American Journal of Epidemiology Vol. 152, No. 4 : 363-370
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Breast Cancer, Lactation History, and Serum Organochlorines
1 Pan American Health Organization, Mexico, Mexico.
2 Instituto Nacional de Salud Publica, Cuernavaca, Mexico.
3 Centre de Toxicologie du Quebec, Quebec, Canada.
4 Centre de Sante Publique de Quebec, Service Sante et Environnement, Quebec, Canada.
The authors analyzed the relation between lactation history, organochlorine serum levels–in particular, 2,2-bis(p-chlorophenyl)-1,1,1-trichloroethane (DDT) and 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDE)–and the risk of breast cancer within a subsample from a larger breast cancer case-control study conducted among women living in Mexico City, Mexico, between 1990 and 1995. From the original study, they selected a random sample of 260 subjects (1:1 case/control ratio). Analysis was restricted to 120 cases and 126 controls who had given birth to at least one child and had complete information on all key variables. Serum DDE levels were higher among cases (mean = 3.84 µg/g lipids, standard deviation = 5.98) than among controls (mean = 2.51 µg/g lipids, standard deviation = 1.97). After adjustment for age, age at menarche, duration of lactation, Quetelet index, and serum DDT levels, serum DDE levels were positively related to the risk of breast cancer (adjusted odds ratio (OR)Q1-Q2 = 1.24, 95% confidence interval (CI): 0.50, 3.06; ORQ1-Q3 = 2.31, 95% CI: 0.92, 5.86; ORQ1-Q4 = 3.81, 95% CI: 1.14, 12.80; test of trend, p = 0.02). The increased risk associated with higher serum DDE levels was more apparent among postmenopausal women (ORQ1-Q4 = 5.26, 95% CI: 0.80, 34.30; test of trend p = 0.03). A longer period of lactation was associated with a slightly decreased risk of breast cancer independently of serum DDE levels (OR = 0.91, 95% CI: 0.85, 0.99 change in risk per 10 months of lactation). Serum DDT level was not related to the risk of breast cancer. The data suggest that high levels of exposure to DDE may increase women's risk of breast cancer, particularly among postmenopausal women. Am J Epidemiol 2000;152:363–70.
breast neoplasms; DDE; lactation; polychlorinated biphenyls
Abbreviations: CI, confidence interval; DDE, 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene; DDT, 2,2-bis(p-chlorophenyl)-1,1,1-trichloroethane; FC, free cholesterol; PCB, polychlorinated biphenyl; SD, standard deviation
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