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Understanding Breast Cancer and Environmental Exposures

Explore the link between environmental carcinogens and breast cancer causes, risk factors, tumor development, and chemicals potentially linked to the disease. Discover the challenges in determining the carcinogen link and take home messages for prevention.

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Understanding Breast Cancer and Environmental Exposures

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  1. Breast Cancer &Environmental Exposures Ken Runkle Chief, Division of Environmental Health Senior Toxicologist Illinois Department of Public Health

  2. Carcinogens Definition:Substances & exposures that lead to cancer • Name a carcinogen. What does it cause?

  3. Cancer Classifications Methylene Chloride 1, 3–butadiene Carcinogens or not?

  4. U.S. Environmental Protection Agency • Group A – Human carcinogen • Group B – Probable human carcinogen • B1 – Limited evidence of carcinogenicity from epidemiological studies • B2 – Inadequate or no data from epidemiological studies • Group C – Possible human carcinogen • Group D – Not classifiable as to human carcinogenicity • Group E – Evidence of non carcinogenicity for humans

  5. International Agency for Research on Cancer (IARC) • Group 1 – Carcinogenic • Group 2A – Probably carcinogenic • Group 2B – Possibly carcinogenic • Group 3 – Not classifiable • Group 4 – Probably not

  6. Exposure and Chemical Fate • Exposure • Distribution • Biotransformation • Absorption • Elimination

  7. Breast Cancer Causes vs. Risk Factors • Causes • High energy radiation • Japanese survivors of WWII • Tubercular woman with repeated chest X-rays • Risk Factors • 1713, Bernardino Ramazzini observed that nuns are more subject to cancer of the breast than other women • So do women who have not borne children • Risk factors are not causes, but may provide clues to causes

  8. Breast Cancer & Tumor Development • Most tumors originate in the ducts and spread to other tissues • More than ½ of breast tumors rely on estrogen for growth • Perhaps 5 to 10% due to inherited genetic mutation

  9. Difficulties in Determining Carcinogen Link • Correlation does not equal causation • Multiple factor interactions • Lack of consistent evidence • Genetic influences

  10. Chemicals Potentially Linkedto Breast Cancer

  11. Hormones • Hormone Replacement Therapy (HRT) & oral contraceptives • Diethylstilbestrol (DES) • Synthetic form of estrogen • Prescribed to women from 1938 to 1971 to help with pregnancy complications; interfered with fetal development • Estrogens/placental hormones in personal care products • Often used in: • Topical anti-aging creams • Some shampoos/conditioners

  12. Xenoestrogens & Endocrine DisruptingCompounds • Alkylphenols • Cleaning products/detergents • Aromatic amines • Foams, dyes, pesticides, pharmaceuticals, diesel exhaust • Bisphenyl-A (BPA) • Plastics, food packaging, lining of canned foods, etc • Dioxins • Created during the production and burning of plastics

  13. Xenoestrogens & Endocrine Disrupting Compounds • PAHs (Polycyclic Aromatic Hydrocarbon) • Created during the combustion of coal and gasoline • Pesticides/Herbicides • Animal/food products • Phthalates • Plastics • Polybrominateddiphenyl ether (PBDE) • Used as flame retardants • Organochlorides • DDT/DDE (Pesticides) • Polychlorinated bi-phenols (PCBs) – used as coolants and insulating fluid

  14. Food Hormones • Phytoestrogens • Found in plant-based products • Zeranol • Animal products • Bovine Growth Hormone (rBST)

  15. Non-Endocrine Disrupting Industrial Chemicals • Benzene • Gasoline fumes/exhaust, cigarette smoke, industrial burning • Organic Solvents • Computer components, cleaning products, cosmetics, dry cleaning • Vinyl chloride • Plastics, tobacco smoke • 1,3 – butadiene • Ethylene oxide • Cosmetics, also used to sterilize surgical instruments

  16. Take Home Messages • Little epidemiological evidence for link between environmental exposures and breast cancer • Nature vs. nurture • Early detection

  17. References • American Cancer Society (www.cancer.org)Environmental Protection Agency (http://www.epa.gov/raf/publications/pdfs/CA%20GUIDELINES_1986.PDF ) • International Agency for Research on Cancer(http://monographs.iarc.fr/ENG/Classification/index.php) • Nudleman, J., & Engle, C. (2010). State of the evidence: the connection between breast cancer and the environment (6th ed.) Retrieved from http://www.breastcancerfund.org/media/publications/state-of-the-evidence. • Nudelman, J. et al. (2009, Jan/March). Policy recommendations emerging from the scientific evidence connecting environmental factors and breast cancer. International Journal of Occupational and Environmental Health, 2009, 79 – 101. • Snedeker, S. (2002, May). Environmental chemicals and breast cancer risk: Why is there concern? Program on Breast Cancer and Environmental Risk Factors in New York State. Retrieved from http://envirocancer.cornell.edu

  18. Contact Information Ken Runkle Chief, Division of Environmental HealthIllinois Department of Public HealthEmail: ken.runkle@illinois.gov

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