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Surgery for BRCA, TP53 and PALB2: a literature review

Chin-Vern Song, Soo-Hwang Teo, Nur Aishah Taib, Cheng-Har Yip
2018 ecancermedicalscience  
The presence of a deleterious mutation, most commonly a BRCA mutation, has a tremendous impact on the management of breast cancer. We review the surgical management of BRCA mutation carriers, and two other potentially high-risk mutations, TP53 and PALB2. A search was done on PubMed, limited to reviews and the English language only. The search terms used were 'BRCA' or 'PALB2' or 'TP53' and 'surgery'. Fifteen articles were identified by searching and one article was obtained from other sources.
more » ... reast-conserving surgery has equivalent survival, but may have an increased risk of local recurrence, compared to mastectomy among BRCA mutation carriers. Contralateral prophylactic mastectomy may not improve overall survival, despite reducing the risk of developing contralateral breast cancer. The use of preoperative genetic testing allows patients to have combined curative and prophylactic surgery. However, preoperative genetic testing may influence patients to make rash decisions. In healthy BRCA mutation carriers, bilateral prophylactic mastectomy is done to prevent breast cancer from occurring. Bilateral prophylactic mastectomy is highly effective in reducing the risk of breast cancer in healthy BRCA mutation-positive women and may have a survival benefit. Prophylactic oophorectomy reduces the risk of ovarian cancer, but may not have an effect on the risk of breast cancer. There is a lack of studies on surgery for non-BRCA mutations. TP53 and PALB2 are potentially high-risk mutations for breast cancer, which may justify the use of prophylactic surgery. Advice should be given on a case-by-case basis. A comprehensive approach is needed to provide optimum treatment for breast cancer patients with deleterious mutations.
doi:10.3332/ecancer.2018.863 pmid:30174725 pmcid:PMC6113980 fatcat:s7iehgpbrfbzfeneh2xinv7ul4

Factors Associated with Cardiovascular Risk Factors Among Breast Cancer Patients

Shridevi Subramaniam, Hafizah Zaharah, Nur Aishah Taib, Ros Suzanna Bustamam, Cheng-Har Yip, Nirmala Bhoo-Pathy
2020 Zenodo  
Introduction Cardiovascular disease (CVD) is increasingly becoming a concern in breast cancer survivors (1). Factors associated with CVD risk factors were determined among breast cancer patients Method Total of 2127 women newly diagnosed with breast cancer were prospectively recruited from four tertiary hospitals in Malaysia Demographic and medical data were collected through interviews and verified with medical records. Height, weight, blood pressure, serum glucose, and lipid profiles were
more » ... ured. Multivariable logistic regression analysis was conducted to determine factors independently associated with risk factors of CVD (hypertension, diabetes mellitus, obesity, hypercholesterolemia and low level of high-density lipoproteins (HDL)). Results Median age at diagnosis was 54 years (interquartile range: 45-62 years). Increasing age and Indian ethnicity were independently associated with most of the CVD risk factors. Breast cancer patients with higher cancer stages were significantly less likely to have hypercholesterolemia, where an inverse linear association was observed; p for trend = 0.004. Patients presenting with de novo metastatic breast cancer for instance were 50% less likely to have hypercholesterolemia compared to women presenting with stage I breast cancer (OR: 0.50, 95%CI: 0.35-0.72). Likewise, women with stage IV breast cancer were significantly more likely to have low HDL levels than women with early breast cancer (OR: 1.88, 95%CI: 1.24-2.84; p for trend = 0.004). De novo metastatic disease and ER positive breast cancers were independently associated with presence of multiple (clustering) CVD risk factors at baseline. Discussion / Conclusion Advanced cancer stage was associated with low HDL and cholesterol. ❑ Previous study reported that low-HDL-cholesterol levels among breast cancer patients were associated with more aggressive tumour characteristics and worse survival (2). While the discussion that CVD and cancer share similar pa [...]
doi:10.5281/zenodo.4007707 fatcat:y6tczbya3rdjhduyg22hqs473m

"Should I Be Continued Breathing?": Management of Life Limiting Condition from Islamic Ethical Perspective

Siti Nur Haidar Hazlan, Nur Aishah Mazlan, Farah Syazana Kabir Ahmad, Fahisham Taib
2020 Education in Medicine Journal  
Spinal muscular atrophy (SMA) is one of the most recognised life-limiting conditions in paediatric palliative care. Despite the advancement of medical technology, many children with severe SMA die early. Often, managing physicians are trapped in dilemma whether to go all-out treating these patients or to be more conservative using palliative approach, knowing our limited resources and the futility of the treatment outcome. This article discusses the challenging aspect of managing these patients
more » ... by using Islamic medical ethics to resolve this dilemma.
doi:10.21315/eimj2020.12.4.7 fatcat:yxwjovctxjhsxiz6q6kv344oba

A Detection Measure of Outliers Based on Forward Search Approach for Cox-Regression Model

Nor Akmal Md Noh, Ibrahim Mohamed, Nur Aishah Mohd Taib
2014 Statistika  
Aishah Mohd Taib  ...  Variable Possible Outlier Variable Possible Outlier Treatment 155,451 Size 135 history 135,451 Weight 135 Gleason No outliers Variance 135 Nor Akmal Md Noh, Ibrahim Mohamed, and Nur  ... 
doaj:37d524b8f8d04c9e822408ed0c81d055 fatcat:7si76pvvpvdepkpwg2dh4wlm6q

The Predictive Accuracy of PREDICT

Hoong-Seam Wong, Shridevi Subramaniam, Zarifah Alias, Nur Aishah Taib, Gwo-Fuang Ho, Char-Hong Ng, Cheng-Har Yip, Helena M. Verkooijen, Mikael Hartman, Nirmala Bhoo-Pathy
2015 Medicine  
Web-based prognostication tools may provide a simple and economically feasible option to aid prognostication and selection of chemotherapy in early breast cancers. We validated PREDICT, a free online breast cancer prognostication and treatment benefit tool, in a resource-limited setting. All 1480 patients who underwent complete surgical treatment for stages I to III breast cancer from 1998 to 2006 were identified from the prospective breast cancer registry of University Malaya Medical Centre,
more » ... ala Lumpur, Malaysia. Calibration was evaluated by comparing the model-predicted overall survival (OS) with patients' actual OS. Model discrimination was tested using receiver-operating characteristic (ROC) analysis. Median age at diagnosis was 50 years. The median tumor size at presentation was 3 cm and 54% of patients had lymph node-negative disease. About 55% of women had estrogen receptor-positive breast cancer. Overall, the model-predicted 5 and 10-year OS was 86.3% and 77.5%, respectively, whereas the observed 5 and 10-year OS was 87.6% (difference: À1.3%) and 74.2% (difference: 3.3%), respectively; P values for goodness-of-fit test were 0.18 and 0.12, respectively. The program was accurate in most subgroups of patients, but significantly overestimated survival in patients aged <40 years, and in those receiving neoadjuvant chemotherapy. PREDICT performed well in terms of discrimination; areas under ROC curve were 0.78 (95% confidence interval [CI]: 0.74-0.81) and 0.73 (95% CI: 0.68-0.78) for 5 and 10-year OS, respectively. Based on its accurate performance in this study, PREDICT may be clinically useful in prognosticating women with breast cancer and personalizing breast cancer treatment in resource-limited settings. (Medicine 94(8):e593) Abbreviations: ER = estrogen receptor, HER2 = human epidermal growth factor receptor, OS = overall survival, ROC = receiveroperating characteristic,
doi:10.1097/md.0000000000000593 pmid:25715267 pmcid:PMC4554151 fatcat:h75mtigvkfbnnfq52a64im2yba

Ethnic Differences in Mammographic Densities: An Asian Cross-Sectional Study

Shivaani Mariapun, Jingmei Li, Cheng Har Yip, Nur Aishah Mohd Taib, Soo-Hwang Teo, Chang-Qing Gao
2015 PLoS ONE  
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 middleincome Asian countries where genetic and lifestyle determinants may be significantly different. Methods 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
more » ... oss ethnic groups were examined using linear regression in 205 randomly selected Chinese women, 138 Malay and 199 Indian women. Results 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 2 ; 95% CI 67.9cm 2 , 76.5cm 2 ) women compared to Malay (92.1cm 2 ; 95% CI 86.9cm 2 , 97.2cm 2 ) and Indian (97.7cm 2 ; 95% CI 93.4cm 2 , 101.9cm 2 ) women (p<0.001), but dense area did not differ across the three ethnic groups. Conclusions 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. b Adjusted for variables associated with percent density [age, BMI, parity and age at first full term pregnancy] c Adjusted for variables associated with dense area [age, BMI and parity] d Adjusted for variables associated with non-dense area [age and BMI]
doi:10.1371/journal.pone.0117568 pmid:25659139 pmcid:PMC4320072 fatcat:as5yjrgg3rg57l5lspfgprgnwm

Radiopathological characteristics and outcomes of phyllodes tumor of the breast in Malaysian women

Shamsiah Abdul Hamid, Kartini Rahmat, Marlina Tanty Ramli, Farhana Fadzli, Suniza Jamaris, Mee Hoong See, Kean Hooi Teoh, Nur Aishah Mohd Taib
2018 Medicine  
Phyllodes tumor or cystosarcoma phyllodes is a rare fibroepithelial neoplasm which arises from the periductal stroma of the breast. They are classified as benign, borderline, and malignant based on the histologic features. However, all phyllodes tumor (PT) subtypes are regarded as having malignant potential and correct diagnosis is important for surgical management and optimal care. This study is a retrospective review of 76 women diagnosed as PT with highlights on the imaging characteristics,
more » ... athology, and surgical treatment over a 7-year period in a tertiary medical center of urban population in Malaysia. There were 45 benign, 16 borderline, and 15 malignant PT. The median age for benign PT was 43, borderline 48.5, and malignant 42 years. The Malay ethnic group constitute 52.6% of cases, with 27.6% and 18.4% in Chinese and Indian ethnic groups, respectively. On mammograms, most benign (64.3%) and 33.3% of malignant PT showed high-density lesions. Calcifications were only seen in 2 benign PT. On ultrasound, 86% of benign PT was well-circumscribed whilst 50.0% of malignant PT had irregular outline. Cystic spaces were seen in 40.0% of malignant and 9.5% of benign PT. 80% of malignant PT lesions were heterogenous. Malignant PT demonstrates tumor heterogeneity, cystic spaces, and posterior acoustic enhancement on ultrasound. Half of malignant PT showed regular borders on ultrasound and appear well circumscribed on mammogram. A total of 46 patients had wide local excision or excision biopsy whilst 30 underwent mastectomy as primary treatment. The majority of the borderline and malignant PTs in our study (75.0% and 85.7% respectively) and only 5 out of the 43 (11.6%) benign PT underwent mastectomy. There were 2 tumor recurrence in the benign PT group and 1 case in the borderline and malignant group respectively. Abbreviations: ACR = American College of Radiology, BIRADS = Breast Imaging Reporting and Data System, CC = craniocaudal, DWI = diffusion weighted imaging, FNAC = fine needle aspiration cytology, MHz = megahertz, MLO = mediolateral oblique, MRI = magnetic resonance imaging, PT = phyllodes tumor, STIR = Short Tau Inversion Recovery, SWE = shearwave elastography, T1FS = T1 weighted fat saturation sequence, T1W = T1 weighted sequence, T2W = T1 weighted sequence, US = ultrasound, WHO = World Health Organization, WLE = wide local excision.
doi:10.1097/md.0000000000011412 pmid:30075507 pmcid:PMC6081195 fatcat:a2i5egsgsbcqhfesw2r4llrpau

Delays in time to primary treatment after a diagnosis of breast cancer: Does it impact survival?

Mastura Mujar, Maznah Dahlui, Cheng Har Yip, Nur Aishah Taib
2013 Preventive Medicine  
Late presentation is common in Malaysia and involves mainly Malay women with resultant poorer outcomes (Taib et al., 2011a (Taib et al., , 2011b Yip et al., 2006) .  ...  et al., 2011a (Taib et al., , 2011b , this date may well be inaccurate.  ... 
doi:10.1016/j.ypmed.2012.12.001 pmid:23234860 fatcat:pdgymg77lrglrk7ogmpxtfwely

Predicting factors for survival of breast cancer patients using machine learning techniques

Mogana Darshini Ganggayah, Nur Aishah Taib, Yip Cheng Har, Pietro Lio, Sarinder Kaur Dhillon
2019 BMC Medical Informatics and Decision Making  
Breast cancer is one of the most common diseases in women worldwide. Many studies have been conducted to predict the survival indicators, however most of these analyses were predominantly performed using basic statistical methods. As an alternative, this study used machine learning techniques to build models for detecting and visualising significant prognostic indicators of breast cancer survival rate. Methods: A large hospital-based breast cancer dataset retrieved from the University Malaya
more » ... ical Centre, Kuala Lumpur, Malaysia (n = 8066) with diagnosis information between 1993 and 2016 was used in this study. The dataset contained 23 predictor variables and one dependent variable, which referred to the survival status of the patients (alive or dead). In determining the significant prognostic factors of breast cancer survival rate, prediction models were built using decision tree, random forest, neural networks, extreme boost, logistic regression, and support vector machine. Next, the dataset was clustered based on the receptor status of breast cancer patients identified via immunohistochemistry to perform advanced modelling using random forest. Subsequently, the important variables were ranked via variable selection methods in random forest. Finally, decision trees were built and validation was performed using survival analysis. Results: In terms of both model accuracy and calibration measure, all algorithms produced close outcomes, with the lowest obtained from decision tree (accuracy = 79.8%) and the highest from random forest (accuracy = 82.7%). The important variables identified in this study were cancer stage classification, tumour size, number of total axillary lymph nodes removed, number of positive lymph nodes, types of primary treatment, and methods of diagnosis. Conclusion: Interestingly the various machine learning algorithms used in this study yielded close accuracy hence these methods could be used as alternative predictive tools in the breast cancer survival studies, particularly in the Asian region. The important prognostic factors influencing survival rate of breast cancer identified in this study, which were validated by survival curves, are useful and could be translated into decision support tools in the medical domain.
doi:10.1186/s12911-019-0801-4 fatcat:5j36b753vffyzdswu65zqetrpu

Investigating Cognitive Presence in Learning Academic Writing Online

Noor Hanim Rahmat, Ira Syaqira Sukimin, Siti Aishah Taib, Norhafizah Amir, Nur Sherina Zainal Abidin
2022 International Journal of Academic Research in Business and Social Sciences  
Writing today includes the act of tapping onto the keyboards of the computer to compose text for publication. Publication here can mean the simple act of getting the text ready to be read by the audience. The wave of online learning has added more challenges to learn academic writing. Writing is an activity that requires engagement. When it comes to academic writing, there are internal and external factors that contribute to the challenges. This study is done to investigate how learners
more » ... learning academic writing online. After undergoing a semester of learning academic writing, online, learners were asked to respond to a survey. It has 4 sections and used a 5-likert scale. The first section is the demographic profile, the section is on planning, the third is on translating and the last section is on reviewing. Data analysis showed that leaners perceived that planning was not as important as the translating and reviewing stages. Findings has interesting pedagogical implications for the teaching of academic writing online.
doi:10.6007/ijarbss/v12-i1/12191 fatcat:exu5bm23orannnhagxkmzjm3w4

Perceived distress and its association with depression and anxiety in breast cancer patients

Chong Guan Ng, Salina Mohamed, Kiran Kaur, Ahmad Hatim Sulaiman, Nor Zuraida Zainal, Nur Aishah Taib, Yuan-Soon Ho
2017 PLoS ONE  
Breast cancer patients often experience a high level of distress. Psychological distress is a broad construct encompass both depression and anxiety. Previous studies in examining which of these psychological symptoms (either anxiety or depression) were more significantly associated with the distress level in breast cancer patients is lacking. This study aims to compare the level of depression and anxiety between patients with different level of distress. The correlation between the changes in
more » ... stress level with depression or anxiety over 12 months was also examined. Methods This study is from the MyBCC cohort study. Two hundred and twenty one female breast cancer patients were included into the study. They were assessed at the time of diagnosis, 6 months and 12 month using Hospital Anxiety and Depression Scale (HADS) and distress thermometer. The information on age, ethnicity, treatment types and staging of cancer were collected. Results 50.2%, 51.6% and 40.3% of patients had perceived high level of distress at baseline, 6 months and 1 year after diagnosis. Those with high perceived level of distress had significant higher anxiety scores even after adjusted for the underlying depressive scores (Adjusted OR at baseline = 1.28, 95% CI = 1.13-1.44; adjusted OR at 6 months = 1.27, 95% CI = 1.11-1.45; adjusted OR at 12 months = 1.51, 95% CI = 1.29-1.76). There were no significant differences in the depressive scores between the subjects with either low or high distress level. There was reduction in perceived level of distress, anxiety and depression scores at 12 months after the diagnosis. The decrease of distress was positively correlated with the reduction of anxiety scores but not the changes of depressive scores (r' = 0.25).
doi:10.1371/journal.pone.0172975 pmid:28296921 pmcid:PMC5351853 fatcat:3zyrxz3rrbhunipjs75jklowjm

Cytologic, Histologic and Immunocytochemical Features in Fine Needle Aspiration of Paraganglioma-like Variant of Medullary Carcinoma

Gita Jayaram, Jantan Nor Hayati, Cheng Har Yip, Sumithra Ranganathan, Nur Aishah Taib
2008 Acta Cytologica  
Nur Aishah Taib, M.S., F.R.C.S.(Ed.) From the Departments of Pathology, Surgery, and Radiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia (  ... 
doi:10.1159/000325449 pmid:18323289 fatcat:bo4ecg6lhfhwlndw555ljj54ka

Quality of Life in CAM and Non-CAM Users among Breast Cancer Patients during Chemotherapy in Malaysia

Ping Lei Chui, Khatijah Lim Abdullah, Li Ping Wong, Nur Aishah Taib, Robert M Lafrenie
2015 PLoS ONE  
Complementary and alternative medicine (CAM) use has become increasingly popular among patients with cancer. The purposes of this study were to compare the QOL in CAM users and non-CAM users and to determine whether CAM use influences QOL among breast cancer patients during chemotherapy. Methodology A cross-sectional survey was conducted at two outpatient chemotherapy centers. A total of 546 patients completed the questionnaires on CAM use. QOL was evaluated based on the European Organization
more » ... r Research and Treatment of Cancer (EORTC) core quality of life (QLQ-C30) and breast cancer-specific quality of life (QLQ-BR23) questionnaires. Results A total of 70.7% of patients were identified as CAM users. There was no significant difference in global health status scores and in all five subscales of the QLQ C30 functional scales between CAM users and non-CAM users. On the QLQ-C30 symptom scales, CAM users (44.96±3.89) had significantly (p = 0.01) higher mean scores for financial difficulties than non-CAM users (36.29±4.81). On the QLQ-BR23 functional scales, CAM users reported significantly higher mean scores for sexual enjoyment (6.01±12.84 vs. 4.64±12.76, p = 0.04) than non-CAM users. On the QLQ-BR23 symptom scales, CAM users reported higher systemic therapy side effects (41.34±2.01 vs. 37.22±2.48, p = 0.04) and breast symptoms (15.76±2.13 vs. 11.08±2.62, p = 0.02) than non-CAM users. Multivariate logistic regression analysis indicated that the use of CAM modality was not significantly associated with higher global health status scores (p = 0.71).
doi:10.1371/journal.pone.0139952 pmid:26451732 pmcid:PMC4599886 fatcat:mrbkyqtdx5chdaubsgyitwua6i

Opportunistic mammography screening provides effective detection rates in a limited resource healthcare system

Yew-Ching Teh, Gie-Hooi Tan, Nur Aishah Taib, Kartini Rahmat, Caroline Judy Westerhout, Farhana Fadzli, Mee-Hoong See, Suniza Jamaris, Cheng-Har Yip
2015 BMC Cancer  
Breast cancer is the leading cause of cancer deaths in women world-wide. In low and middle income countries, where there are no population-based mammographic screening programmes, late presentation is common, and because of inadequate access to optimal treatment, survival rates are poor. Mammographic screening is well-studied in high-income countries in western populations, and because it has been shown to reduce breast cancer mortality, it has become part of the healthcare systems in such
more » ... ries. However the performance of mammographic screening in a developing country is largely unknown. This study aims to evaluate the performance of mammographic screening in Malaysia, a middle income country, and to compare the stage and surgical treatment of screen-detected and symptomatic breast cancer. Methods: A retrospective review of 2510 mammograms performed from Jan to Dec 2010 in a tertiary medical centre is carried out. The three groups identified are the routine (opportunistic) screening group, the targeted (high risk) screening group and the diagnostic group. The performance indicators of each group is calculated, and stage at presentation and treatment between the screening and diagnostic group is analyzed. Results: The cancer detection rate in the opportunistic screening group, targeted screening group, and the symptomatic group is 0.5 %, 1.25 % and 26 % respectively. The proportion of ductal carcinoma in situ is 23.1 % in the two screening groups compared to only 2.5 % in the diagnostic group. Among the opportunistic screening group, the cancer detection rate was 0.2 % in women below 50 years old compared to 0.65 % in women 50 years and above. The performance indicators are within international standards. Early-staged breast cancer (Stage 0-2) were 84.6 % in the screening groups compared to 61.1 % in the diagnostic group. Conclusion: From the results, in a setting with resource constraints, targeted screening of high risk individuals will give a higher yield, and if more resources are available, population-based screening of women 50 and above is effective. Opportunistic mammographic screening is feasible and effective in a middle income country with performance indicators within international standards. Waiting until women are symptomatic will lead to more advanced cancers.
doi:10.1186/s12885-015-1419-2 pmid:25972043 pmcid:PMC4437679 fatcat:srw6qmx5njdh5n4kfzyeykzm6i

The Malaysian Breast Cancer Survivorship Cohort (MyBCC): a study protocol

Tania Islam, Nirmala Bhoo-Pathy, Tin Tin Su, Hazreen Abdul Majid, Azmi Mohd Nahar, Chong Guan Ng, Maznah Dahlui, Samsinah Hussain, Marie Cantwell, Liam Murray, Nur Aishah Taib
2015 BMJ Open  
Correspondence to The past two decades observed a steep Breast cancer is the most common cancer Professor Nur Aishah Taib; increase in  ...  Aishah Taib,2 MyBCC study group To cite: Islam T, Bhoo- ABSTRACT contrast to Western countries, where breast Pathy N, Su TT, et al.  ... 
doi:10.1136/bmjopen-2015-008643 pmid:26503386 pmcid:PMC4636649 fatcat:ss434yurmrctfcf6janzmfhsiy
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