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Air Pollution and Breast Cancer Incidence in the Multiethnic Cohort Study.

Wu et al,

2025

J Clin Oncol

A large California study of over 58,000 racially and ethnically diverse women found that long-term exposure to fine particulate matter (PM2.5) air pollution was associated with a statistically significant 28% increased risk of breast cancer for each 10 μg/m³ increase in PM2.5 concentration, with the association consistent across African American, Latino, and other ethnic groups. When combined with data from 10 other studies in a meta-analysis, PM2.5 exposure showed a borderline significant 5% increased breast cancer risk, providing strong evidence that air pollution is an important breast cancer risk factor. These findings emphasize that breast cancer prevention strategies should extend beyond individual lifestyle changes to include population-level policies aimed at reducing air pollution, particularly as traditional risk factors explain only half of breast cancer cases and incidence continues to rise globally.

Health risk assessment to xenoestrogen through atmospheric PM(2.5) particles: A case study in Suzhou.

Wang et al,

2025

Ecotoxicol Environ Saf

This study analyzed six xenoestrogens (hormone-disrupting chemicals including phthalates, BPA, and alkylphenols) in atmospheric particles at a university campus in China from 2021 to 2023. BPA was the most prevalent xenoestrogen detected, with concentrations of these chemicals being significantly higher in winter than summer, and the overall cancer and non-cancer health risks were below threshold limits for the general population. However, infants and young children showed significantly higher risk values compared to other age groups, indicating they face greater health risks from atmospheric exposure to these endocrine disruptors. The research provides important data for developing policies to reduce health risks from airborne xenoestrogen exposure, particularly for vulnerable populations like children.

Ambient fine particulate matter and breast cancer incidence in a large prospective US cohort.

White et al,

2024

J Natl Cancer Inst

A large US study of nearly 197,000 women found that exposure to fine particulate matter air pollution (PM2.5) during the 1980s—when pollution levels were higher—was associated with an 8% increased risk of breast cancer overall, with each 10 µg/m³ increase in PM2.5 concentration linked to the elevated risk. The association was particularly strong for estrogen receptor-positive breast cancers, showing a 10% increased risk, while no association was found for estrogen receptor-negative tumors. This study provides important evidence that historical air pollution exposure, even decades before diagnosis, may contribute to breast cancer development, particularly for hormone-sensitive tumors, emphasizing the long-term health consequences of air quality and the benefits of pollution reduction efforts.

Long-term exposure to air pollution at residential and workplace addresses and breast cancer risk: A case-control study nested in the French E3N-Générations cohort from 1990 to 2011.

Duboeuf et al,

2024

Eur J Cancer

A French study of over 5,400 women found a suggested 28% increased risk of breast cancer associated with long-term exposure to fine particulate matter (PM2.5) air pollution for each 10 µg/m³ increase in average concentration, though this association did not reach statistical significance, with weaker trends also observed for PM10 and nitrogen dioxide (NO2). This study uniquely examined air pollution exposure at both residential and workplace locations, finding that residential and workplace pollution levels were highly correlated, suggesting that residential exposure assessments can serve as a reasonable proxy for total pollution exposure. The findings contribute to growing evidence linking air pollution to breast cancer risk and suggest that future research should also consider exposure during commuting to capture complete pollution exposure patterns.

Exposure to outdoor ambient air toxics and risk of breast cancer: The multiethnic cohort.

Heck et al,

2024

Int J Hyg Environ Health

A study of 48,665 California women in the Multiethnic Cohort found that exposure to specific ambient air toxics at residential addresses was associated with increased breast cancer risk over a 10-year follow-up period. Industrial chemicals showed the strongest associations, with 1,1,2,2-tetrachloroethane linked to a 322% increased risk, ethylene dichloride to a 181% increased risk, and vinyl chloride to a 127% increased risk. Gasoline-related pollutants also showed elevated risks, including benzene (32% increase), acrolein (126% increase), and toluene (29% increase), with generally stronger associations observed among African American and White women. These findings suggest that toxic air pollutants, particularly from industrial sources and vehicle emissions, may contribute to breast cancer development, which is especially concerning for populations living in high-pollution areas like Los Angeles.

Elevated levels of perfluoroalkyl substances in breast cancer patients within the Greater Manila Area.

Velarde et al,

2022

Chemosphere

Researchers measured 41 endocrine-disrupting chemicals (EDCs) in women living in the Greater Manila Area, Philippines, comparing those with and without breast cancer. They found that certain perfluoroalkyl substances (PFAS) were significantly associated with breast cancer, with some chemicals showing dramatically increased risk: PFDoA was associated with a 1,263% increased risk, PFDA with an 826% increased risk, and PFHxA with a 166% increased risk. Long-chain PFAS levels were higher in women from heavily industrialized areas compared to the National Capital Region. This study provides the first baseline data on EDC exposure levels in Filipino women, filling a critical gap in knowledge about chemical exposures in Southeast Asian populations and suggesting that industrial pollution may be contributing to elevated PFAS levels and breast cancer risk.

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.

Female breast cancer risk in Bryansk Oblast, Russia, following prolonged low dose rate exposure to radiation from the Chernobyl power station accident.

Rivkind et al,

2020

Int J Epidemiol

This Russian study of 468 breast cancer cases found that women exposed to prolonged low-level radiation from the Chernobyl nuclear accident had approximately three times higher breast cancer risk in the highest exposure groups compared to those with the lowest exposure, even though radiation doses were relatively low (averaging just 1.3 centigray). The study tracked women for about 25 years after the 1986 Chernobyl accident and estimated their radiation exposure based on where they lived and what they ate during that time. The findings suggest that even prolonged exposure to low levels of radiation—not just high-dose exposures—can increase breast cancer risk, particularly among women who were younger at the time of exposure.

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.

Environmental Exposure to Pesticides and Breast Cancer in a Region of Intensive Agribusiness Activity in Brazil: A Case-Control Study.

Silva et al,

2019

Int J Env Res Pub Health

This Brazilian case-control study of 351 women in an intensive agricultural region found that women living near cropland where pesticides are used had more than twice the risk of developing breast cancer compared to those who didn’t live near such areas. The study also found that women over 50 who experienced early menarche (first menstrual period at 9-12 years) had approximately double the breast cancer risk. These findings suggest that residential proximity to pesticide-treated agricultural land may be an important environmental risk factor for breast cancer, adding to concerns about pesticide exposure beyond just occupational settings or dietary intake.

Urban Neighborhood and Residential Factors Associated with Breast Cancer in African American Women: a Systematic Review.

Smith et al,

2018

Discov Oncol

This systematic review examined the relation of 4 neighborhood factors on breast cancer incidence and prognosis among African-American women: neighborhood socioeconomic status (nSES), residential segregation, spatial access to mammography, and residential pollution. The authors found that nSES, residential segregation and access to mammography were all related to stage at diagnosis, and nSES and living in more segregated areas were both associated with mortality. Residential pollution was not associated with increased risk of breast cancer in the studies reviewed.

Industrial Air Emissions and Breast Cancer Incidence in a United States-wide Prospective Cohort.

Ish et al,

2025

Epidemiol

A prospective study of 46,150 Sister Study participants followed for a median 13.4 years (4,155 breast cancer cases) used EPA Toxics Release Inventory data to quantify residential air emissions of 28 industrial compounds—many carcinogenic or endocrine-disrupting—during the 10 years before enrollment (2003-2006). Emissions within 3 km of residences showed non-significant associations with breast cancer for nickel compounds (HR = 1.3; 95% CI: 1.0-1.6 for highest vs. no exposure) and trichloroethylene (HR = 1.3; 95% CI: 1.0-1.6), while exposure continuum mapping identified 25 mixture profiles explaining 72% of emissions variance, with the joint-exposure response function suggesting higher breast cancer incidence among individuals with rare, high-emission profiles, though the overall mixture trend was not statistically significant (p = 0.09). These findings indicate that residential proximity to industrial air emissions of certain carcinogens—particularly nickel compounds and trichloroethylene—may be associated with increased breast cancer risk, though the lack of overall mixture association may reflect that individual compounds or specific emission sources are more important than cumulative exposure profiles, or that most participants experienced relatively low emissions with elevated risks concentrated among small subgroups with high exposure to specific pollutants.

Heavy-metal associated breast cancer and colorectal cancer hot spots and their demographic and socioeconomic characteristics.

Tomlinson et al,

2024

Cancer Causes Control

A population-based study using Kentucky cancer registry data (77,637 breast cancer and 56,598 colorectal cancer cases) found that higher ambient air concentrations of carcinogenic metals—cadmium, arsenic, nickel, and chromium(VI)—were associated with increased odds of residing in breast and colorectal cancer hotspots, independent of individual risk factors including age, race, smoking, and neighborhood socioeconomic characteristics. Cancer hotspot populations were disproportionately Black and exhibited markers of lower socioeconomic status, and importantly, the metal-cancer associations persisted even after adjusting for these factors, suggesting environmental metal exposure is an independent contributor to geographic cancer clustering. These findings provide evidence that historically marginalized communities face disproportionate exposure to carcinogenic metals through environmental pollution, likely contributing to cancer disparities, and underscore the urgent need for environmental justice interventions including stricter air quality regulations, cleanup of contaminated sites, and individual-level exposure assessments to fully understand how metal exposures drive cancer inequities in vulnerable populations.

Ethylene oxide emissions and incident breast cancer and non-Hodgkin lymphoma in a US cohort.

Jones et al,

2023

J Natl Cancer Inst

A large cohort study of 451,945 National Institutes of Health-AARP Diet and Health Study participants used EPA Toxics Release Inventory data to estimate historical environmental ethylene oxide (EtO) exposures based on proximity to EtO-emitting facilities, wind patterns, and emission levels from enrollment in 1995-1996. Among 173,670 postmenopausal women, living within 10 km of EtO facilities was associated with statistically significant breast cancer risk for invasive disease (HR = 1.03; 95% CI: 0.97-1.09); women in the highest quartile of the airborne emissions index showed elevated risk of in situ breast cancer at 10 km (HR = 1.25; 95% CI: 1.02-1.53), with no clear patterns for non-Hodgkin lymphoma risk. These findings reveal a novel potential association between environmental EtO exposure and in situ breast cancer—but not invasive breast cancer or lymphohematopoietic cancers—contrasting with occupational studies that found associations with invasive disease. The differential association with in situ versus invasive disease suggests EtO may influence early-stage breast carcinogenesis, though the mechanism remains unclear and warrants further investigation to understand why environmental exposures show different patterns than occupational exposures and why the effect appears limited to pre-invasive lesions.

Air pollution with NO(2), PM(2.5), and elemental carbon in relation to risk of breast cancer- a nationwide case-control study from Denmark.

Poulsen et al,

2023

Environ Res

A nationwide Danish study of 55,745 breast cancer cases matched with controls found that each 10 μg/m³ increase in fine particulate matter (PM₂.₅) air pollution exposure over 20 years was associated with a 21% increased breast cancer risk, with the association particularly strong (32% increased risk) among women diagnosed before age 55. While elemental carbon and nitrogen dioxide also showed modest associations initially, these disappeared in multi-pollutant models, suggesting PM₂.₅ is the primary air pollutant linked to breast cancer risk. These findings add breast cancer to the growing list of cancers associated with air pollution exposure and suggest that younger women may be especially vulnerable, though the authors caution that unmeasured confounding factors may influence the results.

Mosquito control exposures and breast cancer risk: analysis of 1071 cases and 2096 controls from the Ghana Breast Health Study.

Olivos et al,

2023

Breast Cancer Res

A study of over 3,000 Ghanaian women found that using insect repellent room sprays was associated with a 42% increased breast cancer risk compared to women who didn’t use any mosquito control products, while widely-used mosquito coils and insecticide-treated bed nets showed no significant association with breast cancer. The lack of association with bed nets and coils is reassuring given their critical importance for preventing malaria in regions where mosquito-borne diseases are a major health threat, but the findings regarding repellent sprays—used by about half of participants—require further investigation to understand which chemical ingredients may be driving the increased risk. The study had limited ability to assess repellent skin creams due to low usage, and researchers could not determine whether more frequent spray use increased risk, highlighting the need for additional research on insecticide exposures and breast cancer in low- and middle-income countries where these products are essential for disease prevention.

Redlining-associated methylation in breast tumors: the impact of contemporary structural racism on the tumor epigenome.

Miller-Kleinhenz et al,

2023

Front Oncol

A study of 80 Black and White women with breast cancer at Emory University Hospitals (2008-2017) examined associations between contemporary neighborhood redlining—a structural racism measure derived from Home Mortgage Disclosure Act data—and DNA methylation patterns in breast tumor tissue. Contemporary redlining was significantly associated with aberrant methylation at 5 CpG sites (FDR<0.10) in genes implicated in breast carcinogenesis, inflammation, immune function, and stress response (ANGPT1, PRG4), with additional top sites showing interaction by ER status and association with mortality; redlining was also associated with epigenetic age acceleration (β=5.35; 95% CI: 0.30-10.4 by Hannum metric). These novel findings suggest that structural racism—manifested through discriminatory housing policies leading to inequitable social and environmental exposures—may biologically embed in the breast tumor epigenome through altered DNA methylation patterns, potentially contributing to documented racial disparities in breast cancer outcomes and highlighting the need for further research on epigenetic mechanisms linking neighborhood-level structural racism to cancer prognosis.

The impact of social and environmental factors on cancer biology in Black Americans.

Lord et al,

2023

Cancer Causes Control

A review examining how low socioeconomic status (SES) contributes to early chronic disease onset and reduced life expectancy found that neighborhood-level factors—including environmental pollutants, deprivation, social isolation, structural racism, and discrimination—create chronic life stress that affects molecular processes like DNA methylation, inflammation, and immune response, contributing to more aggressive tumor biology, particularly in Black Americans. Despite decades of research showing associations between neighborhood factors and cancer outcomes in marginalized communities, the biological mechanisms linking SES to cancer disparities remain poorly understood, though emerging evidence suggests chronic stress pathways may play a central role. The authors summarize current methods for measuring neighborhood-level deprivation, discrimination, and structural racism in cancer disparities research and recommend adopting a multi-faceted intersectional approach to reduce cancer health inequities and develop effective interventions promoting health equity.

Drinking water contamination from perfluoroalkyl substances (PFAS): an ecological mortality study in the Veneto Region, Italy.

Mastrantonio et al,

2018

Eur J Public Health

A 34-year study in Italy’s Veneto Region, where drinking water was contaminated with PFAS chemicals from a manufacturing plant operating since 1964, found significantly higher mortality rates in contaminated communities compared to uncontaminated areas for multiple diseases including diabetes, heart disease, stroke, Alzheimer’s, and breast cancer in women. Women in PFAS-contaminated areas showed elevated mortality from kidney cancer, breast cancer, and Parkinson’s disease, while both men and women had increased deaths from cardiovascular and metabolic diseases. These population-level findings suggest PFAS exposure—from widespread “forever chemicals” used in nonstick cookware, food packaging, stain-resistant fabrics, and firefighting foam—may increase risks for multiple serious diseases including breast cancer, though individual-level studies are needed to confirm causal relationships and understand the mechanisms behind these health impacts.

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