Environment and Breast Cancer: Science Review

Evidence From Humans
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Breast cancer, lactation history, and serum organochlorines
Romieu, I., Hernandez-Avila, M., Lazcano-Ponce, E., Weber, J. P., Dewailly, E. American Journal of Epidemiology. 2000. 152:4, 363-70.
Topic area
Environmental pollutant - pesticide, DDT, DDE
Study design
Hospital based case-control
Funding agency
Other: American Institute for Cancer Research Min
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre and Post menopausal
Number of Controls
Controls: 126
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
Parent study was a slightly larger study among Mexican women first described in Romieu et al, 1996. Analysis restricted to participants who breast-fed and did not use hormone replacement therapy. Cases of biopsy-confirmed breast cancer were included. Controls were from a randomly-selected sample of Mexico City residents, age-matched with cases.
Exposure Investigated
Exposures investigated
Serum concentration of DDT and DDE, expressed by lipid weight
Exposure assessment comment
A single measure of serum pesticide concentration close to the time of diagnosis may not be representative of the etiologic pesticide dose.
Statistical Analysis
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
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.
Age, socioeconomic status, age at menarche, age at full-term pregnancy, parity, menopausal status, and family history of breast cancer, months of lactation, serum DDT (for DDE analysis only).
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
Description of major analysis
Analysis restricted to women who had breast-fed and did not use hormone replacement therapy. Linear regression to find predictors of serum DDT and DDE levels. Multivariate logistic regression analyses to assess the relationship between breast cancer and
Strength of associations reported
Lactation and parity were associated with decreased serum DDE, while age and SES were associated with increased DDE. Of these, only age was related to DDT (as was BMI).
Among all women, the ORs for quartiles of DDE exposure (adjusted for age, age at menarche, duration of lactation, BMI, and serum DDT levels) were 1.00, 1.24 (95% CI: 0.5-3.06), 2.31 (95% CI: 0.92-5.86), 3.81 (95% CI: 1.14 -12.8).
Results Comments
Significantly increased risk with increasing levels of DDE. Thorough control of confounding, including months of lactation. Relationships stronger in postmenopausal women and when controlling for the effect of DDT.
Author address
Pan American Health Organization, Mexico. iromieu@insp3.insp.mx