Every year billions of dollars are spent on breast cancer research.
Still, the disease rages on, although more women are surviving.
A major national report released in February concluded that a key to reducing breast cancer would be to shift some of the focus - and increase funding - to prevention.
One recommendation was to intensify the study of environmental factors that might affect whether a woman gets cancer and how long she survives afterward.
The group’s broad definition of environment included lifestyle behaviors, such as exercise, alcohol consumption, and maintaining proper weight.
But the committee also took note of pesticides, bisphenol A, flame retardants, and other endocrine-disrupting chemicals thought to affect the breast.
To Jeanne Rizzo, president of the Breast Cancer Fund, a national advocacy group, and co-chair of the committee that released the report, the findings validated what her group had been saying for years.
“We are all exposed to a cocktail of carcinogens and endocrine disrupters every day that puts us at great risk for breast cancer,” she said. Preventing exposures may keep “many people from ever having to get the devastating disease.”
Here are some of the numbers:
The National Institutes of Health alone spent $2.4 billion on breast cancer research from 2008 to 2010. Nongovernment groups funded $1.5 billion in research.
But only 10 percent of the money went to projects looking at prevention or environmental factors.
And still breast cancer takes a toll. Last year, about 227,000 women were diagnosed; 44,000 women died. Costs surpassed $17 billion.
The 270-page report is said to be the largest analysis yet of peer-reviewed literature on breast cancer and the environment.
The panel members included representatives of federal agencies, nonfederal scientists and physicians, and advocates.
Their mission was to review the current science, look at funding, and make recommendations. (Read the report at http://www.niehs.nih.gov/about/boards/ibcercc/.)
Michele Forman, who chaired the panel and is an epidemiologist at the University of Texas at Austin, said the new mantra is “prevention.”
“We can no longer ignore the major research gaps in understanding the role of the environment in breast cancer,” she said.
The report also identified vulnerable periods in a female’s life, when breast tissue is changing rapidly. They include early childhood, puberty, pregnancy, and lactation.
“There’s rapid cell development going on during those periods,” Rizzo said. “The breast is in a stage where it’s more vulnerable to exposures.”
While estrogen-disrupting chemicals are believed to play a part in breast cancer, most experts think the biggest factor driving modern breast cancer trends is changes in childbearing. Having fewer children and at later ages affects lifetime exposure to estrogen, known to promote breast cancer.
Other “estrogenic” chemicals the report listed include nonylphenols in cleaning compounds and the linings of food cans, the pesticides DDT and dieldrin, plus the perfluorooctanoic acid (PFOA) that is in nonstick coatings and that make products grease- and waterproof.
“I’d say, take precaution and avoid exposure,” Rizzo said. “Especially at vulnerable times.”
Not that there’s “compelling proof” they cause cancer, she said, “but we weigh risks every day.”
If there was a 10 percent chance your chicken sandwich was spoiled, would you take a bite?
So Rizzo and others urge women to avoid using plastic food containers, which may contain bisphenol A. Wash hands before eating, because cash register receipts can contain bisphenol A. Seek personal-care products advertised as phthalate-free. Avoid nonstick cookware.
Ultimately, she and others hope researchers will find ways to better assess exposure to not just one chemical, but many, which is what actually happens.
“You have all these insults that can happen that sets the breast up to be more reactive to these other insults,” Rizzo said. “Every exposure, everything that happens in your system, has an impact on whether the message is ‘grow properly’ or ‘don’t.’
