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Carcinogenic air pollutants and breast cancer risk in the Arkansas rural community health study: A nested case-control study.

Ellis et al,

2025

Environ Pollut

A study of 574 breast cancer cases and 2,295 controls from rural Arkansas found that moderate exposure to polycyclic aromatic hydrocarbons (PAHs) and high chromium exposure were associated with statistically significant 32% increased breast cancer risk, with the strongest effects observed among women with a family history of breast cancer. When examining 12 hazardous air pollutants as a mixture, there was a suggested but non-statistically significant 21% increased breast cancer risk, with chromium, propylene dichloride, and PCBs contributing most to the elevated risk. This study is important because it demonstrates that hazardous air pollutants pose breast cancer risks even in rural areas, which are often overlooked in environmental health research despite experiencing different pollution sources and healthcare disparities compared to urban populations.

Trajectories of long-term exposure to PCB153 and Benzo[a]pyrene (BaP) air pollution and risk of breast cancer.

Desnavailles et al,

2024

Environ Health

This large French cohort study analysed long-term residential exposure trajectories of PCB153 and benzo[a]pyrene (BaP) among more than 10,000 women and estimated associations with breast cancer risk. Women in the highest trajectory class for PCB153 had an OR of ~1.69 (95% CI: 1.08–2.64) compared to the lowest class; associations for BaP were weaker and not consistently statistically significant. The research highlights how evolving environmental exposures over decades may influence hormone-sensitive cancer risk.

Multiple xenoestrogen air pollutants and breast cancer risk: Statistical approaches to investigate combined exposures effect.

Amadou et al,

2024

Environ Pollut

A French study of over 10,000 women found that combined exposure to a mixture of four hormone-disrupting air pollutants (benzo[a]pyrene, cadmium, dioxin, and PCB153) was associated with an approximately 10-11% increased risk of breast cancer. Using advanced statistical methods that account for simultaneous exposure to multiple pollutants rather than examining each separately, researchers found that benzo[a]pyrene, cadmium, and PCB153 showed the strongest individual contributions to increased breast cancer risk within the mixture. This research provides important evidence that the cumulative effect of multiple air pollutants acting together on hormone pathways may be a significant risk factor for breast cancer development.

Multi-pollutant exposure profiles associated with breast cancer risk: A Bayesian profile regression analysis in the French E3N cohort.

Giampiccolo et al,

2024

Environ Int

A comprehensive French study of over 10,000 women examined exposure to eight different air pollutants simultaneously and identified that women exposed to high levels of nitrogen dioxide (NO₂), particulate matter, and PCB153 had a 38-61% increased risk of breast cancer compared to women with low pollution exposure. Using advanced statistical modeling that groups women by their combined pollution exposure patterns rather than examining pollutants individually, researchers found that specific combinations of high pollutant exposures were strongly associated with elevated breast cancer risk. This study provides important evidence that the combined “cocktail effect” of multiple air pollutants, particularly traffic-related pollution (NO₂) and industrial chemicals (PCB153), may significantly increase breast cancer risk beyond what individual pollutants cause alone.

Systematic review and meta-analysis of breast cancer risks in relation to 2,3,7,8-tetrachlorodibenzo-p-dioxin and per- and polyfluoroalkyl substances.

Cong et al,

2023

Environ Sci Poll Res

This meta-analysis pooled data from 17 epidemiological studies to examine whether exposure to the dioxin compound 2,3,7,8-TCDD or to per- and polyfluoroalkyl substances (PFAS) is associated with breast cancer risk. The authors found evidence of a modest but statistically significant increased breast cancer risk associated with TCDD levels in the body,

Endocrine-disrupting chemicals: A Systematic Review of Epidemiological Studies

Wan et al,

2022

Crit Rev Food Sci Nutr

A systematic review of 131 epidemiological studies examining endocrine-disrupting chemicals (EDCs) and breast cancer risk found evidence that exposure to various EDCs—including pesticides (DDT/DDE, atrazine, dioxin), synthetic chemicals (BPA, phthalates, PFAS, PCBs, PBDEs), and other compounds found in everyday products—may elevate breast cancer risk, particularly when exposure occurs during early life. The review identified food as a major route of EDC exposure and emphasized that because most EDCs persist in the environment and accumulate in the body over time, long-term multi-generational health impacts need to be assessed. The authors call for improved exposure assessments of EDCs in food and food packaging, along with careful evaluation of their links to breast cancer development to inform policy-making and regulations aimed at protecting public health.

A Congener-specific and Mixture Analysis of Plasma Polychlorinated Biphenyl Levels and Incident Breast Cancer.

Parada et al,

2021

Epidemiol

A study of 1,407 North Carolina women examined the relationship between blood levels of polychlorinated biphenyls (PCBs)—banned industrial chemicals that persist in the environment—and breast cancer risk. The researchers found that exposure to mixtures of PCBs was associated with increased breast cancer risk, with stronger associations observed among Black women (50% increased risk) compared to White women (10% increased risk) at higher exposure levels. Several individual PCB compounds showed elevated breast cancer risk when comparing highest to lowest exposure groups, with risk increases ranging from 20-40%. These findings support the hypothesis that PCB exposure may increase breast cancer risk, though additional studies in other populations are needed to confirm the results.

Long-term atmospheric exposure to PCB153 and breast cancer risk in a case-control study nested in the French E3N cohort from 1990 to 2011.

Deygas et al,

2021

Environ Res

A French study of over 10,000 women found that long-term atmospheric exposure to PCB153, a widespread environmental pollutant with estrogen-like properties, was associated with a 19% increased risk of breast cancer for each standard deviation increase in cumulative exposure. The association was particularly strong for women who became postmenopausal during the study period (23% increased risk) and for estrogen receptor-positive breast cancers (18% increased risk), while no association was found for estrogen receptor-negative tumors. This is the first study to link airborne PCB exposure to breast cancer risk, providing evidence that these persistent environmental pollutants may contribute to hormone-sensitive breast cancer development even decades after their use was banned.

DNA methylation level in blood and relations to breast cancer, risk factors and environmental exposure in Greenlandic Inuit women.

Wielsøe et al,

2020

Basic Clin Pharmacol Toxicol

This case-control study of serum-levels of persistent organic pollutants among Greenlandic Inuit included 74 breast cancer cases and 80 matched controls. Researchers measured blood methylation of repetitive elements (LINE-1) and genes such as ATM and ESR2, alongside serum persistent organic pollutant (POP) levels. They found that women in the second tertile of ATM methylation had OR ≈ 2.33 (95% CI: 1.04–5.23) and those in the third tertile of ESR2 methylation had OR = 2.22 (95% CI: 0.97–5.05); women in the highest tertile of LINE-1 methylation had OR = 0.42 (95% CI: 0.18–0.98). These results suggest that altered DNA methylation associated with environmental pollutant burdens may play a role in breast cancer etiology in this population.

Influence of exposure to endocrine disruptors and other environmental chemicals on breast development in girls: A systematic review of human studies.

Olivas-Martínez et al,

2025

Int J Hyg Environ Health

New research highlights the link between endocrine-disrupting chemicals (EDCs) and earlier breast development in girls. A systematic review of 68 studies found that 10 out of 14 high-quality studies linked prenatal and postnatal exposure to EDCs like organohalogenated compounds and phthalates to earlier thelarche. With thelarche now occurring nearly three months earlier per decade, these findings raise serious concerns about long-term health risks, including breast cancer. Reducing exposure to harmful chemicals in everyday products is crucial to protecting hormonal health and preventing early puberty.

Exposure to air pollutants and breast cancer risk: mediating effects of metabolic health biomarkers in a nested case-control study within the E3N-Generations cohort.

Mercoeur et al,

2024

Breast Cancer Res

A nested case-control study within the French E3N-Generations cohort examined 523 breast cancer cases and 523 matched controls to investigate whether thirteen metabolic health biomarkers mediate the relationship between exposure to three air pollutants (nitrogen dioxide, PCB153, and benzo[a]pyrene) and breast cancer risk. The study found that benzo[a]pyrene exposure was associated with a significant 2.32-fold increased breast cancer risk (highest vs. lowest quartile), PCB153 showed inconsistent positive associations, and nitrogen dioxide showed no association; among biomarkers, estradiol was associated with increased breast cancer risk (OR = 1.22 per SD). Four-way decomposition mediation analysis revealed suggestive evidence that albumin, HDL and LDL cholesterol, parathormone, and estradiol may partially mediate the associations between all three pollutants and breast cancer risk, though findings were limited by statistical power. These results provide preliminary mechanistic insights suggesting that air pollutants may influence breast cancer risk through alterations in metabolic biomarkers—particularly lipid metabolism and hormone regulation—though larger studies are needed to confirm these pathways and establish the clinical significance of these mediating effects in the relationship between environmental exposures and breast cancer development.

Endocrine-disrupting chemicals and breast cancer: a meta-analysis.

Liu et al,

2023

Frontiers

This meta-analysis aimed to evaluate the association between exposure to endocrine-disrupting chemicals (EDCs), including phthalates and other common environmental pollutants, and breast cancer risk. The study found that certain EDCs—such as p,p′-DDT, chlordane, HCH, and specific PCBs—were positively associated with increased breast cancer risk, while a few compounds like BBP and PFDoDA showed a negative association.

Hormonal Injustice: Environmental Toxicants as Drivers of Endocrine Health Disparities.

Weiss et al,

2023

Endocrinol Metab Clin North Am

Multiple social and structural determinants of health undoubtedly contribute to the marked racial/ethnic-, gender-, and socioeconomic-based disparities in endocrine health; however, the contribution of environmental injustice is vastly underappreciated. Indeed, those groups disproportionately burdened by endocrine disorders are often exposed to higher levels of various EDCs, including PCBs, phthalates, bisphenols, OC pesticides, air pollutants, PFASs, toxic metals/metalloids, and BFRs. These chemicals threaten our reproductive and metabolic health, contributing to diabetes prevalences, obesity, and disorders related to hormonal regulation. This review increases awareness of these disparities and encouraged equitable healthcare for those who are disadvantaged.

Dietary intakes of dioxins and polychlorobiphenyls (PCBs) and breast cancer risk in 9 European countries.

Fiolet et al,

2022

Environ Int

A large prospective study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort examined 318,607 women from nine European countries over a median 14.9 years of follow-up, identifying 13,241 incident invasive breast cancer cases, to assess whether dietary intake of 17 dioxins and 35 polychlorobiphenyls (PCBs)—persistent organic pollutants with endocrine-disrupting and carcinogenic properties—was associated with breast cancer risk. Dietary exposures to dioxins, dioxin-like PCBs (DL-PCBs), non-dioxin-like PCBs (NDL-PCBs), and combined dioxins + DL-PCBs showed no associations with breast cancer incidence (all HRs approximately 1.00-1.01 per 1 SD increase), with results remaining consistent when analyzed by quintile groups, by country, by estrogen receptor status, or after adjusting for contributing food groups and nutritional factors. These findings from one of the largest prospective studies on this topic do not support an association between dietary intake of dioxins and PCBs—the main exposure route for these chemicals in the general population—and breast cancer risk. Despite the established endocrine-disrupting properties of these pollutants and some previous suggestions of positive associations, this comprehensive European study provides reassuring evidence that typical dietary exposures to dioxins and PCBs are not linked to increased breast cancer incidence.

Endocrine disrupting chemicals and breast cancer: a systematic review of epidemiological studies.

Wan et al,

2022

Crit Rev Food Sci Nutr

This systematic review of 131 epidemiological studies evaluated the association between various endocrine-disrupting chemicals, including phthalates and hormonal exposures like contraceptive pills, and the risk of breast cancer. It found that several EDCs, particularly phthalates and oral contraceptive use, were consistently associated with increased breast cancer risk across multiple studies.

Environmental exposures and breast cancer risk in the context of underlying susceptibility: A systematic review of the epidemiological literature.

Zeinomar et al,

2020

Environ Res

A systematic review of 100 publications across 56 epidemiologic studies found that research enriched with women at higher baseline breast cancer risk—through family history, early-onset disease, or genetic susceptibility—consistently showed stronger and more frequent associations between environmental chemical exposures and breast cancer compared to average-risk populations. Specifically, 80% of studies enriched with family history or early-onset cases showed significant associations with exposures including PAHs, air pollution, DDT, PCBs, PFAS, metals, personal care products, and occupational chemicals, while 74% of studies examining genetic susceptibility found significant gene-environment interactions for various pollutants in women with variants affecting carcinogen metabolism, DNA repair, and oxidative stress. These findings suggest that the inconsistent evidence for environmental chemicals and breast cancer in the literature may partly stem from studying predominantly average-risk populations who may be less susceptible to environmental carcinogens, highlighting the critical need for future research to focus on high-risk populations and measure exposures during key windows of susceptibility (puberty, pregnancy, menopause) to more accurately capture the role of environmental chemicals in breast cancer development.

Breast Cancer and Exposure to Organochlorines in the CECILE Study: Associations with Plasma Levels Measured at the Time of Diagnosis and Estimated during Adolescence.

Bachelet et al,

2019

Int J Env Res Public Health

A French population-based case-control study (CECILE study) of 695 breast cancer cases and 1,055 controls measured plasma levels of organochlorine compounds (OCs)—p,p’-DDE and PCB153—at the time of diagnosis and used a physiologically-based pharmacokinetic (PBPK) model to estimate PCB153 exposure levels during adolescence (ages 11-20), when breast tissue may be particularly susceptible to hormonal disruption. The study found no clear association between measured OC levels at diagnosis and breast cancer risk overall, though there was a trend toward decreasing breast cancer odds ratios with increasing OC levels in women aged 50 and over; similarly, negative associations were observed between breast cancer and estimated adolescent PCB153 exposure levels. The PBPK modeling revealed that women born after 1960 had the highest estimated PCB153 exposures during adolescence (coinciding with peak environmental contamination), while older women had very low adolescent exposures, yet the unexpected negative associations between OC levels and breast cancer risk remained unexplained and may represent study artifacts. Despite these puzzling findings, the study demonstrates that PBPK models can be valuable tools in epidemiological research for back-estimating exposures during critical developmental windows, which could help address important questions about how early-life environmental exposures influence cancer risk decades later.

Environmental estrogen-like endocrine disrupting chemicals and breast cancer.

Morgan et al,

2017

Molec Cell Endocrinol

This study examines the role of environmental estrogen-like endocrine-disrupting chemicals (EEDs) in breast cancer development. EEDs are synthetic compounds that mimic estrogen, and the ones being studied in this paper include polychlorinated biphenyls (PCBs), bisphenol A (BPA), and phthalates. The results of the study show that of the EEDs tested, only one type of PCB, PCB138, had a strong association with the formation of breast cancer, where as phthalates (and it metabolites) but and BPA showed no strong correlation. Additionaly, the researchers identify that these EEDs promote the proliferation of breast cancer cells, induce epigenetic changes that may increase susceptibility to cancer, as well as alter developmental pathways during critical windows of breast development.

A comprehensive assessment of endocrine-disrupting chemicals in an Indian food basket: Levels, dietary intakes, and comparison with European data.

Sharma et al,

2021

Environ Pollut

A study comparing endocrine-disrupting chemical (EDC) contamination in Indian food found that while all tested foods—especially dairy and meat—contained organochlorine pesticides, PCBs, PBDEs, and dioxins, overall dietary exposure levels were comparable to or lower than those in Europe despite weaker regulations in India. Urban Delhi markets had higher contamination than peri-urban areas, with organochlorine pesticides being the primary contaminants, yet Indians’ lower meat consumption meant their total EDC exposure was similar to Europeans’ despite some European foods having higher chemical residues. The findings highlight that EDC contamination is a global food system issue driven by international trade of food and animal feed, underscoring the need for internationally harmonized standards on EDC limits in food to protect public health worldwide, as chemical exposures that increase risks for diseases like breast cancer cross borders through the global food supply.

Environmental pollutants and breast cancer: epidemiologic studies.

Brody et al,

2007

Cancer

A comprehensive review found that while laboratory studies have identified numerous environmental chemicals that cause breast tumors in animals or mimic estrogen, human epidemiological evidence is strongest for PAHs (found in air pollution and grilled foods) and PCBs (banned industrial chemicals), particularly in women with certain genetic variations affecting how their bodies process these chemicals and hormones. Evidence linking dioxins and organic solvents to breast cancer is limited but suggestive, while many chemicals identified as mammary carcinogens in animal studies have never been investigated in human populations due to challenges in measuring past exposures and the decades-long delay between exposure and cancer diagnosis. The review argues that given these methodological limitations in human studies, policymakers should rely more heavily on animal and laboratory evidence to develop regulations that reduce chemical exposures, as waiting for definitive human proof may unnecessarily delay prevention strategies that could reduce breast cancer rates.

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