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Health tracking can help provide critical information to understand the link between environmental contaminants and disease.

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VICTORIES

State of the Evidence 2010
6th Edition of State of the Evidence Published

The science linking breast cancer to our environment mounts.

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STRONG VOICES

Sarah Janseen, M.D., Ph.D., M.P.H.
Sarah Janssen

A physician, scientist, advocate and mother committed to protecting our health and our environment, Dr. Janssen is a 2010 Hero.

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Childhood and Adolescence

Today, girls are entering puberty earlier than a generation ago—in part due to childhood exposures to endocrine disruptors. Early puberty puts girls at a higher risk for later-life breast cancer. Research also shows that childhood exposures to medical radiation and chemicals like DDT are linked to higher rates of breast cancer.

Girls get their first periods today, on average, a few months earlier than did girls 40 years ago, and they get their breasts one to two years earlier.[1] This trend may be due to exposures to endocrine disrupting compounds—like BPA and phthalates[2],[3]—before puberty when the reproductive system, including breast tissue, is exquisitely sensitive to low levels of estrogens.[4] The younger girls are when they enter puberty, the greater their risk of breast cancer later in life.

Evidence suggests that breast development is sensitive to other chemical exposures as well. A recent study illustrated that childhood and early adolescent exposures to the now banned pesticide DDT led to a five-fold increase in breast cancer before age 50.[5] This is a particularly powerful study for two reasons. First, scientists often have to rely on people's best guesses about what they were exposed to earlier in life. In this case, however, scientists had access to blood samples taken during adolescence which allowed for actual measurements of DDT exposure. Second, since DDT was banned in 1972, new exposures to the chemical were limited after that time. This is rare, since often exposures persist throughout the lifetime, making it difficult to determine the ages when the exposures affected later health.

Research on childhood and adolescent exposures to radiation illustrate a similar effect. Women in Hiroshima and Nagasaki who were under 20 when the United States dropped the atomic bombs had higher rates of breast cancer than older women.[6],[7] Similarly, young women exposed to massive amounts of radiation from the 1986 Chernobyl nuclear reactor accident are experiencing higher rates of breast cancer.[8] It is too early to assess the effects on women who were girls or teens at the time of the accident.

Girls who received repeated X-rays for scoliosis and adolescent and very young women who received radiation treatment for Hodgkin's and non-Hodgkin's lymphoma experienced higher rates of breast cancer than women who were older at the time of their X-rays or radiation treatment.[9],[10],[11],[12] Their rates were also elevated relative to their peers who did not receive medical radiation.

  1. Steingraber S (2007). The Falling Age of Puberty in US Girls: What We Know, What We Need to Know. San Francisco, CA: Breast Cancer Fund.
  2. Aksglaede L, Juul A, Leffers H, Skakkebaek NE, Andersson AM (2006).  The sensitivity of the child to sex steroids:  possible impact of exogenous estrogens.  Human Reproduction Update 12:341-349.
  3. Steingraber S (2007). The Falling Age of Puberty in US Girls: What We Know, What We Need to Know. San Francisco, CA: Breast Cancer Fund.
  4. Aksglaede L, Juul A, Leffers H, Skakkebaek NE, Andersson AM (2006).  The sensitivity of the child to sex steroids:  possible impact of exogenous estrogens.  Human Reproduction Update 12:341-349.
  5. Cohn BA, Wolff MA, Cirillo PM, Sholtz RI (2007). DDT and breast cancer in young women: New data on the significance of age at exposure. Environmental Health Perspectives (Accessed pre-publication on 7/30/07) http://www.ehponline.org/docs/2007/10260/abstract.html.
  6. Land CE (1995). Studies of cancer and radiation dose among A-bomb survivors: The example of breast cancer. Journal of the American Medical Association 274:402-407.
  7. Land CD (1997). Radiation and breast cancer risk. Progress in Clinical Biological Research 396:115124.
  8. Pukkala E, Kesminiene A, Poliakov S, Ryzhov A, Drozdovitch V, Kovgan L, Kyyronen P, Malakhova IV, Gulak L, Cardis E.  (2006). Breast cancer in Belarus and Ukraine after the Chernobyl accident.  International Journal of Cancer 651-658.
  9. Schellong G (1998).  Pediatric Hodgkin’s disease: Treatment in the late 1990s.  Annals of Oncology 9 (Suppl 5): S115-S119.
  10. Clemons MM, Loijens L, and Goss  P (2000).  Breast cancer risk following irradiation for Hodgkin’s disease.  Cancer Treatment Reviews 26: 291-300.
  11. Tward JD, Wendland MMM, Shrieve DC, Szabo A, Gafffney DK (2006).  The risk of secondary malignancies over 30 years after the treatment of Non-Hodgkins Lymphoma.  Cancer 107: 108-115.
  12. Howe GR, McLaughlin J (1996).  Breast cancer mortality between 1950 and 1987 after exposure to fractionated moderate-dose-rate ionizing radiation in the Canadian fluoroscopy cohort study and a comparison with breast cancer mortality in the atomic bomb survivors study.  Radiation Research 145: 694-707.