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IOM identifies factors that may increase breast cancer risk
San Antonio Breast Cancer Symposium
SAN ANTONIO — In a new report, the Institute of Medicine singled out several environmental factors that may increase a woman’s risk for breast cancer and highlighted steps that people can take towards prevention of the disease.
Some risk factors that top the IOM report’s list include: unnecessary medical radiation; the use of certain combination estrogen-progestin menopausal hormone therapy; excessive alcohol consumption; weight gain; lack of physical activity; and smoking. The IOM’s Committee on Breast Cancer, which was charged with writing the report, however, points out the importance of consulting a physician when making lifestyle decisions. For instance, the report notes that radiation from mammograms is low, whereas radiation from CT scans is much higher. Consulting with a physician to determine whether these procedures are necessary is essential.
Even assessing lifestyle choices may be complicated, the report states. Although it is well-known that excessive alcohol consumption definitely increases risk for cancer and other health issues, even one drink of beer or wine per day can have a similar effect on risk for breast cancer. Nevertheless, this small amount of alcohol may also have cardioprotective benefits. In this case, the report again advises patients to discuss their other risk factors, such as genetic predisposition, with physicians to decide how alcohol consumption contributes to their risk for developing disease.
The report also addresses certain environmental exposures, such as bisphenol A (BPA), pesticides, ingredients in cosmetics and dietary supplements or other substances about which researchers have not yet drawn conclusions. Currently, the committee notes, studies are insufficient in this area. Moreover, in some cases, researchers are limited to using animal models and cells and the results may not be as applicable to humans.
Even so, certain areas where research is inconclusive, but provocative, should receive more attention. These include: overnight shift work and accompanying disruptions of the sleep cycle; chemicals that mutate genes, alter gene expression or affect hormones; and gene-environment interactions. Furthermore, closer examination of how these exposures impact patients throughout the lifespan, such as at specific stages of breast development, or how combinations of multiple exposures may affect risk is needed, the report states.
“Breast cancer develops over many years, so we need better ways to study exposures throughout women’s lives, including when they are very young,” committee chair Irva Hertz-Picciotto, PhD, MPH, professor in the department of public health sciences and chief of the division of environmental and occupational health at the University of California, Davis, said in a press release. “We also need improved methods to test for agents that may be contributing to breast cancer risk and to explore the effects of combined exposures.”
The report, titled Breast Cancer and the Environment: A Life Course Approach, is available from the National Academies Press or can be downloaded at www.nap.edu.
Earn CME this spring at the HemOnc Today Breast Cancer Review & Perspective meeting to be held March 23-24, 2012 at the Hilton San Diego Bayfront. See details at HemOncTodayBreastCancer.com.
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