title: Trends of breast cancer treatment in Sabah, Malaysia: a problem with lack of awareness.
abstract: BACKGROUND
  Sabah, formerly known as North Borneo, is part of East Malaysia. 52.2 percent of patients with breast cancer in Sabah presented at advanced stages and up to 20.4 percent of patients defaulted proper treatment, opting for traditional therapy. We performed a two-year prospective study looking at the treatment trends of breast cancer in Sabah.
  
  
  METHODS
  Our subjects were all newly-diagnosed breast cancer cases seen at the hospital in 2005 and 2006. Type of surgery, chemotherapy, radiotherapy, hormonal therapy and surgical complication for each patient were studied.
  
  
  RESULTS
  Out of 186 newly-diagnosed cases, 152 (81.7 percent) had surgery, 126 (67.7 percent) had chemotherapy, 118 (63.4 percent) had radiotherapy and 92 (49.5 percent) had hormonal therapy. 18.3 percent did not have surgery either due to refusal of treatment or advanced disease. They were more likely to be non-Chinese (91.1 percent, p-value is 0.02). Only 15.8 percent had breast-conserving surgery. The most frequent surgical complication was seroma formation (15.0 percent) . The commonest chemotherapy regime and hormonal therapy were anthracycline-based regime (88.1 percent) and tamoxifen (95.8 percent), respectively.
  
  
  CONCLUSIONS
  The proportion of breast-conserving surgery and usage of modern adjuvant therapies are low in Sabah. This can be attributed to lack of breast cancer awareness leading to late presentation and refusal of treatment, coupled with insufficient health service funding.
authors.affiliation: Department of Surgery, Queen Elizabeth Hospital, Kota Kinabalu 88300, Malaysia.
authors.forename: B D K
authors.initials: BD
authors.lastname: Leong
authors.forename: J A
authors.initials: JA
authors.lastname: Chuah
authors.forename: V M
authors.initials: VM
authors.lastname: Kumar
authors.forename: S
authors.initials: S
authors.lastname: Rohamini
authors.forename: Z S
authors.initials: ZS
authors.lastname: Siti
authors.forename: C H
authors.initials: CH
authors.lastname: Yip
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008296:Malaysia; D008495:Medical Oncology / Q000639:trends; D008875:Middle Aged; D009367:Neoplasm Staging; D010349:Patient Compliance; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome