1. A Case for Environmental Breast Cancer Research Alee Rowley

2. How Cancer is Caused…

3. Breast Cancer… is developed in the lobes and lobules, NOT the fatty tissues.

4. What Leads to Breast Cancer?

5. Estrogen… stimulates mitosis, especially when in combination with progesterone only PROMOTES the growth of breast cancer

6. Internal Risk Factors Age First period Menopause Offspring Relatives affected First term live birth Genetic mutations (BRCA1 and BRCA2 genes) White women…

7. Blacks vs. Whites:

8. Female Breast Cancer Incidence Rates, 2005 Color on MapIntervalStates Light blue96.4 to 113.7 Alabama, Arizona, Arkansas, Florida, Georgia, Idaho, Indiana, Mississippi, Nevada, New Mexico, Texas, Utah, and Wyoming Medium blue113.8 to 119.4 The District of Columbia, Hawaii, Kentucky, Louisiana, North Carolina, North Dakota, Ohio, South Carolina, Vermont, Virginia, and West Virginia Royal blue119.5 to 122.9 California, Illinois, Iowa, Michigan, Missouri, Montana, Nebraska, New York, Pennsylvania, Rhode Island, South Dakota, and Tennessee Dark blue123.0 to 133.3 Alaska, Colorado, Connecticut, Delaware, Kansas, Maine, Massachusetts, Minnesota, New Hampshire, New Jersey, Oklahoma, Oregon, and Washington Light GreyDid not meet USCS data quality criteriaMaryland and Wisconsin

9. Female Breast Cancer Death Rates, 2005 Color on MapIntervalStates Light blue17.9 to 22.5 Alaska, Arizona, Colorado, Florida, Hawaii, Idaho, Iowa, Maine, Minnesota, New Mexico, Oregon, Vermont, and Wyoming Medium blue22.6 to 23.6 California, Delaware, Georgia, Indiana, Kentucky, Massachusetts, New Hampshire, North Dakota, South Dakota, Texas, Washington, and Wisconsin Royal blue23.7 to 25.2 Arkansas, Connecticut, Kansas, Michigan, Montana, Nebraska, Nevada, New York, North Carolina, Oklahoma, Pennsylvania, Rhode Island, and Utah Dark blue25.3 to 29.9 Alabama, the District of Columbia, Illinois, Louisiana, Maryland, Mississippi, Missouri, New Jersey, Ohio, South Carolina, Tennessee, Virginia, and West Virginia

10. Incidence/Mortality vs. Race Louisiana White persons, percent 2008: 64.8% Black persons, percent 2008: 32.0% Mississippi White persons, percent, 2008: 60.6% Black persons, percent, 2008: 37.2% Virginia White persons, percent, 2008: 73.0% Black persons, percent, 2008: 19.9% Missouri White persons, percent, 2008: 85.0% Black persons, percent, 2008: 11.5% Illinois White persons, percent, 2008: 79.1% Black persons, percent, 2008: 14.9% Alabama White persons, percent, 2008: 71.0% Black persons, percent, 2008: 26.4% Tennessee White persons, percent, 2008: 80.4% Black persons, percent, 2008: 16.8% South Carolina White persons, percent, 2008: 68.7% Black persons, percent, 2008: 28.5% Ohio White persons, percent, 2008: 84.8% Black persons, percent, 2008: 12.0% West Virgina White persons, percent, 2008: 94.5% Black persons, percent, 2008: 3.6% New Jersey White persons, percent, 2008: 76.0% Black persons, percent, 2008: 14.5% Oregon White persons, percent, 2008: 90.1% Black persons, percent, 2008: 2.0% Maine White persons, percent, 2008: 96.4% Black persons, percent, 2008: 1.0% Washington White persons, percent, 2008: 84.3% Black persons, percent, 2008: 3.7% Alaska White persons, percent, 2008: 70.6% Black persons, percent, 2008: 4.3% Colorado White persons, percent, 2008: 89.7% Black persons, percent, 2008: 4.3% Kansas White persons, percent, 2008: 88.7% Black persons, percent, 2008: 6.2% Oklahoma White persons, percent, 2008: 78.1% Black persons, percent, 2008: 8.0% Minnesota White persons, percent, 2008: 89.0% Black persons, percent, 2008: 4.6% New Hampshire White persons, percent, 2008: 95.5% Black persons, percent, 2008: 1.2% Massachusetts White persons, percent, 2008: 86.2% Black persons, percent, 2008: 7.0% New Jersey White persons, percent, 2008: 76.0% Black persons, percent, 2008: 14.5% High Incidence Rates: High Mortality Rates:

11. …there’s a missing link… About 90% of women who develop breast cancer do not have a family history Heritability is only about 27% One percent increase each year for the last 60 years Incidence in different parts of the world…. ENVIRONMENT must play a role.

12. Environment: n. [en-vahy-ruhn-muhnt] Voluntary as well as involuntary exposures, social class, and urban/rural differences, and exposures that occur outside the body as well as those that modify the internal milieu (surroundings). Totality of living and working conditions as well as the physical, biological, social, and cultural factors such as employment, income, housing, industrial emissions, pollution, and hazardous chemicals.

13. External Risk Factors-ENVIRONMENT

14. Controversy Environmental influence is insignificant Many studies do not coincide ◦ National Cancer Institute studies ◦ Studies published JAMA ◦ Long Island Breast Cancer Study Project

15. Holes in the Research Vulnerability in development of the mammary gland More vulnerability at certain times in life People are exposed through entire lifespan Difficulty in finding an unexposed group Different subtypes of breast cancer Self-reporting Protective factors Conflicting study results

16. Current Studies…

17. References Breast Cancer Action. (2004, October). What you should know about the environment and breast cancer. Retrieved from Breast Cancer Action Web site: http://bcaction.org/index.php?page=environment-and- breast-cancer Halls, Steven B. (2008, May). Detailed Breast Cancer Risk Calculator. Retrieved from halls.md Web site: http://www.halls.md/index.htm Henderson, J. (2009, December 3). Cancer. Lecture presented for HE 434 Diseases, Western Oregon University, Monmouth, OR. Millikan, Robert. (2003). Environmental influences and breast cancer. Retrieved from California Breast Cancer Research Program Web site: http://www.cbcrp.org/publications/papers/millikan/page_02.php Nancy Nelson. (2004, June). Breast cancer and the environment studies supported by the National Cancer Institute. Retrieved from National Cancer Institute Web site: www.cancer.gov/newscenter/benchmarks- vol4-issue3/page2 National Breast Cancer Coalition. (2003, October). Environmental risk factors for breast cancer. Retrieved from California Breast Cancer Research Program Web site: http://www.stopbreastcancer.org//index.php?option=com_content&task=view&id=183&Itemid=178 National Institute of Environmental Health Sciences. (2007, January). Environmental factors and breast cancer risk. Retrieved from National Institute of Environmental Health Sciences Web site: www.niehs.nih.gov/health/docs/brca-fs.pdf National Institute of Environmental Health Sciences. (2006). BCERC Research. Retrieved from National Institute of Environmental Health Sciences Web site: http://www.bcerc.org/research.htm