Environmental organochlorine exposure as a potential etiologic factor in breast cancer.

Known risk factors for breast cancer do not account for a significant proportion of the overall incidence. Reproductive factors and endogenous hormones are thought to be responsible for a large component of risk. An environmental contribution has been sought in the past to explain the international trends in breast cancer rates and changes in risk among migrating populations. Recently, environmental research has turned to investigation of exogenous chemical exposures, including environmental contamination, as potential risk factors that may arise from the hormonal activity or from the carcinogenicity of many of these chemicals. Several reports since 1991 suggest that organochlorines may be a risk factor for breast cancer. The data are strongest for DDT. For PCBs, the results to date have been equivocal if not entirely negative. However, different groups of polychlorinated biphenyl (PCB) congeners are known to provoke biological responses that are structure specific. A wide divergence of estrogenic response, cytochrome P450 activity, and biological half-life exists within these groups of PCB congeners. Therefore, understanding breast cancer risk from PCB exposure requires attention to congener structures in complex mixtures and to temporal changes in exposure. Investigation of environmental contributions to breast cancer risk offers the potential for understanding more about the etiology of this complex disease and may also provide opportunities for prevention of the most common cancer among women in the United States.