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Ken Runkle Chief, Division of Environmental Health Senior Toxicologist Illinois Department of Public Health Breast Cancer & Environmental Exposures

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Carcinogens Definition: Substances & exposures that lead to cancer Name a carcinogen. What does it cause?

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Cancer Classifications Carcinogens or not? Methylene Chloride 1, 3butadiene

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U.S. Environmental Protection Agency Group A Human carcinogen Group B Probable human carcinogen B1 Limited evidence of carcinogenicity from epidemiological studies B2 Inadequate or no data from epidemiological studies Group C Possible human carcinogen Group D Not classifiable as to human carcinogenicity Group E Evidence of non carcinogenicity for humans

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International Agency for Research on Cancer (IARC) Group 1 Carcinogenic Group 2A Probably carcinogenic Group 2B Possibly carcinogenic Group 3 Not classifiable Group 4 Probably not

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Exposure and Chemical Fate Exposure Distribution Biotransformation Absorption Elimination

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Breast Cancer Causes vs. Risk Factors Causes High energy radiation Japanese survivors of WWII Tubercular woman with repeated chest X-rays Risk Factors 1713, Bernardino Ramazzini observed that nuns are more subject to cancer of the breast than other women So do women who have not borne children Risk factors are not causes, but may provide clues to causes

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Breast Cancer & Tumor Development Most tumors originate in the ducts and spread to other tissues More than of breast tumors rely on estrogen for growth Perhaps 5 to 10% due to inherited genetic mutation

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Difficulties in Determining Carcinogen Link Correlation does not equal causation Multiple factor interactions Lack of consistent evidence Genetic influences

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Chemicals Potentially Linked to Breast Cancer

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Hormones Hormone Replacement Therapy (HRT) & oral contraceptives Diethylstilbestrol (DES) Synthetic form of estrogen Prescribed to women from 1938 to 1971 to help with pregnancy complications; interfered with fetal development Estrogens/placental hormones in personal care products Often used in: Topical anti-aging creams Some shampoos/conditioners

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Xenoestrogens & Endocrine Disrupting Compounds Alkylphenols Cleaning products/detergents Aromatic amines Foams, dyes, pesticides, pharmaceuticals, diesel exhaust Bisphenyl-A (BPA) Plastics, food packaging, lining of canned foods, etc Dioxins Created during the production and burning of plastics

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Xenoestrogens & Endocrine Disrupting Compounds PAHs (Polycyclic Aromatic Hydrocarbon) Created during the combustion of coal and gasoline Pesticides/Herbicides Animal/food products Phthalates Plastics Polybrominated diphenyl ether (PBDE) Used as flame retardants Organochlorides DDT/DDE (Pesticides) Polychlorinated bi-phenols (PCBs) used as coolants and insulating fluid

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Food Hormones Phytoestrogens Found in plant-based products Zeranol Animal products Bovine Growth Hormone (rBST)

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Non-Endocrine Disrupting Industrial Chemicals Benzene Gasoline fumes/exhaust, cigarette smoke, industrial burning Organic Solvents Computer components, cleaning products, cosmetics, dry cleaning Vinyl chloride Plastics, tobacco smoke 1,3 butadiene Ethylene oxide Cosmetics, also used to sterilize surgical instruments

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Take Home Messages Little epidemiological evidence for link between environmental exposures and breast cancer Nature vs. nurture Early detection

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References American Cancer Society (www.cancer.org) Environmental Protection Agency (http://www.epa.gov/raf/publications/pdfs/CA%20GUIDELINES_1986.PDF ) International Agency for Research on Cancer (http://monographs.iarc.fr/ENG/Classification/index.php) Nudleman, J., & Engle, C. (2010). State of the evidence: the connection between breast cancer and the environment (6 th ed.) Retrieved from http://www.breastcancerfund.org/media/publications/state-of-the-evidence. Nudelman, J. et al. (2009, Jan/March). Policy recommendations emerging from the scientific evidence connecting environmental factors and breast cancer. International Journal of Occupational and Environmental Health, 2009, 79 101. Snedeker, S. (2002, May). Environmental chemicals and breast cancer risk: Why is there concern? Program on Breast Cancer and Environmental Risk Factors in New York State. Retrieved from http://envirocancer.cornell.edu

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Contact Information Ken Runkle Chief, Division of Environmental Health Illinois Department of Public Health Email: ken.runkle@illinois.gov