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Reduce Risk of Breast Cancer

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					                       Reduce Risk of Breast Cancer
Women can reduce their risk of breast cancer by not taking combination estrogen/progestin hormone
therapy, not smoking, minimizing their exposure to radiation during CT scans and the like,
avoiding weight gain after menopause, cutting back on alcohol, and staying active, a new report says.
“The potential risk reductions from any of these actions for any individual woman will vary and may be
modest,” according to a brief summary of the nearly 400-page Institute of Medicine report, presented
at the San Antonio Breast Cancer Symposium. “Because much of the evidence on breast cancer risk
factors has come from studies of postmenopausal breast cancer in white women, it is hard to judge
the potential benefit for younger women or women of other races.”
The report, requested by Susan G. Komen for the Cure, examines what’s known about the link
between breast cancer and any factors other than those directly inherited through genes, which it
refers to as “environmental factors.”
“Such factors include how a woman grows and develops during her lifetime; what she eats and drinks;
the physical, chemical, and microbial agents she encounters; how much physical activity she engages
in; medical treatments and interventions she undergoes; and social and cultural practices that she
experiences,” according to the summary brief.
The Institute of Medicine (IOM), part of the National Academies, provides independent advice to
policy makers, the private sector, and the public.



Much Left to Learn

More than 230,000 U.S. women are expected to be diagnosed with breast cancer this year. Despite
decades of research costing millions of dollars, much about how environmental factors contribute to
breast cancer risk remains unknown, Irva Hertz-Picciotto, PhD, chair of the IOM’s Committee on
Breast Cancer and the Environment, said at a news conference.
“The evidence is less than persuasive but suggests a possible association with increased risk” for
such factors as secondhand smoke, nighttime shift work, and exposure to such chemicals as benzene
and ethylene oxide, chemicals found in some vehicle and workplace fumes and tobacco smoke,
according to the committee.
Animal studies have shown that that some environmental agents, such as the chemical bisphenol A
(BPA) -- widely used in plastic containers -- are at least biologically plausible risk factors, but studies
in humans are lacking, the panelists say.



Ideal Study Hard to Do

Part of the problem is that environmental exposures begin in the womb and continue throughout life,
so tracking them is virtually impossible, committee member Robert Hiatt says.
The ideal study would follow individuals for that entire span, he says, but that would be prohibitively
expensive and time-consuming.
“The breast undergoes substantial changes over a woman’s lifetime,” the committee members note.
“Future research should emphasize a ‘life course’ model.”
Testing of chemicals in animals often occurs too late in their life span to provide clues about the
impact of early exposures in humans, says panel member David Eaton, PhD, professor of
environmental and occupational health sciences at the University of Washington.
Ideal Study Hard to Do continued...

“Also,” says Hertz-Picciotto, professor of public health sciences at the UC Davis Health System, “we
need to consider possible combined effects of many low-level exposures.”
Still, Hiatt says, “I actually think the time is very exciting for getting some place in this area.”
For example, he says, some studies are now looking at what determines the age at which girls
enter puberty. Previous research has shown that the earlier the onset of puberty, the greater the
breast cancer risk in adulthood.
And sophisticated molecular approaches can now uncover “fingerprints” left behind by exposures long
ago, says Cheryl Lyn Walker, PhD, director of the Institute of Biosciences and Technology at the
Texas A&M Health Science Center.
Karuna Jaggar MA, executive director of Breast Cancer Action, a San Francisco-based advocacy
group, said she was “deeply disappointed” with the report. Instead of encompassing everything from
stress to abdominal fat, Jaggar said in a statement, it should have focused on "the chemicals we are
all exposed to in our everyday lives."
“The report recommendations for women merely rehash the little bit we already know about lifestyle
and breast cancer and miss an opportunity to focus on relatively unknown areas of the environment,”
Jaggar said in a statement.

				
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posted:3/31/2012
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