AND THE ENVIRONMENT
A LIFE COURSE APPROACH
Committee on Breast Cancer and the Environment:
The Scientific Evidence, Research Methodology, and Future Directions
Board on Health Care Services
Board on Health Sciences Policy
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001
NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
This study was supported by a contract between the National Academy of Sciences and Susan G. Komen for the Cure®. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.
Library of Congress Cataloging-in-Publication Data
Institute of Medicine (U.S.). Committee on Breast Cancer and the Environment: The Scientific Evidence, Research Methodology, and Future Directions.
Breast cancer and the environment : a life course approach / Committee on Breast Cancer and the Environment: The Scientific Evidence, Research Methodology, and Future Directions, Board on Health Care Services, Board on Health Sciences Policy.
p. ; cm.
Includes bibliographical references.
ISBN 978-0-309-22069-9 (pbk.) — ISBN 978-0-309-22070-5 (PDF)
[DNLM: 1. Breast Neoplasms—etiology. 2. Environmental Exposure—adverse effects. 3. Breast Neoplasms—prevention & control. 4. Risk Factors. WP 870]
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Copyright 2012 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
Cover credit: Illustration by Diana Ong/Getty Images.
The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.
Suggested citation: IOM (Institute of Medicine). 2012. Breast cancer and the environment: A life course approach. Washington, DC: The National Academies Press.
“Knowing is not enough; we must apply.
Willing is not enough; we must do.“
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
Advising the Nation. Improving Health.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering and Medicine
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The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.
COMMITTEE ON BREAST CANCER AND THE
ENVIRONMENT: THE SCIENTIFIC EVIDENCE, RESEARCH
METHODOLOGY, AND FUTURE DIRECTIONS
IRVA HERTZ-PICCIOTTO (Chair), Professor and Chief, Division of Environmental and Occupational Health, University of California, Davis
LUCILE ADAMS-CAMPBELL, Professor of Oncology, Associate Director, Minority Health and Health Disparities Research, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center
PEGGY DEVINE, Founder and President, Cancer Information and Support Network
DAVID EATON, Associate Vice Provost for Research, and Professor and Director, Center for Ecogenetics and Environmental Health, University of Washington
S. KATHARINE HAMMOND, Professor, Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley
KATHY J. HELZLSOUER, Director, The Prevention and Research Center, Mercy Medical Center
ROBERT A. HIATT, Professor and Chair, Department of Epidemiology and Biostatistics, and Director, Population Sciences, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco
CHANITA HUGHES HALBERT, Associate Professor, Department of Psychiatry, University of Pennsylvania, and Director, Center for Community-Based Research and Health Disparities
DAVID J. HUNTER, Dean for Academic Affairs and Vincent L. Gregory Professor in Cancer Prevention, Harvard School of Public Health
BARNETT KRAMER, Editor-in-Chief, Journal of the National Cancer Institute, and Editor-in-Chief, National Cancer Institute Physician Data Query (PDQ) Screening and Prevention Editorial Board
BRYAN M. LANGHOLZ, Professor, Division of Biostatistics, Department of Preventive Medicine, University of Southern California (resigned July 2011)
PEGGY REYNOLDS, Senior Research Scientist, Cancer Prevention Institute of California
JOYCE S. TSUJI, Principal Scientist, Center for Toxicology and Mechanistic Biology, Exponent
CHERYL LYN WALKER, Welch Professor and Director, Institute of Biosciences and Technology, Texas A&M Health Science Center
LAUREN ZEISE, Chief, Reproductive and Cancer Hazard Assessment Branch, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency
LOIS JOELLENBECK, Study Director
JANE DURCH, Senior Program Officer
SHARYL NASS, Senior Program Officer
NIHARIKA SATHE, Research Assistant (from November 2010)
CASSANDRA CACACE, Research Assistant (until December 2010)
ASHLEY McWILLIAMS, Senior Program Assistant (until December 2010)
PATRICK BURKE, Financial Associate
ROGER HERDMAN, Director, Board on Health Care Services
ANDREW POPE, Director, Board on Health Sciences Policy
Commissioned Paper Authors
REBECCA SMITH-BINDMAN, University of California, San Francisco School of Medicine
LINDA DIX-COOPER, University of California, Berkeley
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:
Mary Helen Barcellos-Hoff, NYU Langone Medical Center
Julia G. Brody, Silent Spring Institute
Diana Chingos, USC Norris Comprehensive Cancer Center
Kathryn Guyton, U.S. Environmental Protection Agency
Leena Hilakivi-Clarke, Georgetown Lombardi Comprehensive Cancer Center
William A. Knaus, The University of Virginia Health Sciences Center
Ruth M. Parker, Emory University School of Medicine
Lorenz Rhomberg, Gradient
Stephen H. Safe, Texas A&M University
Michael Thun, American Cancer Society
David M. Umbach, National Institute of Environmental Health Sciences, National Institutes of Health
Sandy Walsh, California Breast Cancer Organizations
Noel S. Weiss, University of Washington
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by David G. Hoel, Medical University of South Carolina, and David A. Savitz, Brown University. Appointed by the National Research Council and the Institute of Medicine, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.
The committee is grateful for the contribution of participants at its three public meetings. The presentations and discussions at these meetings were valuable in informing the committee about relevant research findings, issues of interest in the research community, the perspectives of advocacy organizations, and the concerns of individuals with breast cancer and their families. The agendas for these meetings appear in Appendix A.
The committee was also ably assisted by Linda Dix-Cooper from the University of California, Berkeley, and Dr. Rebecca Smith-Bindman from the University of California, San Francisco, from whom the committee commissioned papers.
The study was conducted with the generous support of Susan G. Komen for the Cure®. The Institute of Medicine staff worked closely with Dr. Amelie Ramirez, who is a member of the Susan G. Komen for the Cure Scientific Advisory Board and Director of the Institute for Health Promotion Research at the University of Texas Health Science Center at San Antonio. Dr. Ramirez was helpful and supportive as the committee’s point of contact with the Scientific Advisory Board, which originally requested this study. In addition, Kendall Bergman graciously assisted the staff in the administrative coordination with Komen for the Cure.
The committee and project staff appreciate the work of copy editor Laura Penny and gratefully acknowledge valuable assistance within the National Academies from Laura Harbold DeStefano, Greta Gorman, Diedtra Henderson, Jillian Laffrey, William McLeod, Janice Mehler, Abbey Meltzer, Michael Park, Christine Stencel, Vilija Teel, and Lauren Tobias.
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Tables, Figures, and Boxes
4-2 Lifetime Incidence of Breast Tumors in U.S. Men and Women and Overall Percentage of Control Animals That Developed Spontaneous Mammary Tumors in Recent Reports on National Toxicology Program Carcinogenesis Studies
F-1 Selected Units of Ionizing Radiation
F-2 Summary of U.S. Population’s Annual Exposure to Ionizing Radiation from Different Sources, 2006–2010
F-3 Typical Effective Doses of Radiation for Common Conventional X-ray and CT Procedures
F-4 Typical Annual Occupational Exposures to Radiation
F-5 Estimated Number of Future Breast Cancers That Might Occur Related to a Single Year of Medical Radiation Exposure
F-1 Energy spectrum of radiation
F-2 Sample doses of and exposures to ionizing radiation
F-3 Proportion of radiation from various sources, 1985 (left) and 2006 (right)
F-4 Median effective radiation dose (interquartile range, minimum, and maximum) for each type of CT study
F-5 Estimated range in the lifetime attributable risk of cancer if a 20-year-old woman underwent one of several types of CT studies using observed radiation dose
F-6 Projected number of future cancers (mean and 95% uncertainty limits) that could be related to CT scan use in the United States in 2007, according to cancer type
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American Cancer Society
acceptable daily intake
aqueous fire fighting foams
aryl hydrocarbon receptor
Agency for Healthcare Research and Quality
American Institute for Cancer Research
AMP-activated protein kinase
Agency for Toxic Substances and Disease Registry
adipose tissue hypoxia
benign breast disease
Breast Cancer Association Consortium
body mass index
Breast and Prostate Cancer Cohort Consortium
constitutive androstate receptor
Centers for Disease Control and Prevention
Code of Federal Regulations
Cancer Genetic Markers of Susceptibility project
Cancer Intervention and Surveillance Modeling Network
California Teachers Study
directed acyclic graphs
ductal carcinoma in situ
di(2-ethylhexyl) phthalate; also bis(2-ethylhexyl) phthalate
Dietary Supplement Health and Education Act
European Chemical Agency
endocrine disrupting compound
European Food Safety Authority
epidermal growth factor receptor
extremely low frequency electromagnetic field
Environmental Protection Agency
estrogen receptor negative
estrogen receptor positive
estrogen response element
Food and Agriculture Organization of the United Nations
Food and Drug Administration
follicle stimulating hormone
Government Accountability Office
genome-wide association studies
human epidermal growth factor receptor
Heart and Estrogen/Progestin Replacement Study
Department of Health and Human Services
High Production Volume Chemical program
International Agency for Research on Cancer
insulin-like growth factor
insulin-like growth factor binding protein
Institute of Medicine
(WHO) International Program on Chemical Safety
mitogen-activated protein kinase
mouse mammary tumor virus
N-methyl-N-nitrosourea; also N-nitroso-N-methylurea
Mammography Quality Standards Act
Multiple Risk Factor Intervention Trial
National Academy of Sciences
National Cancer Institute
National Health and Nutrition Examination Survey
Nurses’ Health Study
National Institute on Alcohol Abuse and Alcoholism
National Institute of Environmental Health Sciences
National Institutes of Health
number needed to harm
number needed to treat
National Program of Cancer Registries
National Research Council
National Toxicology Program
Office of Environmental Health Hazard Assessment
Occupational Safety and Health Administration
polycyclic aromatic hydrocarbon
population attributable risk
polybrominated diphenyl ether
Physician Data Query
peroxisome proliferator-activated receptor
parts per million
progesterone receptor negative
progesterone receptor positive
prostate specific antigen
Registration, Evaluation, Authorisation and Restriction of Chemical Substances
receiver operating characteristic
reactive oxygen species
Surveillance, Epidemiology, and End Results Program
selective estrogen receptor down-regulator
selective estrogen receptor modulator
sex hormone binding globulin
single nucleotide polymorphism
Study of Tamoxifen and Raloxifene
terminal duct lobular unit
triple negative breast cancer
tumor necrosis factor
Toxic Substances Control Act
U.S. Preventive Services Task Force
volatile organic compound
World Cancer Research Fund
Women’s Environment, Cancer, and Radiation Epidemiology Study
Women’s Health Initiative
World Health Organization