Table II.
Cultural practices of the three major ethnic groups in Malaysia and breast cancer risks.
| A, Dietary habits | ||
|---|---|---|
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| Ethnicity | Practice | Breast cancer risk |
| Malay | Turmeric/curcumin consumption | Reduced risk: Curcumin inhibits proliferation and induces apoptosis of breast cancer cell lines (14) |
| High consumption of vegetables and fruits | Reduced risk: High dietary fibre reduces breast cancer risk in a study of Malaysians compared with controls (22) Women, aged 25 to 70 years, followed-up for 15 years, in the European Prospective Investigation into Cancer and Nutrition Study showed that high fibre intake reduced breast cancer risk (23) | |
| Chinese | Soy product consumption | Reduced risk: A meta-analysis of Chinese women (aged 30–79 years) followed up for 10 years and other studies in Asia and Western countries found that an increase in soy intake reduced breast cancer risk (16) |
| Alcohol consumption | Increased risk: Alcohol consumption is a risk factor for breast cancer in premenopausal women (25) | |
| Indian | Turmeric/curcumin consumption | Reduced risk: As aforementioned (14) |
| Alcohol consumption | Increased risk: As aforementioned (25) | |
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| B, Confinement diet | ||
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| Ethnicity | Practice | Breast cancer risk |
|
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| Malay | Turmeric/curcumin consumption | Reduced risk: As aforementioned (14) |
| Kacip Fatimah (Labisia pumila) consumption | Reduced risk: Cytotoxic activity against the MCF-7 breast cancer cell line (30,31) | |
| Chinese | Alcohol consumption | Increased risk: As aforementioned (25) |
| Ginseng and Dong Quai (Angelica sinensis) consumption | Conflicting reports: Recent studies showed that Dong Quai did not induce breast cancer but caution use in oestrogen receptor-positive breast cancer patients, while ginseng inhibits growth of breast cancer cell lines (37,38) | |
| Indian | Turmeric/curcumin | Reduced risk: As aforementioned (14) |
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| C, Fertility rate | ||
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| Ethnicity | Practice | Breast cancer risk |
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| Malay | Highest parity rate, lowest usage of OCP | Reduced risk: Increased parity lessens breast cancer risks (28) |
| Chinese | Lowest parity rate, highest usage of OCP | Increased risk: Use of OCP increase breast cancer risk (28) |
| Indian | Parity and usage of OCP ranking between that of the Malays and the Chinese | Medium risk |
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| D, Breastfeeding | ||
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| Ethnicity | Practice | Breast cancer risk |
|
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| Malay | Most practiced | Reduced risk: Decrease breast cancer risk if breastfeeding for >6 months (28) |
| Chinese | Least practiced | Increased risk: No breast feeding protective effect against breast cancer (27) |
| Indian | In between the Malays & the Chinese | Reduced risk: Decrease breast cancer risk if breastfeeding for >6 months (28) |
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| E, Postmenopausal diet | ||
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| Ethnicity | Practice | Breast cancer risk |
|
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| Malay | Kacip Fatimah (Labisia pumila) consumption | Reduced risk: As aforementioned (30,31) |
| Chinese | Dong Quai (Angelica sinensis) consumption | Conflicting reports: As aforementioned (37) |
| Indian | Data not available | Data not available |
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| F, Traditional healer | ||
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| Ethnicity | Practice | Breast cancer risk |
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| Malay | Strong belief | Increased risk: These women had the worst outcome (8–10) |
| Chinese | No strong belief | No increased risk |
| Indian | No strong belief | No increased risk |