Environment and Breast Cancer: Science Review

Evidence From Humans
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Mammographic findings and occupational exposure to pesticides currently in use on Crete
Dolapsakis, G., Vlachonikolis, I. G., Varveris, C., Tsatsakis, A. M. European Journal of Cancer. 2001. 37:12, 1531-6.
Topic area
Environmental pollutant - Pesticides, organophosphates, organocarbamates
Study design
Prospective cohort
Funding agency
Other: Ministry of Health of Greece
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Post menopausal
Number in Cohort
Cohort: 1062
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
Participants in an outreach, screening mammography program in Crete who had a first mammogram between 1988 and 1993 and followed up until 1998. 522 women with at least 10 years work in greenhouses for more than 4 hours/day and 540 women residents of large towns with non-agricultural occupations. Women selected were 40 years and older and had at least one breast cancer risk factor (family history, history of benign breast disease age at menarche, 12 years or younger, age at menopause 55 years or older, oral contraceptive use, menopausal estrogen use, nulliparity, age at first birth 25 years or older, obesity, positive physical exam).
Exposures investigated
Organophosphate, organocarbamate pesticides. Worked in greenhouses for more than 4 hours daily for at least 10 years.
Statistical Analysis
Breast cancer outcome investigated
Other: Fibrocystic changes, ductal hyperplasia without atypia, both fibrocystic and ductal hyperplasia, fibroadenoma, inflammatory mastitis, gross cystic disease, mammographic signs of cancer, biopsy-confirmed malignancy
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.
Not controlled
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
No significant differences in fibrocystic changes, lipoma, mammographic signs of cancer, biopsy-confirmed malignancy
Significant differences between exposed vs. non-exposed OR (95% CI) were found for:
ductal hyperplasia without atypia 1.87 (1.1-3.13)
fibrocystic and ductal hyperplasia 1.85 (1.3-2.6)
fibroadenoma 4.86 (1.4-16.7)
inflammatory mastitis 2.21 (1.2-4.0)
gross cystic disease 1.44 (1.1-2.0)
Among exposed women, the rate of malignancy was significantly higher in 40-49 year old women than older women, contrary to expectation.
Results Comments
Higher risk in younger women is notable.
Author address
Department of Radiology, Venizelion Hospital, 71409 Heraklion, Crete, Greece.