Lifestyle link to breast cancer

NST: KUALA LUMPUR: One in 16 Chinese and Indian women and one in 28 Malay women will develop breast cancer in their lifetime.
But why do more Chinese than Malays develop the disease?
Professor Dr Yip Cheng Har puts it down to the Chinese having fewer children at a later age and breast-feeding them for shorter periods.
The Universiti Malaya Faculty of Medicine lecturer said a generally higher socio-economic status, diet and genetics also played a role.
The incidence among the Chinese is the highest with 59.7 per 100,000, followed by the Indians at 55.8 per 100,000. The Malays have the lowest incidence at 33.9 per 100,000.
"We do not know what it is in the Chinese diet that makes their women more prone to breast cancer.
"Dietary studies are usually based on recall or population studies (in different geographical areas) and so are very difficult to verify."
Dr Yip said research had shown that a diet rich in animal fats and low in vegetables could lead to breast cancer but these studies were inconclusive.
"Socio-economic status is related to lifestyle — richer women have richer food and are less likely to have children young. They also have fewer children."
She said the Breast Cancer Research Initiatives Foundation (Carif) was carrying out an in-depth study on the role of genetics in the disease.
She said there was also a possibility of under-reporting in Malay women because they were more likely to seek alternative therapy.
Of the 3,738 cases of breast cancer in 2003, about 50 per cent of patients were aged below 50, with prevalence among those between 40 and 49.
But the incidence of breast cancer in Malaysia is much lower compared with developed countries, including the US and European countries. For example, the Malaysian rate is half that of the US.
Dr Yip said the lower incidence in Malaysia and other countries in Asia and Africa could be due to the differing risk factors associated with lifestyle, reproductive factors and diet.
"Breast cancer is a cancer of the affluent countries and the incidence rate increases with industrialisation and economic development," she added.
The mean age of onset in Malaysia and other developing countries is lower than that in developed countries, where the mean age is 60.
This could be due to the population age structure where much of the population in developing countries was young, with the median age of Malaysians being 24 years.
Dr Yip said Malay women generally had Stage Three and Four breast cancer while this was the case with only 15 per cent of the Chinese and 20 per cent of the Indians.
She said this differed from developed countries where people were generally more aware of the disease and came in for treatment early.
She said mammography as a population-based screening procedure for breast cancer was not a policy in Malaysia as its value was negligible given the limited resources.
Dr Yip said the Department of Family Health had formed a technical committee to look into a pilot mammography screening project for the purpose of assessing the feasibility of introducing mammography screening.
In 1993, the Health Ministry decided to set up breast clinics in all major hospitals, but their development had been stagnant due to a lack of resources.
Dr Yip’s message to women is this: Breast cancer can be cured if detected and treated early.