Environment and Breast Cancer: Science Review

Evidence From Humans
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Environmental toxins and breast cancer on Long Island. II. Organochlorine compound levels in blood
Gammon, M. D., Wolff, M. S., Neugut, A. I., Eng, S. M., Teitelbaum, S. L., Britton, J. A., Terry, M. B., Levin, B., Stellman, S. D., Kabat, G. C., Hatch, M., Senie, R., Berkowitz, G., Bradlow, H. L., Garbowski, G., Maffeo, C., Montalvan, P., Kemeny, M., Citron, M., Schnabel, F., Schuss, A., Hajdu, S., Vinceguerra, V., Niguidula, N., Ireland, K., Santella, R. M. Cancer Epidemiology, Biomarkers and Prevention. 2002. 11:8, 686-97.
Topic area
Environmental pollutant - Pesticide, organochlorine, PCBs, DDT, DDE, chlorda
Study design
Population based case-control
Funding agency
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Post menopausal
Number of Controls
Controls: 429
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
Female residents of Nassau and Suffolk Counties (Long Island), NY, participating in the Long Island Breast Cancer Study Project, age 20 or older, English-speaking, newly diagnosed with in situ or invasive breast cancer in 1996-1997. Cases identified by regional hospital pathology laboratories. Controls matched by 5-year age group, identified by random-digit-dialing or Medicare records (for women 65 and older). Participants in this analysis were randomly selected from study participants who donated blood samples.
Exposure Investigated
Exposures investigated
Serum levels of p,p'-DDE, p,p'DDT, oxychlordane, trans-nonachlor, dieldrin, and 24 PCB congeners. In statistical analyses, chlordane was analyzed as the sum of oxychlordane and transnonachlor; PCBs were analyzed as the sum of congeners 118, 153, 138, 180
How exposure was measured
Questionnaire, in person Biological
Exposure assessment comment
Blood levels near diagnosis, particularly in a population years after the chemicals were banned, may not be representative of etiologically relevant exposure.
Breast cancer outcome investigated
Primary breast cancer
ER, PR status
Ethnic groups with separate analysis
If this study provided a separate analysis by ethnic or racial group, the groups are listed here.
Predominantly white
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, age squared, age at menarche, parity, number of live births, lactation, months of lactation, age at first birth, number of miscarriages, history of fertility problems, BMI at reference, BMI at age 20, alcohol intake, cigarette smoking, family history
Description of major analysis
Unconditional logistic regression, continuous and categorical exposures, test for trend. Effect modifiers considered: BMI at age 20, BMI at reference, breastfeeding history, menopausal status, length of residence on Long Island, age.
Strength of associations reported
Highest compared to lowest quintile multivariate adjusted OR (95% CI); test for trend p> 0.05
DDE: 1.2 (0.76-1.90)
DDT: 1.15 (0.74-1.79)
Dieldrin 1.37 (0.69-2.72)
Results Comments
Factors found to affect DDE levels in controls: age, alcohol, BMI at age 20, number of pregnancies, months of hormone replacement use, race, religion. For DDT levels: age at reference, race, religion. For Peak-4 PCBs: age, number of pregnancies, marital status, race, religion, years of residence on Long Island, weight at age 20, weight at reference date. Numbers become small for analyses of effect modification. For example, for nulliparous women, highest compared with lowest tertile of chlordane multivariate adjusted OR 2.83 (0.93-8.65) based on 28 cases and 11 controls in the upper tertile. Thus, although the analysis is thorough, some analyses may not have adequate statistical power to be responsive to the underlying research question.
Author address
Department of Epidemiology, University of North Carolina, School of Public Health, Chapel Hill, North Carolina 27599-7435, USA. gammon@email.unc.edu
Controls participation rate
68% (73% of these donated blood, resulting in 50%