Plasma Organochlorine Levels and the Risk of Breast Cancer
David J. Hunter, M.B., B.S., Susan E. Hankinson, Sc.D., Francine Laden, S.M., Graham A. Colditz, M.B., B.S., JoAnn E. Manson, M.D., Walter C. Willett, M.D., Frank E. Speizer, M.D., and Mary S. Wolff, Ph.D.
Background Exposure to "environmental estrogens" such as organochlorinesin pesticides and industrial chemicals has been proposed asa cause of increasing rates of breast cancer. Several studieshave reported higher blood levels of 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene(DDE) and polychlorinated biphenyls (PCBs) in patients withbreast cancer than in controls.
Methods We measured plasma levels of DDE and PCBs prospectivelyamong 240 women who gave a blood sample in 1989 or 1990 andwho were subsequently given a diagnosis of breast cancer beforeJune 1, 1992. We compared these levels with those measured inmatched control women in whom breast cancer did not develop.Data on DDE were available for 236 pairs, and data on PCBs wereavailable for 230 pairs.
Results The median level of DDE was lower among case patientsthan among controls (4.71 vs. 5.35 parts per billion, P = 0.14),as was the median level of PCBs (4.49 vs. 4.68 parts per billion,P = 0.72). The multivariate relative risk of breast cancer forwomen in the highest quintile of exposure as compared with womenin the lowest quintile was 0.72 for DDE (95 percent confidenceinterval, 0.37 to 1.40) and 0.66 for PCBs (95 percent confidenceinterval, 0.32 to 1.37). Exposure to high levels of both DDEand PCBs was associated with a nonsignificantly lower risk ofbreast cancer (relative risk for women in the highest quintilesof both DDE and PCBs as compared with women in the lowest, 0.43;95 percent confidence interval, 0.13 to 1.44).
Conclusions Our data do not support the hypothesis that exposureto 2,2-bis (p-chlorophenyl)-1,1,1-trichloroethane (DDT) andPCBs increases the risk of breast cancer.
Source Information
From the Channing Laboratory, Department of Medicine (D.J.H., S.E.H., F.L., G.A.C., J.E.M., W.C.W., F.E.S.), and the Division of Preventive Medicine (J.E.M.), Harvard Medical School and Brigham and Women's Hospital, Boston; the Departments of Epidemiology (D.J.H., S.E.H., F.L., G.A.C., J.E.M., W.C.W.), Environmental Health (F.E.S.), and Nutrition (W.C.W.), Harvard School of Public Health, Boston; Harvard Center for Cancer Prevention, Boston (D.J.H., G.A.C., W.C.W.); and the Division of Environmental and Occupational Medicine, Mount Sinai Hospital, New York (M.S.W.).
Address reprint requests to Dr. Hunter at the Channing Laboratory, 181 Longwood Ave., Boston, MA 02115.
Organochlorine Residues and Breast Cancer
vom Saal F. S., Welshons W. V., Hansen L. G., Talbott E. O., Zborowski J. V., Kuller L. H., Gammon M. D., Terry M. B., Teitelbaum S. L., Britton J. A., Levin B., Bigsby R. M., Steinmetz R., Verma S. P., Goldin B. R., Murray D. W., Lichter S. R., Hunter D. J., Laden F., Wolff M. S., Safe S.
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N Engl J Med 1998;
338:988-991, Apr 2, 1998.
Correspondence
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