Study of risk factors and marker status in women with breast cancer in Brunei Darussalam.

OBJECTIVE: To investigate the associations between breast cancer staging and body mass index (BMI), menopausal status, and family history of breast cancer, as well as to assess the expression of tumor markers in women with breast cancer in Brunei Darussalam. METHODS: A retrospective cross-sectional study was carried out at The Brunei Cancer Centre. Cases of women with breast cancer between 2000 and 2013 were retrieved from the medical records section and entered into a clinical proforma. These were reviewed and analyzed using appropriate statistical methods. RESULTS: Overall, the mean age at diagnosis was 53.6 years ± 9.83. The postmenopausal women had a significantly higher risk of being diagnosed with late-onset breast cancer than premenopausal women (P = 0.022). The expressions of PR (P = 0.034), Her2 (P = 0.046), and CatD (P = 0.004) were significantly different in breast cancer staging. Other factors did not have a statistically-significant association with breast cancer staging. CONCLUSION: While most of the factors studied were not significantly different in breast cancer staging, our findings showed that it is recommended that high-risk women perform regular breast screening after the age of 40 years old. A future study highly appreciates comparing breast cancer risk factors among the Bruneian and Western populations.

Public knowledge of and attitudes toward genetics and genetic testing in Brunei Darussalam.

The world has been experiencing encouraging research in genetics, but current public knowledge, awareness, and perception of this area remain unknown for Brunei Darussalam. This study aimed to investigate the Brunei population's genetics and genetic testing literacy, and their attitude toward them. A cross-sectional study was carried out targeting public population in Brunei Darussalam. Questionnaires on knowledge and attitudes were randomly distributed in frequented venues in the Brunei-Muara district and uploaded online for distribution through social media. Responses were scored and analyzed using appropriate statistical methods. Overall, the sample population (n = 474) comprised 75.7% female, 64.3% aged 18-29 years old, 39.7% with a bachelor's degree, and 2.3% and 5.3% with a personal history and family history of genetic disease(s), respectively. Younger participants scored higher for disease-related questions and showed more concern on the impact of testing on employment but were more fearful of testing. Higher educational qualifications were associated with a higher knowledge score, a more optimistic view on DNA research, and less reluctance to take a genetic test for an untreatable disease. Participants with a personal history of genetic disease(s) were more knowledgeable and displayed higher curiosity. Participants with a family history of genetic disease(s) were also more knowledgeable and would want testing even for an untreatable disease. Significantly less was known about the social consequences of testing compared to the medical possibilities. Investigating the knowledge and attitudes of the population is vital preceding efforts toward national adaptation of genetic testing, keeping in mind the various obstacles and issues surrounding the subject.

Fluorescence in situ hybridisation analysis of human epidermal growth factor receptor 2 status for breast cancer cases in Brunei Darussalam.

BACKGROUND: Breast cancer is one of the leading cancers among females of Brunei Darussalam. There are four subtypes of breast cancer, including human epidermal growth factor receptor 2 (HER-2) positive breast cancer, which is known to be more aggressive and have a poor prognosis. AIM: This study aims to assess the proportion of HER-2 positive cases and the association of HER-2 positivity with patients' epidemiological and clinicopathological factors in Brunei Darussalam. METHODS AND RESULTS: A total of 146 breast cancer cases that were sent for fluorescence in situ hybridisation (FISH) analysis from 1 January 2012 to 31 December 2016 were obtained from The Brunei Cancer Centre, Brunei Darussalam. Data analysis was done with regards to age at diagnosis, ethnicity, stage at diagnosis and HER-2 results by immunohistochemistry (IHC) and FISH. Majority of the study population were diagnosed before the age of 50 years and the median age was 52.0 years. 58.2% (n = 85) cases were reported as IHC 3+, followed by 23.3% (n = 34) IHC 2+ cases and 18.5% (n = 27) negative cases. The proportion of true HER-2 positive cases in total by FISH analysis was 34.9% (n = 51). Majority of Stage IV HER-2 positive cases had metastases to the liver or bones. CONCLUSIONS: Age at diagnosis is significant in determining HER-2 status of tumours by FISH (P = .045). Tumour size (P < .001) and lymph node (P = .006) are significant in metastases of tumours. The proportion of HER-2 positive cases is consistent with findings from the Asian region but higher than that of Western countries. Determining false-positive and false-negative results by IHC test is important to ensure adequate treatment for patients with breast cancer.