 Tao P, Li H, Wang Q, Cao LQ, Li JY, Yang F, Wang YP. A case-control study on association of SULT1A1 polymorphism, smoked meat intake with breast cancer risk. Zhonghua Yu Fang Yi Xue Za Zhi 2012;46:831–5 • 16 Dong JY, He K, Wang P, Qin LQ. Dietary fiber intake and risk of breast cancer: a meta-analysis of prospective cohort studies. Am J Clin Nutr 2011;94:900–5 • 17 Fung TT, Chiuve SE, Willett WC, Hankinson SE, Hu FB, Holmes MD. Intake of specific fruits and vegetables in relation to risk of estrogen receptor-negative breast cancer among postmenopausal women. Breast Cancer Res Treat 2013;138(3):925-30 • 18 Wu Y, Zhang D, Kang S. Physical activity and risk of breast cancer: a meta-analysis of prospective studies. Breast Cancer Res Treat 2013;137(3):869-82 • 19 Scoccianti C, Key TJ, Anderson AS, et al. European code against cancer 4th edition: breast feeding and cancer. Cancer Epidemiol 2015;39(supp.1):S101-6 • 20 Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breast feeding: a collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet 2002;360(9328):187-95 • 21 Collaborative Group on Hormonal Factors in Breast Cancer. Type and timing of menopausal hormone therapy and breast cancer risk: individual participant meta-analysis of the worldwide epidemiological evidence. Lancet 2019;394(10204):1159-68 • 22 McDonald JA, Goyal A, Terry MB. Alcohol intake and breast cancer risk: weighing the overall evidence. Curr Breast Cancer Rep 2013;5(3):10.1007/s12609-013-0114 • 23 Jones ME, Schoemaker MJ, Wright LB, Ashworth A, Swerdlow AJ. Smoking and risk of breast cancer in the Generations Study cohort. Breast Cancer Res 2017;19(1):118. doi: 10.1186/s13058-017-0908-4 • 24 Catsburg C, Miller AB, Rohan TE. Active cigarette smoking and risk of breast cancer. Int J Cancer 2015;136:2204-9 • 25 Duffy SW, Tabar L, Yen AMF, et al. Mammography screening reduces rates of advanced and fatal breast cancers: results in 549,091 women. Cancer 2020;126(13):2971-9 • 26 Division of Cancer Prevention and Control, Centers for Disease Control and Prevention. What is a mammogram? Available: • 27 Arnold M, Pfeifer K, Quante AS. Is risk-stratified breast cancer screening economically efficient in Germany? PLoS One 2019;14(5):e0217213. doi: 10.1371/journal.pone.0217213 • 28 Gagnon J, Levesque E, Borduas F, et al. Recommendatations on breast cancer screening and prevention in the context of implementing risk stratification: impending changes to current policies. Cur Oncol 2016;23(6). doi:
  33. 33. Thank you E-mail: WA: 0149972321 Tel: 085329333