Environment and Breast Cancer: Science Review

Evidence From Humans
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N-acetyltransferase 2, exposure to aromatic and heterocyclic amines, and receptor-defined breast cancer
Rabstein, S., Bruning, T., Harth, V., Fischer, H. P., Haas, S., Weiss, T., Spickenheuer, A., Pierl, C., Justenhoven, C., Illig, T., Vollmert, C., Baisch, C., Ko, Y. D., Hamann, U., Brauch, H., Pesch, B. Eur J Cancer Prev. 2010. 19:2, 100-9.
Topic area
Environmental pollutant - Occupation Aromatic amines Heterocyclic amines
Study design
Population-based case-control
Funding agency
Federal Ministry of Education and Research (BMBF)
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
No analysis based on menopausal status
Number of Controls
Controls: 1047
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
The GENICA study enrolled 1155 incident breast cancer cases and 1143 population controls living in the Greater Region of Bonn, Germany, between 2000-2004. Cases and contorls were Caucasian and were ≤ 80 years of age. Controls were frequency matched to cases on birth year. Analyses were restricted to cases and controls with DNA samples available (1021 cases, 1051 controls) and complete data for potential confounders.
Exposure Investigated
Exposures investigated
Occupational exposure to aromatic and heterocyclic amines assessed based on expert ratings of self-reported job tasks. Job tasks with potential exposure to aromatic amines included: film development, preparation/mixing of materials in rubber industry, and
How exposure was measured
Questionnaire, in person Biological
Exposure assessment comment
Reporting of job tasks after case diagnosis could result in differential recall between cases and controls. 56.4% of the cases and 59.7% of the controls were defined as slow acetylators based on genotyping.
Breast cancer outcome investigated
Primary incident breast cancer
Confounders considered
Other breast cancer risk factors, such as family history, age at first birth, and hormone replacement therapy use, that were taken into account in the study.
Smoking, family history of breast cancer, physical activity, BMI, menopausal status, OCP use, HRT use, number of mammograms > 2 years before interview, parity, breastfeeding.
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked Yes. No, if not.
Strength of associations reported
≥1 year occupational exposure to aromatic or heterocyclic amines vs <1 year or never occupationally exposed:

Overall breast cancer: aOR 1.05 (95% CI 0.70-1.56)
ER+ tumors (8 cases): aOR 1.26 (95% CI 0.81-1.95)
ER- tumors (7 cases): aOR 0.81 (95% CI 0.36-1.82)
PR+ tumors: aOR 1.24 (95% CI 0.79-1.94)
PR- tumors (8 cases): aOR 0.82 (95% CI 0.38-1.76)
Results Comments
There was no evidence of statistical interaction between NAT2 genotype (slow acetylator or fast acetylator) and occupational aromatic or heterocyclic amine exposure.
Author address
BGFA-Research Institute of Occupational Medicine of the German Social Accident Insurance, Ruhr University Bochum, Germany. rabstein@bgfa.de