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Title:	Breast cancer risk among malaysian women: assoiation of dietary, lifestyle factors and biomarkers with quantitative and qualitative values of electrical impedance tomography (EIT) and effectiveness of lifestyle intervention
Authors:	Norsham Juliana Nordin (P60314)
Supervisor:	Suzana Binti Shahar, Prof. Dr.
Keywords:	Breast cancer Women Dietary Lifestyle Dissertations, Academic -- Malaysia
Issue Date:	1-Oct-2015
Description:	Due to the increase in the incidence of breast cancer, there are various modalities for breast cancer detection and several approaches for breast cancer prevention. However, very few studies focus on non-invasive screening namely electrical impedance tomography (EIT). Therefore, a three phases study was designed to validate the EIT device in detecting breast abnormalities as compared to the gold standard of breast cancer screening ie mammogram. Further, the association between dietary, lifestyle factors and biomarkers with quantitative values of EIT and the effectiveness of home based dietary and lifestyle intervention (Her Shape) on improving EIT quantitative values and obesity related markers were also determined. The first phase was a single center validation study among 164 women attending mammography screening at Universiti Kebangsaan Malaysia Medical Center. The second phase was a crosssectional study to screen 450 women around Klang Valley for their EIT quantitative values in relation to dietary intake and physical activities. The third phase was a randomized controlled trial of a 4-month Her Shape module study among obese women with high adiposity of the breast as detected using EIT. Results in the first phase indicated that EIT sensitivity (169.4%; 255.3%), specificity (163.3%; 257.0%), positive predictive value (167.1%; 258.0%) and negative predictive value (165.8%, 254.2%) for the two raters in this study were moderate with the reliability for each rater (Intrarater: 1K=0.88; 2K : =0.79)(Interrater: K =0.22) ranged between good to very good. Numeric pain distress score of EIT was also lower (1.5 + 0.8) as compared to mammography (4.2 + 0.9). EIT quantitative values extremum cu (adjusted OR= 4.6; 95% CI: 2.8-7.4), distribution discrimination% (adjusted OR= 2.3; 95% CI: 1.4 - 3.6), tomogram comparison (adjusted OR= 3.2; 95% CI: 1.5 - 6.7); vitamin C (adjusted OR = 2.0; 95% CI: 1.1 - 3.8); physical activities of all item total time (adjusted OR = 3.4; 95% CI: 2.3 - 6.5), household activities total time (adjusted OR= 2.3; 95% CI: 1.2 - 4.4), all item activity score (adjusted OR = 3.4; 95% CI: 2.3 - 6.5), household activities activity score (adjusted OR = 2.8; 95% CI: 1.4 - 5.5); and biomarkers ie adiponectin (adjusted OR = 2.2; 95% CI: 1.8 - 8.0)] were predictors of abnormal mammogram. Whilst in the second phase, high waist circumference (OR=1.7; 95% CI: 1.1 - 2.6); high fat percentage (OR = 3.0; 95% CI: 1.9 -4.8); and low activity score of leisure time activities (adjusted OR = 7.8; 95% CI: 1.9 - 10.6) were predictors of breast adiposity as assessed using EIT. The third phase showed that there were significant intervention effect with reduction on the mean of total calorie (p=0.002) and carbohydrates intake (p<0.005), body weight (p=0.045), body mass index (BMI) (p<0.05), total cholesterol/ HDL (p=0.045), and MMP-9 (p<0.05). Mean of vitamin C intake (p=0.003), minutes/week (p<0.001) and activity score of the physical activity (p=0.001), and extremum Cu of the EIT (p=0.022) increased significantly after the four months among the intervention group as compared to the control group. In conclusion, EIT has the potential to be used as a complementary screening modality to the existing methods and the quantitative values of EIT has the potential as health discriminating index. Furthermore the Her Shape intervention was beneficial in reducing the weight and adiposity of the breast and may lead to lowering the risk towards developing breast cancer.,Ijazah Doktor Falsafah
Pages:	292
Call Number:	WP870.N863b 2015 9
Publisher:	UKM, Kuala Lumpur
Appears in Collections:	Faculty of Health Sciences / Fakulti Sains Kesihatan

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