Risk Factors for Breast Cancer Occurrence in Women Age 15-65
Years in Kendari City in 2018
La Banudi
1*
, Nur Hamsar Sarmin
2
, Djasmurni
2
and Sitti Aisa
1
1
Health Polytechnic of Kendari, Ministry of Health, Jalan Jenderal A.H Nasution No. G-14, Kambu, Kendari, Sulawesi
Tenggara, Indonesia 93231
2
Mandala Waluya College of Health Sciences, Jalan Jenderal A.H Nasution, Kambu, Kendari, Sulawesi Tenggara,
Indonesia 93561
Keywords: Breast Cancer, Menarche, Breastfeeding History, Family History, Hormonal Contraception, Smoking
History.
Abstract: Basic Health Research of Indonesia "Riskesdas" in 2013 noted the prevalence of cancer in Indonesia was 1.4
per 1000 population or around 347,792 people and is the number 7 cause of death (5.7%) of all causes of
death. The incidence of cancer in Southeast Sulawesi was 0.5 ‰ with an estimated absolute number of 590
cases. This research was analytic survey research with a case-control study approach. The population in this
study were women aged 15-65 years who were diagnosed with breast cancer. The sample amounted to 100
respondents divided into 50 case samples and 50 control samples. The test analysis used was the odds ratio.
The odds ratio test results indicated that a history of menarche was a risk factor for breast cancer, a history of
breastfeeding was a risk factor for breast cancer incidence. Family history was a risk factor for breast cancer
incidence. A history of hormonal contraception was a risk factor for breast cancer. The age of giving birth to
a first child was not a risk factor for breast cancer, smoking history was a risk factor for breast cancer.
1 INTRODUCTION
Cancer is one of the leading causes of death
worldwide. Cancer is an abnormal growth of body
tissue cells that turn malignant. Cancer is a disease
that does not recognize social status and can attack
anyone and arise due to abnormal growth of body
tissue cells that turn into cancer cells in its
development. Breast cancer is a condition where cells
have lost control and normal mechanisms, resulting
in abnormal, fast, and uncontrolled growth that occurs
in breast tissue. (Heena et al., 2019; Suardita,
Chrisnawati, & Agustina, 2016)
Based on data from Global Burden Cancer
(Globocan), the International Agency for Research on
Cancer (IARC), stated that breast cancer was the
highest cause of death from cancer in women. Breast
cancer ranks first in new cases, and deaths from
cancerwere 43.3% and 12.9%. Globocan also
presented data on cases of breast cancer in 2012 that
occurred in the world reached 1,677,000 and the
mortality rate reached 522,000. (Fan et al., 2019;
Wahyuni, Chrisnawati, & Santoso, n.d.)
The incidence of cancer in Asia was 20 people
among the 100,000 population. While the incidence
of breast cancer in Southeast Asia was recorded at
55,097 cases, and the death rate was 24,961 cases.
Breast cancer is a major problem worldwide because
of its high mortality and morbidity. (Fan et al., 2019;
Suardita et al., 2016)
Globocan data for 2012 noted that the incidence
of cancer in women in Indonesia is 134 per 100,000
population with the highest incidence of breast cancer
of 40 per 100,000, followed by cervical cancer of 17
per 100,000 women. Furthermore, Globocan
estimated the mortality rate in Indonesia for breast
cancer to be 16.6 deaths per 100,000 population,
followed by cervical cancer with 8.2 deaths per
100,000 population. An increasing number of breast
cancers in Indonesia can be seen from patients who
came for treatment, where 60-70% of sufferers were
in advanced stages. (Rukmi & Handayani, 2013)
More than 25% of women were diagnosed with
cancer, one of which was breast cancer. Until now,
the exact cause of breast cancer was unknown, but
many studies had shown that there were several
factors associated with an increased risk or possibility
Banudi, L., Sarmin, N., Djasmurni, . and Aisa, S.
Risk Factors for Breast Cancer Occurrence in Women Age 15-65 Years in Kendari City in 2018.
DOI: 10.5220/0009191202630270
In Proceedings of the 2nd Health Science International Conference (HSIC 2019), pages 263-270
ISBN: 978-989-758-462-6
Copyright
c
 2020 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
263

of breast cancer. These factors were risk factors
which include reproductive factors such as menarche
or first menstruation less than 12 years old,
menopause at the age of more than 50 years, giving
birth to a first child over 30 years of age, parity,
history of breastfeeding; endocrine factors such as
long-term use of oral contraceptives; diets such as
fatty foods, alcohol; genetic or family history,
exposure to ion and ultraviolet (UV) radiation during
breast growth, history of smoking or exposure to
cigarette smoke. (Fan et al., 2019; Wyatt, Jenkins,
Plevak, Pont, & Pruthi, 2019)
The use of oral contraceptives (birth control pills)
had a slightly greater risk of developing breast cancer
than women who had never used it. This risk can
decrease after stopping pill use. Women who stop
using oral contraceptives for more than 10 years were
less likely to have an increased risk of breast cancer.
In addition to contraceptive pills, other hormonal
contraceptives such as injectable contraceptives
given every 3 months were also known to affect
breast cancer. Women who used injectable
contraceptives tend to have an increased risk of breast
cancer. (Phipps et al., 2011)
Palmer et al (2011) in Rukmi (2013) showed that
the age of giving birth to a first child was a factor that
can cause a woman to develop breast cancer. Women
with a history of giving birth to their first child before
the age of 25 had a 30% to 40% reduction in the risk
of breast cancer compared to women who had
children after the age of 35 or in nulliparous women,
regardless of the number of births. The increased risk
of developing breast cancer was thought to be due to
the stimulation of maturation of breast cells induced
by pregnancy, which made these cells more sensitive
to carcinogenic transformations. (Rukmi &
Handayani, 2013)
Suciawati (2017) explained that women who
smoke or were exposed to cigarette smoke can trigger
breast cancer. Cigarette smoke contains chemicals in
higher concentrations and is very dangerous for
health. The longer exposure to cigarette smoke, the
more particles of substances that are toxic and
carcinogens accumulate in the body. (Ayu, Setiowati,
Tanngo, & Soebijanto, 2016)
Initial studies at the Public Hospital of
Bahteramas, the number of patients with breast
cancer by 87 patients in 2015, then increased by 97
patients in 2016 and increased dramatically in 2017
by 128 patients. From January to March 2018 there
were 26 patients. In Public Hospital of Kendari City
Hospital there were 18 patients in 2016, declining to
12 patients in 2017 and from January to March in
2018 there were 6 patients. Anugrah Medika Medical
Oncology Clinic, which specializes in handling breast
cancer cases from 2015 to 2018, found 91 sufferers
and 35 domiciled in Kendari City. Breast cancer is
cancer that is commonly found in women aged 15-65
years.
Based on the description above, breast cancer is
one of the life-threatening health problems that
continue to experience an increase in incidence
caused by various factors. Therefore it is very
important to research to analyze the risk factors for
breast cancer.
2 METHODS
This research was analytic survey research with case-
control approach. Research with a case-control
approach was research conducted to determine risk
factors or health problems that were suspected to have
a close relationship with diseases that occur in the
community.
The sample is part of the number and
characteristics of the population or part of the object
under study and is considered representative of the
entire population. The control group was taken from
the community in the area of Public Hospital of
Bahteramas with the same age criteria as the case
group and had carried out controls in polyclinic of
oncology, so the number of samples in this study was
100 people consisting of 50 case groups and 50
control groups. Matching used in this study was age,
ie women aged 15 to 65 years and women who were
married, to balance between case samples and control
samples to have the same characteristics.
Data collected from respondents during the study
took place using a questionnaire. Secondary data is
data obtained from other parties, namely from
medical record reports of Public Hospital of
Bahteramas, Public Hospital of Kendari City, and
Oncology Clinic of Anugrah Medika Kendari.Data
analysis is an activity in research which includes the
preparation, tabulation and application of data.
Explain or describe the characteristics of each
research variable. This analysis produced the
frequency distribution and percentage of each
variable. This analysis is used to see the extent of the
relationship between variables. In this study the odds
ratio test, which is a hypothesis test or analysis to
obtain relative risk. Analysis of the data in this case
to test the null hypothesis was used epidemiological
analysis (Odds Ratio) using a 2x2 table.
In conducting research, it is necessary to have a
recommendation from the institution of another party
by applying for permission to the agency where the
HSIC 2019 - The Health Science International Conference
264

research. After obtaining approval, the research is
conducted by emphasizing research ethics issues
which include:
Informed Consent: This consent sheet is given to
respondents who meet the inclusion criteria, and are
accompanied by the title of the study and the benefits
of the study. If the subject refuses the researcher will
not force the will and continue to respect the rights of
the subject.
Anonymity: To maintain confidentiality, the
researcher will not include the name of the
respondent, but the sheet is given a code.
Confidentiality: The confidentiality of respondent
information is guaranteed by the researcher and only
certain data groups will be reported as research
results. (Nursalam, 2013).
3 RESULTS AND DISCUSSION
The characteristics of the respondents as described in
table 1 below. The table showed that of the 100 most
respondents at age 50-57 which amounted to 34
respondents, while the smallest in the age group 58-
65 years as many as 16. Respondents who had jobs as
housewives numbered 80 people, as many as 19 civil
servants and there were 1 entrepreneur. The level of
education with the highest percentage was 39 people
in high school, and the lowest was 8 people in
elementary school.
Table 1: Characteristics of Respondents in Women Aged
15-65 Years in Kendari City.
Characteristics
Group
Total
Case
Control
Age
34-41
12
12
24
42-49
13
13
26
50-57
17
17
34
58-65
8
8
16
Occupation
Housewife
39
41
80
Civil Servant
11
8
19
Entrepreneur
-
1
1
Level of education
Elementary
School
2
6
8
Middle School
10
10
20
High School
29
10
39
College
9
24
33
The distribution of descriptive analysis was
described in table 2 showed that out of 100
respondents based on a history of menarche,
respondents in the risk category amounted to 25
people (25.0%) and the non-risk category amounted
to 75 people (575.0%). For breastfeeding history,
there were 43 risk categories (43.0%) and 57
respondents (57.0%) with no risk categories. Family
history at risk was 53 respondents (53.0%), and those
who were not at risk were 47 respondents (47.0%).
At-risk due to the use of hormonal contraception as
many as 73 people (73.0%), while those who are not
at risk were 27 respondents (27.0%). Risks due to the
age of giving birth to the first child were 19
respondents (19.0%) while those who were not at risk
totaled 81 respondents (81.0%). Risks resulting from
a smoking history of 72 respondents (72.0%) while
those who were not at risk totaled 28 respondents
(28.0%).
Table 2: Distribution of Respondent Descriptive Analysis
in Women Aged 15-65 Years in Kendari City.
No.
Descriptive Analysis
n
%
1
History of Menarche
Risky
No-Risk
25
75
25.0
75.0
2
History of
Breastfeeding
Risky
No-Risk
43
57
43.0
57.0
3
History of Family
Risky
No-Risk
53
47
53.0
47.0
4.
The Use of Hormonal Contraception
Risky
No-Risk
73
27
73.0
27.0
5.
Age of Childbirth First Child
Risky
No-Risk
19
81
19.0
81.0
6
History of Smoking
.
Risky
No-Risk
72
28
72.0
28.0
Risk factors for breast cancer seen in table 3
below. The results of the analysis using the Odds
Ratio test obtained the value of Odds Ratio (OR) =
Risk Factors for Breast Cancer Occurrence in Women Age 15-65 Years in Kendari City in 2018
265

2.705 CI 95% = 1.040-7.036, this meant that women
who had menarche <12 years would be 2.705 times
more likely to develop breast cancer compared to
women who had menarche at age > 12 years. Because
of the value of OR (2.705)> 1, the history of
menarche was a risk factor for breast cancer in
women aged 15-65 years in Kendari City in 2018.
The results of the analysis using the Odds Ratio
test obtained the value of Odds Ratio (OR) = 3.551 CI
95% = 1.541-8.181, this meant that women who did
not breastfeed their babies would have a risk of 3,551
times greater breast cancer than women who
breastfed their babies. Because of the OR value
(3,551)> 1, breastfeeding history was a risk factor for
breast cancer incidence in women aged 15-65 in
Kendari City in 2018.
The results of the analysis using the Odds Ratio
test obtained the value of Odds Ratio (OR) = 2.912 CI
95% = 1,290-6,571, this meant that women who had
family member who suffered from breast cancer
would be 2,912 times more likely to have breast
cancer than those who did not have family members
with breast cancer. Because of the OR value (2,912)>
1, family history was a risk factor for breast cancer in
women aged 15-65 years in Kendari City in 2018.
The results of the analysis using the Odds Ratio
test obtained the value of Odds Ratio (OR) = 14.462
CI 95% = 3.3972-52,656, this meant that women who
used hormonal contraception ≥ 5 years would have a
risk of 14,462 times greater breast cancer than women
who used hormonal contraception <5 years. Because
the OR value (14.462)> 1, a history of hormonal
contraceptive use was a risk factor for the incidence
of breast cancer in women aged 15-65 years in
Kendari City in 2018.
The results of the analysis using the Odds Ratio
test obtained the value of Odds Ratio (OR) = 0.516 CI
95% = 0.184-1.444, this meant that women who given
birth to their first child at age> 35 years were 0.516
times more likely to develop breast cancer compared
to women who given birth first child at age <35 years.
Because the OR value (0.516) <1, the age of giving
birth to the first child was not a risk factor for the
incidence of breast cancer in women aged 15-65 years
in Kendari City in 2018.
The results of the analysis using the Odds Ratio
test obtained the value of Odds Ratio (OR) = 10.615
CI 95% = 3.319-33,951, this meant that women who
smoked or had family members who smoked would
have a risk of 10,615 times more likely to develop
breast cancer compared to women who did not smoke
or non-smoking family members. Because of the OR
value (10,615)> 1, smoking history was a risk factor
for breast cancer incidence in women aged 15-65
years in Kendari City in 2018.
If menarche occurred above the age of 13 years,
the risk of cancer dropped 35% compared to girls who
menarche at the age of 12 years and under (Rosma,
2008). Early menstrual age is related to the length of
exposure to the hormones estrogen and progesterone
in women that affect the process of tissue
proliferation including breast tissue. Early menarche
will cause a large number of menstrual cycles and
repeated estrogen reduction has a stimulatory effect
on the mammary epithelium thereby increasing the
likelihood of abnormal breast tissue. (Mulia &
Conference, 2017)(Ma et al., 2010)
The results of the analysis using the Odds Ratio
test obtained the value of Odds Ratio (OR) = 2.705 CI
95% = 1.040-7.036, this meant that women who had
menarche <12 years would be 2.705 times more likely
to develop breast cancer compared to women who
had menarche at age > 12 years. Because of the value
of OR (2.705)> 1, the history of menarche was a risk
factor for breast cancer in women aged 15-65 years in
Kendari City in 2018.
This study was in line with research by Priyatin
(2013), the results of statistical analysis obtained
OR> 1 = 2.638, which can increase the risk. This
meant that the age of menarche with a risk category
increased the incidence of breast cancer. Women of
childbearing age at the age of menarche at risk (<12
years) had a risk of 2,638 times higher for breast
cancer. (Wahyuni et al., n.d.)
This was consistent with the results of research of
(Mulia & Conference, 2017) which stated that there
was a significant relationship between early
menstruation with breast cancer. Women with early
menstruation had 9 times the risk of breast cancer
compared with women who did not menstruate early.
(Tutuncuoglu & Krogan, 2019)
Breastfeeding does not protect women from
breast cancer but affects estrogen levels in a woman's
body. The hormone estrogen in women is a major
ingredient in breast cancer. Breastfeeding can reduce
estrogen levels, so the risk of a woman suffering from
breast cancer will decrease every time a woman is
pregnant and breastfeeding. Breastfeeding will
suppress the menstrual cycle and can help eliminate
toxins in the breast. Breastfeeding can cause changes
in breast cells that make female cells more resistant
to cancer-related cell mutations. (Banudi, 2013)
The results of the analysis using the Odds Ratio
test obtained the value of Odds Ratio (OR) = 3.551 CI
95% = 1.541-8.181, this meant that women who did
not breastfeed their babies would have a risk of 3,551
times greater breast cancer than women who
HSIC 2019 - The Health Science International Conference
266

breastfed their babies. Because of the OR value
(3,551)> 1, breastfeeding history was a risk factor for
breast cancer incidence in women aged 15-65 in
Kendari City in 2018. This study was in line with
research conducted by Priyatin (2013), the results of
statistical analysis obtained OR = 2.118. This meant
that breastfeeding with a risk category increased the
incidence of breast cancer. The stronger suspicion of
breastfeeding with risk categories was a risk factor for
breast cancer. Women of childbearing age with risk
categories (not breastfeeding) had a risk of 2.118
times higher for breast cancer.
This was consistent with the results of (Cowppli-
Bony et al., 2019) that found that breastfeeding
reduced the risk of breast cancer in women whose
sisters, or mothers or daughters had the disease, so
breastfeeding naturally reduced the risk of
contracting the disease by 59 percent.
Family history is one of the most important factors
considering that cancer can be influenced by genetic
disorders. Some families may have a higher risk of
developing certain breast cancer compared to other
families. For example, a woman's risk of developing
breast cancer increased 1.5-3 times if her mother or
sister had breast cancer. (Cheng, Shen, & Id, 2019)
The results of the analysis using the Odds Ratio
test obtained the value of Odds Ratio (OR) = 2.912 CI
95% = 1,290-6,571, this meant that women who had
family member who suffered from breast cancer
would be 2,912 times more likely to have breast
cancer than those who did not have family members
with breast cancer. Because of the OR value (2,912)>
1, family history was a risk factor for breast cancer in
women aged 15-65 years in Kendari City in 2018.
This study was in line with research conducted by
Priyatin (2013), the results of statistical analysis
obtained OR = 6.938. The results of the analysis
showed that OR> 1 = 6,938 which can increase the
risk, this meant a family history with a risk category
increased the incidence of breast cancer. Increasingly
suspected family history of risk categories is a risk
factor for breast cancer. Women of childbearing age
with a family history of risk categories (there was a
family history that had blood relations with
respondents who had or were suffering from breast
cancer) had a 6,938 times higher risk of developing
breast cancer. (Maria, Sainal, & Nyorong, 2017).
The risk of breast cancer showed an increase
along with an increase in the woman's age at first
pregnancy or giving birth to a first child at a relatively
older age (> 35 years), whereas in nulliparous had a
30% risk of developing into cancer compared to
multiparous women.
The results of the analysis using the Odds Ratio
test obtained the value of Odds Ratio (OR) = 0.516 CI
95% = 0.184-1.444, this meant that women who given
birth to their first child at age> 35 years were 0.516
times more likely to develop breast cancer compared
to women who given birth first child at age <35 years.
Because the OR value (0.516) <1, the age of giving
birth to the first child was not a risk factorfor the
incidence of breast cancer in women aged 15-65 years
in Kendari City in 2018.
This was consistent with the results of research
conducted by Briston (2008) in the United States with
a cohort design that women who had the first
pregnancy after 35 years had a 3.6 times greater risk
of developing breast cancer than women whose first
pregnancy was before 35 years (RR = 3,6).
Women who are pregnant at an older age will
experience more menstrual cycles before becoming
pregnant. In each menstrual cycle, FSH (follicle-
stimulating hormone) is released by the anterior
pituitary lobe which causes several primary follicles
to develop in the ovary. Generally one follicle or even
more than one follicle that develops into de Graff
follicles that produce estrogen. (Fan et al.,
2019)(Palmer et al., 2011)
The use of hormonal drugs for >5 years will
increase the risk of cancer (Rasjidi, 2010). There is
still controversy to date regarding the role of
hormonal contraception in the development of breast
cancer. However, several studies showed that
hormonal contraception plays a role in increasing the
risk of breast cancer in premenopausal women, but
not in women in the post-menopausal period.
(Banudi, 2013)
The results of the analysis using the Odds Ratio
test obtained the value of Odds Ratio (OR) = 14.462
CI 95% = 3.3972-52,656, this meant that women who
used hormonal contraception ≥ 5 years would have a
risk of 14,462 times greater breast cancer than women
who used hormonal contraception <5 years. Because
the OR value (14.462)> 1, a history of hormonal
contraceptive use was a risk factor for the incidence
of breast cancer in women aged 15-65 years in
Kendari City in 2018.
This research was in line with research conducted
by (Rukmi & Handayani, 2013). The results showed
that women who experienced breast cancer the most
were women with a history of using hormonal
contraception for 10 years totaling 16 more people
than those without breast cancer. The test results
obtained a p-value of 0.001 meaning p-value <0.05,
so that Ha was accepted and Ho was rejected. The
conclusion is that there was a relationship between
the factors of hormonal contraceptive use and the
Risk Factors for Breast Cancer Occurrence in Women Age 15-65 Years in Kendari City in 2018
267

incidence of breast cancer in the Public Hospital of
DadiKeluarga, Purwokerto. The odds ratio value of
7.43 meant that women with hormonal contraception
for 10 years had a 7.43 times greater risk of
developing breast cancer compared to women using
hormonal contraception <10 years with 95% CI,
meaning that the research can be trusted to truth 95%.
The risk of breast cancer showed an increase
along with an increase in the woman's age at first
pregnancy or giving birth to a first child at a relatively
older age (> 35 years), whereas in nulliparous had a
30% risk of developing into cancer compared to
multiparous women.
The results of the analysis using the Odds Ratio
test obtained the value of Odds Ratio (OR) = 0.516 CI
95% = 0.184-1.444, this meant that women who given
birth to their first child at age> 35 years were 0.516
times more likely to develop breast cancer compared
to women who given birth first child at age <35 years.
Because the OR value (0.516) <1, the age of giving
birth to the first child was not a risk factorfor the
incidence of breast cancer in women aged 15-65 years
in Kendari City in 2018.
This was consistent with the results of research
conducted by Briston (2008) in the United States with
a cohort design that women who had the first
pregnancy after 35 years had a 3.6 times greater risk
of developing breast cancer than women whose first
pregnancy was before 35 years (RR = 3,6). (Heena et
al., 2019)
Women who are pregnant at an older age will
experience more menstrual cycles before becoming
pregnant. In each menstrual cycle, FSH (follicle-
stimulating hormone) is released by the anterior
pituitary lobe which causes several primary follicles
to develop in the ovary. Generally one follicle or even
more than one follicle that develops into de Graff
follicles that produce estrogen. (Fan et al., 2019)
A smoker is seven times more susceptible to the
type of cancer, including breast cancer when
compared to non-smokers. Epidemiological
investigations had found that the likelihood of passive
smoking for breast cancer was greater than the risk of
occurrence in women with a history of active smokers
(Kemenkes, 2016). Cigarette smoke can increase the
risk of breast cancer because cigarette smoke contains
chemicals in high concentrations that can cause breast
cancer. The chemicals in tobacco smoke reach the
breast tissue and are found in breast milk. Cigarette
smoke can also have different effects on the risk of
breast cancer in smokers and those who are only
exposed to cigarette smoke. (Maria et al., 2017)
The results of the analysis using the Odds Ratio
test obtained the value of Odds Ratio (OR) = 10.615
CI 95% = 3.319-33,951, this meant that women who
smoked or had family members who smoked would
have a risk of 10,615 times more likely to develop
breast cancer compared to women who did not smoke
or non-smoking family members. Because of the OR
value (10,615)> 1, smoking history was a risk factor
for breast cancer incidence in women aged 15-65
years in Kendari City in 2018.
Table 3: Risk Factors Analysis of Breast Cancer
Occurrence in Women Aged 15-65 Years in Kendari City.
N
o
Variables
Breast
Cancer
Total
Odds Ratio
(CI 95%)
Case
Cont
rol
n
%
n
%
N
%
1
History of Menarche
Risky
1
7
1
7
8
8
2
5
2
5
2,705
(1,040–
7,036)
No-Risk
3
3
3
3
4
2
4
2
7
5
7
5
2
History of Breastfeeding
Risky
2
9
2
9
1
4
1
4
4
3
4
3
3,551
(1,541–
8,181)
No-Risk
2
1
2
1
3
6
3
6
5
7
5
7
3
History of Family
Risky
3
3
3
3
2
0
2
0
5
3
5
3
2,912
(1,290–
6,571)
No-Risk
1
7
1
7
3
0
3
0
4
7
4
7
4
The Use of Hormonal Contraception
Risky
4
7
4
7
2
6
2
6
7
3
7
3
14,462
(3,972–
52,656)
No-Risk
3
3
2
4
2
4
2
7
2
7
5
Age of Childbirth First Child
Risky
7
7
1
2
1
2
1
9
7
3
0,516
(0,184–
1,443)
No-Risk
4
3
4
3
3
8
3
8
8
1
2
7
6
History of Smoking
Risky
4
6
4
6
2
6
2
6
7
2
7
2
10,615
(3,319–
33,951)
No-Risk
4
4
2
4
2
4
2
8
2
8
This research was in line with research conducted.
The results showed that based on the results of
statistical tests using OR, it was known that smoking
(p = 0.063, OR = 2.002; 95% CI: 1.020-3.930), so that
it was statistically significant between smoking and
the incidence of breast cancer. In other words,
smoking is a risk factor for the incidence of breast
cancer.
HSIC 2019 - The Health Science International Conference
268

Based on the results of Suciawati's research
(2016), there was a significant relationship between
smoking history and the incidence of breast cancer.
Based on OR, respondents who smoked had a 2.5
times greater chance of developing breast cancer
compared to respondents who did not smoke. This
was consistent with Maria's research (2017) that
smoking was a risk factor for the incidence of breast
cancer. Furthermore according to research by
Hosseinzadeh et al in 2014 showed that there was a
positive relationship between active and passive
smokers against breast cancer. (Ayu et al., 2016).
4 CONCLUSIONS
History of menarche was a risk factor for breast
cancer incidence in women aged 15-65 years in
Kendari City in 2018. Breastfeeding history was a
risk factor for breast cancer incidence in women aged
15-65 years in Kendari City in 2018. Family history
was a risk factor for breast cancer events in women
aged 15-65 years in Kendari City in 2018. History of
hormonal contraceptive use was a risk factor for
breast cancer incidence in women aged 15-65 years
in Kendari City in 2018. The age of first childbirth
was not a risk factor for breast cancer incidence in
women age 15 -65 years in Kendari City in 2018.
Smoking history was a risk factor for the occurrence
of breast cancer in women aged 15-65 years in
Kendari City in 2018.
REFERENCES
Ayu, D., Setiowati, I., Tanngo, E. H., & Soebijanto, R. I.
(2016). Hubungan antara Pemakaian KB Hormonal
dengan Kejadian Kanker Payudara di Poli Onkologi
Satu Atap RSUD Dr. Soetomo, Februari-April 2015.
Indonesian Journal of Cancer, 10(January-March), 11–
17.
Banudi, L. (2013). Gizi Kesehatan Reproduksi. Jakarta:
EGC.
Cheng, W., Shen, X., & Id, M. X. (2019). Decreased breast
cancer-specific mortality risk in patients with a history
of thyroid cancer. 1–13.
https://doi.org/10.1371/journal.pone.0221093
Cowppli-Bony, A., Trétarre, B., Marrer, E., Defossez, G.,
Daubisse-Marliac, L., Coureau, G., FRANCIM
network. (2019). Compliance with clinical guidelines
for breast cancer management: A population-based
study of quality-of-care indicators in France. PloS One,
14(10), e0224275.
https://doi.org/10.1371/journal.pone.0224275
Fan, M., Xia, P., Liu, B., Zhang, L., Wang, Y., Gao, X., &
Li, L. (2019). Tumour heterogeneity revealed by
unsupervised decomposition of dynamic contrast-
enhanced magnetic resonance imaging is associated
with underlying gene expression patterns and poor
survival in breast cancer patients. Breast Cancer
Research : BCR, 21(1), 112.
https://doi.org/10.1186/s13058-019-1199-8
Heena, H., Durrani, S., Riaz, M., Alfayyad, I., Tabasim, R.,
Parvez, G., & Abu-shaheen, A. (2019). Knowledge ,
attitudes , and practices related to breast cancer
screening among female health care professionals : a
cross sectional study. 1–11.
Kemenkes. (2016). Bulan Peduli Kanker. Jakarta.
Ma, H., Wang, Y., Sullivan-Halley, J., Weiss, L.,
Marchbanks, P. A., Spirtas, R., … Bernstein, L. (2010).
Use of four biomarkers to evaluate the risk of breast
cancer subtypes in the women’s contraceptive and
reproductive experiences study. Cancer Research,
70(2), 575–587. https://doi.org/10.1158/0008-
5472.CAN-09-3460
Maria, I., Sainal, A., & Nyorong, M. (2017). Risiko Gaya
Hidup terhadap Kejadian Kanker Payudara pada
Wanita. 13(2), 157–166.
https://doi.org/10.30597/mkmi.v13i2.1988
Mulia, S., & Conference, I. (2017). Advances in Health
Science Research, volume 6 2nd Sari Mulia
International Conference on Health and Sciences
(SMICHS 2017). 6(Smichs), 1–11.
Nursalam. (2013). Metodologi Penelitian Ilmu
Keperawatan : Pendekatan Praktis. Jakarta: Salemba
Medika.
Palmer, J. R., Boggs, D. A., Wise, L. A., Ambrosone, C. B.,
Adams-Campbell, L. L., & Rosenberg, L. (2011). Parity
and lactation in relation to estrogen receptor negative
breast cancer in African American women. Cancer
Epidemiology Biomarkers and Prevention, 20(9), 1883–
1891. https://doi.org/10.1158/1055-9965.EPI-11-0465
Phipps, A. I., Chlebowski, R. T., Prentice, R., McTiernan,
A., Wactawski-Wende, J., Kuller, L. H., Li, C. I. (2011).
Reproductive history and oral contraceptive use in
relation to risk of triple-negative breast cancer. Journal
of the National Cancer Institute, 103(6), 470–477.
https://doi.org/10.1093/jnci/djr030
Rukmi, D. K., & Handayani, D. (2013). Faktor Risiko
Kanker Payudara Wanita. KESMAS - Jurnal Kesehatan
Masyarakat, 8(2).
https://doi.org/10.15294/kemas.v8i2.2635
Suardita, I. W., Chrisnawati, & Agustina, D. M. (2016).
Faktor-faktor resiko pencetus prevalensi kanker
payudara. Jurnal Keperawatan Suaka Insan, 1(2), 1–14.
https://doi.org/Umwelt-Zustand Nr. 0728
Tutuncuoglu, B., & Krogan, N. J. (2019). Mapping genetic
interactions in cancer : a road to rational combination
therapies. 4, 1–12.
Wahyuni, E., Chrisnawati, & Santoso, R. B. (n.d.). Riwayat
Menyusui , Riwayat Menarche , Riwayat.
Risk Factors for Breast Cancer Occurrence in Women Age 15-65 Years in Kendari City in 2018
269

Wyatt, K. D., Jenkins, S. M., Plevak, M. F., Pont, M. R. V.,
& Pruthi, S. (2019). A personalized , web-based breast
cancer decision making application : a pre-post survey.
7, 1–11.
HSIC 2019 - The Health Science International Conference
270