A Case for Environmental Breast Cancer Research

Alee Rowley

How Cancer is Caused…

Breast Cancer…

is developed in the lobes and lobules, NOT the fatty tissues.

What Leads to Breast Cancer?

Estrogen…stimulates mitosis, especially when in

combination with progesterone

only PROMOTES the growth of breast cancer

Internal Risk FactorsAgeFirst periodMenopauseOffspringRelatives affectedFirst term live birthGenetic mutations (BRCA1 and

BRCA2 genes)White women…

Blacks vs. Whites:

Female Breast Cancer Incidence Rates, 2005

Color on Map Interval States

Light blue 96.4 to 113.7

Alabama, Arizona, Arkansas, Florida, Georgia, Idaho, Indiana, Mississippi,

Nevada, New Mexico, Texas, Utah, and Wyoming

Medium blue 113.8 to 119.4

The District of Columbia, Hawaii, Kentucky, Louisiana, North Carolina, North Dakota, Ohio, South Carolina, Vermont, Virginia, and West Virginia

Royal blue 119.5 to 122.9

California, Illinois, Iowa, Michigan, Missouri, Montana, Nebraska, New York, Pennsylvania, Rhode Island,

South Dakota, and Tennessee

Dark blue 123.0 to 133.3

Alaska, Colorado, Connecticut, Delaware, Kansas, Maine,

Massachusetts, Minnesota, New Hampshire, New Jersey, Oklahoma,

Oregon, and WashingtonLight Grey Did not meet USCS data quality criteria Maryland and Wisconsin

Female Breast Cancer Death Rates, 2005

Color on Map Interval States

Light blue 17.9 to 22.5

Alaska, Arizona, Colorado, Florida, Hawaii, Idaho, Iowa, Maine,

Minnesota, New Mexico, Oregon, Vermont, and Wyoming

Medium blue 22.6 to 23.6

California, Delaware, Georgia, Indiana, Kentucky, Massachusetts,

New Hampshire, North Dakota, South Dakota, Texas, Washington,

and Wisconsin

Royal blue 23.7 to 25.2

Arkansas, Connecticut, Kansas, Michigan, Montana, Nebraska,

Nevada, New York, North Carolina, Oklahoma, Pennsylvania, Rhode

Island, and Utah

Dark blue 25.3 to 29.9

Alabama, the District of Columbia, Illinois, Louisiana, Maryland,

Mississippi, Missouri, New Jersey, Ohio, South Carolina, Tennessee,

Virginia, and West Virginia

Incidence/Mortality vs. Race

LouisianaWhite persons, percent 2008: 64.8% Black persons, percent 2008: 32.0%

MississippiWhite persons, percent, 2008: 60.6%Black persons, percent, 2008: 37.2%

VirginiaWhite persons, percent, 2008: 73.0%Black persons, percent, 2008: 19.9%

MissouriWhite persons, percent, 2008: 85.0% Black persons, percent, 2008: 11.5%

IllinoisWhite persons, percent, 2008: 79.1%Black persons, percent, 2008: 14.9%

AlabamaWhite persons, percent, 2008: 71.0%Black persons, percent, 2008: 26.4%

TennesseeWhite persons, percent, 2008: 80.4%Black persons, percent, 2008: 16.8%

South CarolinaWhite persons, percent, 2008: 68.7% Black persons, percent, 2008: 28.5%

OhioWhite persons, percent, 2008: 84.8% Black persons, percent, 2008: 12.0%

West VirginaWhite persons, percent, 2008: 94.5% Black persons, percent, 2008: 3.6%

New JerseyWhite persons, percent, 2008: 76.0% Black persons, percent, 2008: 14.5%

Oregon White persons, percent, 2008: 90.1% Black persons, percent, 2008: 2.0%

Maine White persons, percent, 2008: 96.4% Black persons, percent, 2008: 1.0%

WashingtonWhite persons, percent, 2008: 84.3% Black persons, percent, 2008: 3.7%

AlaskaWhite persons, percent, 2008: 70.6% Black persons, percent, 2008: 4.3%

ColoradoWhite persons, percent, 2008: 89.7% Black persons, percent, 2008: 4.3%

KansasWhite persons, percent, 2008: 88.7%Black persons, percent, 2008: 6.2%

OklahomaWhite persons, percent, 2008: 78.1%Black persons, percent, 2008: 8.0%

MinnesotaWhite persons, percent, 2008: 89.0%Black persons, percent, 2008: 4.6%

New HampshireWhite persons, percent, 2008: 95.5% Black persons, percent, 2008: 1.2%

MassachusettsWhite persons, percent, 2008: 86.2% Black persons, percent, 2008: 7.0%

New JerseyWhite persons, percent, 2008: 76.0% Black persons, percent, 2008: 14.5%

High Incidence Rates:

High Mortality Rates:

…there’s a missing link…About 90% of women who

develop breast cancer do not have a family history

Heritability is only about 27%One percent increase each year

for the last 60 yearsIncidence in different parts of the

world….ENVIRONMENT must play a role.

Environment: n. [en-vahy-ruhn-muhnt]

Voluntary as well as involuntary exposures, social class, and urban/rural differences, and exposures that occur outside the body as well as those that modify the internal milieu (surroundings).

Totality of living and working conditions as well as the physical, biological, social, and cultural factors such as employment, income, housing, industrial emissions, pollution, and hazardous chemicals.

External Risk Factors-ENVIRONMENT

Controversy

Environmental influence is insignificant

Many studies do not coincide ◦National Cancer Institute studies◦Studies published JAMA◦Long Island Breast Cancer Study

Project

Holes in the ResearchVulnerability in development of the

mammary glandMore vulnerability at certain times in life

People are exposed through entire lifespan

Difficulty in finding an unexposed groupDifferent subtypes of breast cancerSelf-reportingProtective factorsConflicting study results

Current Studies…

The Long Island Breast Caner Study

Project, Long Island, New York

Sister Study

ReferencesBreast Cancer Action. (2004, October). What you should know about the environment and breast

cancer. Retrieved from Breast Cancer Action Web site: http://bcaction.org/index.php?page=environment-and-breast-cancer

Halls, Steven B. (2008, May). Detailed Breast Cancer Risk Calculator. Retrieved from halls.md Web site: http://www.halls.md/index.htm

Henderson, J. (2009, December 3). Cancer. Lecture presented for HE 434 Diseases, Western Oregon University, Monmouth, OR.

Millikan, Robert. (2003). Environmental influences and breast cancer. Retrieved from California Breast Cancer Research Program Web site: http://www.cbcrp.org/publications/papers/millikan/page_02.php

Nancy Nelson. (2004, June). Breast cancer and the environment studies supported by the National Cancer Institute. Retrieved from National Cancer Institute Web site: www.cancer.gov/newscenter/benchmarks-vol4-issue3/page2

National Breast Cancer Coalition. (2003, October). Environmental risk factors for breast cancer. Retrieved from California Breast Cancer Research Program Web site: http://www.stopbreastcancer.org//index.php?option=com_content&task=view&id=183&Itemid=178

National Institute of Environmental Health Sciences. (2007, January). Environmental factors and breast cancer risk. Retrieved from National Institute of Environmental Health Sciences Web site: www.niehs.nih.gov/health/docs/brca-fs.pdf

National Institute of Environmental Health Sciences. (2006). BCERC Research. Retrieved from National Institute of Environmental Health Sciences Web site: http://www.bcerc.org/research.htm