Environment and Breast Cancer: Science Review

Evidence From Humans
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Associations of persistent organic pollutants in serum and adipose tissue with breast cancer prognostic markers
Arrebola, J. P., Fernandez-Rodriguez, M., Artacho-Cordon, F., Garde, C., Perez-Carrascosa, F., Linares, I., Tovar, I., Gonzalez-Alzaga, B., Exposito, J., Torne, P., Fernandez, M. F., Olea, N. Sci Total Environ. 2016. 566-567, 41-49.
Topic area
Environmental pollutant - PCBs OCPs
Study design
Hospital-based case-only
Funding agency
Cyber de EpidemiologĂ­a Instituto de Salud Carlos
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
No analyses based on menopausal status
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
103 breast cancer cases were newly diagnosed women (mean age 53.6) recruited between January 2012 and June 2014 from San Cecilio University Hospital in Granada, southern Spain.
Comment about participation selection
This hospital-based study lacks a comparison group of a population without breast cancer.
Exposures investigated
Breast adipose tissue and lipid-standardized serum p,p'-DDE and HCB from fasting samples collected at time of surgery (about 40% of participants had been treated with neoadjuvant chemotherapy).
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, education, BMI, perceived weight loss (yes/no), age at menarche, oral contraceptive consumption, accumulated breastfeeding time, and receipt of nonadjuvant chemotherapy
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
Adipose tissue HCB concentrations (ng/g lipid), compared to lowest quartile:
ER(+) cancers:
Q2 (19.4-67.38): aOR 1.11 (95% CI 0.29-4.16)
Q3 (67.38-194.6): aOR 2.39 (95% CI 0.47-12.21)
Q4 (>194.6): aOR 28.35 (95% CI 1.85-435.50)

PR(+) cancers:
Q2 (19.4-67.38): aOR 3.82 (95% CI 1.07-13.60)
Q3 (67.38-194.6): aOR 6.68 (95% CI 1.40-31.85)
Q4 (>194.6): aOR 11.15 (95% CI 1.70-73.29)

E-cadherin(+) cancers:
Q2 (19.4-67.38): aOR 0.25 (95% CI 0.01-4.14)
Q3 (67.38-194.6): aOR 0.08 (95% CI 0.00-1.85)
Q4 (>196.4): aOR 0.01 (95% CI 0.00-0.33)

p53(+) cancers:
Q2 (19.4-67.38): aOR 0.57 (95% CI 0.16-2.01)
Q3 (67.38-194.6): aOR 0.17 (95% CI 0.04-0.72)
Q4 (>196.4): aOR 0.20 (95% CI 0.04-1.09)

Adipose tissue PCB-180 concentrations (ng/g lipid), compared to lowest quartile:
HER2(+) cancers:
Q2 (19.8-44.7): aOR 1.96 (95% CI 0.14-27.43)
Q3 (44.7-85.8): aOR 7.62 (95% CI 0.66-87.55)
Q4 (>85.8): aOR 8.80 (95% CI 0.82-94.11)

Serum PCB-180 concentrations (ng/g lipid), compared to lowest quartile:
p53(+) cancers:
Q2 (9.4-23.4): aOR 1.61 (95% CI 0.38-6.84)
Q3 (23.4-46.1): aOR 3.30 (95% CI 0.65-16.72)
Q4 (>46.1): aOR 5.36 (95% CI 0.93-30.81)

Serum PCB-138 concentrations (ng/g lipid), compared to lowest quartile:
ER(+) cancers:
Q2 (7.8-18.6): aOR 2.35 (95% CI 0.52-10.75)
Q3 (18.6-40.4): aOR 4.59 (95% CI 0.76-27.89)
Q4 (>40.4): aOR 5.11 (95% CI 0.92-28.34)

PR(+) cancers:
Q2 (7.8-18.6): aOR 2.33 (95% CI 0.64-8.55)
Q3 (18.6-40.4): aOR 5.91 (95% CI 1.15-30.41)
Q4 (>40.4): aOR 3.97 (95% CI 0.94-16.77)
Results Comments
No significant associations were observed for adipose or serum POP concentrations and Ki-67 expression. No significant associations were observed for adipose or serum p,p'DDE concentrations and any of the tumor prognostic markers. All quartiles of HCB were negatively associated with p53 tumors (Q3 significant). p53 expression prevents proliferation of abnormal cells. All quartiles of HCB were negatively associated with E-cadherin+ tumors (Q4 significant). Lack of E-cadherin is associated with increased tumor invasiveness and metastasis.
Author address
Instituto de Investigacion Biosanitaria (ibs. GRANADA), Hospitales Universitarios de Granada, Spain; Virgen de las Nieves University Hospital, Radiation Oncology Department, Oncology Unit, Granada, Spain; CIBER en Epidemiologia y Salud Publica (CIBERESP),
Reviewers Comments
Results for serum HCB and tumor markers were not consistent with findings for HCB in breast adipose tissue. Levels in breast tissue may better reflect exposure. Alternatively, levels in breast tissue could reflect changes caused by the tumor.