Environment and Breast Cancer: Science Review

Evidence From Humans
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DNA damage and breast cancer risk
Smith, T. R., Miller, M. S., Lohman, K. K., Case, L. D., Hu, J. J. Carcinogenesis. 2003. 24:5, 883-9.
Topic area
Body size
Study design
Other:clinic-based case-control study
Funding agency
NCI, NIH, American Cancer Society and Friends you
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Pre menopausal
Post menopausal
Number of Controls
Control: 70
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
In: Women diagnosed with breast cancer at the Georgetown University Medical Center between 8/95 and 11/96 (cases); women who visited the Comprehensive Breast Center or the Cancer Assessment and Risk Evaluation (CARE) program which specialize in breast cancer screenings (controls); English speaking; at least 18 years of age Ex: previous cancer diagnosis
Comment about participation selection
Strengths: neither the laboratory nor data entry personnel had knowledge of the subjects' case control status; used comet assay protocol to detect significant differences in single strand breaks between cases and controls; analyzed breast cancer risk by BMI and comet tail moments; results showing that DNA damage among cases is 1.5-1.75 times higher is in agreement with other studies; used LAI Automated Comet Assay Analysis System, which eliminates subjective comet assessments Limitations: does not stratify results by menopausal status; does not evaluate DNA damage from breast tissue, but from peripheral lymphocytes; 30% of study subjects did not return their risk questionnaires in the original study; biomarker measurements in surrogates, such as lymphocytes, may be influenced by tumor-associated factors; limited sample size; BMI only available for 35 cases and 45 controls; does not specify how anthropometric data was obtained
Exposure Investigated
How exposure was measured
Questionnaire, in person
Exposure assessment comment
Does not specify how anthropometric data was obtained
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.
Adequately controlled, Confounders: age
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
Effect modifier: comet tail moment
Strength of associations reported
Association between breast cancer risk and women with a high amount of DNA damage at baseline who also had a high BMI, >24.12, OR=40.69(5.93-279.05)
Association between breast cancer risk and women with a high amount of DNA damage after exposure to ionizing radiation who also had a high BMI, >24.12, OR=17.15(3.44-85.50)
Association between breast cancer risk and women with a high amount of DNA damage remaining after repair who also had a high BMI, >24.12, OR=26.24(3.95-174.44)
Author address
Department of Cancer Biology, Wake Forest University Health Sciences, Medical Center Blvd., Winston-Salem, NC 27157, USA.