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Abstract
Women who do early detection of breast cancer can be said to be still a little. Though the
importance of breast examination since early is to know a woman's breasts under normal
circumstances or not. This study aims to determine the proportion of several specific factors
that cause the risk of breast cancer incidence in women aged 25-65 years with an
observational analytic method with case control design. Sampling is done by using
probability sampling with simple random sampling technique approach. The sample size was
23 women in the case group and 46 women in the control group in the working area of
Gandus and Dempo, South Sumatera – Palembang sub-districts from May to September
2017. Screening data were collected using a questionnaire and analyzed by bivariate analysis
using chi square and fisher's exact statistical tests, continued with multivariate analysis using
multiple logistic regression statistic test. Based on the results of bivariate analysis found that
there are 7 specific risk factors from the overall 15 related factors (p value <0.05) with risk
factors for breast cancer incidence. The seven specific risk factors were age (OR: 0.6, 95%
CI: 0.53-0.79), first menstrual period (OR: 24; 95% CI: 2.76-207.98), history of tumor (OR:
3.2, 95% CI: 2.28-4.75), long breastfeeding (OR : 95% CI: 2.23-4.54), consumption of fatty
foods (OR: 0.2; 95% CI: 0.07-1.00), types of hormonal contraceptives (p value <0 , 05). The
result of multivariate analysis with multiple logistic regression was found that menstrual age
was the specific factor of a person detected at risk of breast cancer (p value 0.05-0.55) is very
important because most women are not aware of breast cancer symptoms and risk factors that
are difficult to handle.
4. Result
The proportion of women at risk of breast cancer incidence was 33.3% of the 69
women aged 25-65 years.
Clinical breast examination results were good in case group and control group
are not normal (case group) most found at had no history of breast cancer. In this
age ≥ 40 years. Mean age of respondents study 8.7% breastfeeding <6 months,
between case group and control group 1: 3. where the results of the analysis prove that
Mean age of respondents in case group there is a relationship between
39.79 ± 5.71, while in the control group breastfeeding duration and risk of breast
30.46 ± 5.33. In the distribution of the first cancer incidence. In this study there was
menstrual age is categorized into 2 namely no ridge between the consumption of
<12 Years, and ≥ 12 Years. eating fibrous foods with the risk of cancer
incidence breast (p value> 0,05). Most
The majority of respondents in the case groups consumed a high-fat diet
case group experienced first menstruation (69.6%), as did the control group (89.1%).
at age ≥ 12 years (65.2%), as well as in the There is relationship between fatty food
control group (97.8%). In this study there consumption and risk of breast cancer
is a relationship between the first incidence (p value <0,05). The majority of
menstrual age of respondents with the risk respondents in the group of cases doing
of breast cancer incidence (p value <0.05). physical activity ≥ 30 minutes in a day
The results of chi-square analysis showed (95.7%), in this study respondents
that in the history of benign tumors in considered that doing housework is also a
breast (p <0.05) with abnormal CBE sport so that most respondents in the
examination (case group), 8.7% of control group also the majority of physical
respondents had a history of benign tumors activity ≥ 30 minutes per day (100%).
in the breast.
The results of statistical analysis
The OR value indicates that women prove that there is no relationship between
with a history of benign tumors in the physical activity with risk of breast cancer
breast 3.19 times will be at risk of breast incidence (p value> 0,05). There was no
cancer (2.23-4.54, 95% CI). In the association between the use of oral
distribution of family history of cancer, hormonal contraceptives and the risk of
13% of cases have a family history of breast cancer incidence (p value> 0.05).
cancer. Cancer family history variable was The pregnancy age variable during
associated with risk of breast cancer (p abortion was not associated with cancer
value <0,05). In this study all respondents risk (p value> 0.05). This is because the
majority of respondents in the case group using multiple logistic regression statistic
never had an abortion (82.6%) as well as test. Some specific factors have p value
in the control group (91.3%). Specific <0.05 hereinafter is explained in table 3
factors associated with the risk of breast below.
cancer incidence were then analyzed by
Table.4 Final Model Multiple Logistic Regression Analysis Of Specific Breast Cancer Risk
Factors
Based on the result of multivariate analysis that the first age mestruasi is a specific risk factor
in the last modeling (p value <0.05, Exp (B): 0.05, 95% CI: 0,06-0,55) with multiple logistic
regression statistic.
Age is one factor that can increase rapidly Based on Marice's research (2014), that
entering reproductive age (Wakai et al, menopause meiliki 3.58 times the risk of
2000). having breast tumor than in women who
have not menopause. However, other
First Menstrual Age studies suggest that the early age of
menopause is unrelated to breast cancer
In this study found 34.8% of respondents risk. At age <55 Years at risk 2 times
who experienced the first menstruation> breast cancer than women who experience
12 years, according to Indrati (2005) states menopause <55 Years.
that early menstrual age associated with
duration of exposure to estrogen and History of Benign Tumor In Breast
hormone progesterone. This hormone
affects the proliferation of tissue, including Dupont (2004), said that women who had
the breast tissue. This is stated also by previously had benign tumors in the breast
Sirait et al (2009) states that breast tissue is are at risk for developing breast cancer. In
very sensitive to estrogen hormones the Indrati study (2005), it was discussed
because exposure to estrogen hormone in that an increased risk of breast cancer in
women who previously had benign tumors will decrease exposure to estrogen in the
in the breast was associated with an breast will decrease. During breastfeeding
excessive proliferation process. the hormones estrogen and progesterone
Proliferative events that occur in the breast will decrease so that the exposure of these
tissue without accompanied by the control hormones in the breast organ will prevent
of cell death programmed by apoptosis the occurrence of proliferation that may
process cause malignancy because the occur so that the risk of causing breast
body is unable to detect any damage to cancer (Indrati (2005), Tjindarbumi
DNA. (2003), Wakai (1995)). But this study is
not in line with research Rianti (2012)
Family Cancer History which proves that there is no relationship
history menyusi with incidence of breast
Genetically the cause of a person can be at cancer. This proves that the history of
risk of breast cancer is a mutation of genes breastfeeding is not specifically linked to
BRCA1 and BRCA2 (Van de Velve et al, breast cancer incidence. According to
1999). In the Yulianti study (2016), it also Lanfranchi (2006), that there is a process
proves that this study is in line where a that occurs from the time of pregnancy
person with a family history of 2.77 times until breastfeeding for breastfeeding. At
had breast cancer, where in the study it that time there is a change of cell type
was discussed that the BRCA gene present from type 3 to type 4 and will produce
in DNA serves to control cell growth in milk. Based on this, the duration of
order not to proliferate . Women who breastfeeding is a specific factor to be
inherit a mutated gene from a family will known.
be at risk of breast cancer. (Lanfranchi,
2005). Stress Level
History of Breast Cancer and Ovarian In the Marice study (2014), proving that
Cancer there is a relationship between stress levels
with breast tumors (p value <0.05). The
Breasts are organs on the right and left statement of Walta Gautama (2014) in
sides of the body where the system is Asep Chandra (2014), on Kompas media,
strongly influenced by the same factors that stress can trigger the occurrence of
(Indrati (2005), Scheinn (1997)). Women breast cancer where stress will increase
who have a previous history of breast one's estrogen hormone, so that can trigger
cancer are at risk for developing breast the occurrence of breast cancer. In severe
cancer. Women who have a history of stress conditions can lead to disruption of
ovarian cancer may also be at risk of the body's cellular balance. The state of
developing breast cancer. This is because stress can affect the cell to become
the discovery of the relationship between hyperactive and may experience
breast cancer and ovarian cancer is proliferation so that it can experience a
estimated due to imbalance hormone proliferation that can be at risk of breast
estrogen (Indarati (2005); Dupont (2004); cancer incidence. (KKP, MOH, 2017).
Pherson (2000)).