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Studies Look Beyond Genes for Breast Cancer Risk Factors

While significant gains have been made in detecting and treating breast cancer and the death rate is on the decline in the US, scientific research has not yet found the major causes of the disease. Now, well-designed population studies will search for answers in women's environments and lifestyles.

Researchers will look beyond the genes known to cause a small sliver of breast cancer cases to factors such as nutrition, exercise, chemical exposures, as well as home and work environments.

The National Institutes of Health (NIH) recently announced funding of four new Breast Cancer and the Environment Research Centers to study environmental factors throughout a woman's life that might increase her risk of developing the disease.

"Although diagnosis and treatment are improving, breast cancer is the leading cancer in women," NIH director Elias A. Zerhouni, MD, said. "To improve this picture, we need to better understand the elusive environmental piece of the breast cancer puzzle. If we can understand the early events that can set the stage for breast cancer, we can do more to prevent this disease."

In one collaborative project, the centers will use animals to study the development of mammary tissue and the effects of specific environmental agents. Another project will enroll young girls of different ethnic groups and study their life exposures to a wide variety of environmental, nutritional, and social factors that impact puberty. Early puberty has been shown to increase breast cancer risk later in life.

The four centers are the University of Cincinnati; Fox Chase Cancer Center in Philadelphia; the University of California, San Francisco; and Michigan State University in East Lansing. The centers will receive funding from the National Institute of Environmental Health Sciences (NIEHS) and the National Cancer Institute, both agencies of the NIH, amounting to $5 million a year over seven years.

In addition, the centers will work with advocacy groups, including the American Cancer Society, who will play a part in outreach activities to translate the results of the research into improved understanding, diagnosis, and prevention of breast cancer.

The National Institute of Environmental Health Sciences is also currently recruiting the sisters of women who have had breast cancer to study hereditary and environmental risk factors for the development of the disease.

The Sister Study is the first long-term study of its kind. It will enroll 50,000 US women from diverse racial, ethnic, and socioeconomic backgrounds, all of whom have a sister who has or had breast cancer.

Sisters of women with breast cancer, on average, have a higher risk of developing the disease than women who don't have a sister or mother with breast cancer.

The significance of studying sisters lies in the fact that, beyond sharing genes, sisters are also more likely to have been exposed to the same environments early in life and often have similar lifestyles as adults, which provide investigators opportunities to study the factors that can lead to breast cancer.

Studying the impact of the environment on breast cancer has been challenging. Generally, researchers have not had much information about which potentially harmful exposures may lead to breast cancer. The Sister Study hopes to change that by collecting detailed exposure information from women who have not developed the disease. The researchers will measure chemical levels in blood, urine and toenail samples, and even in samples of household dust.

The study will collect data annually from women over a 14-year period, and is currently enrolling women in the US between the ages of 35 and 74 with a full or half-sister who has or had breast cancer. The study only seeks women who have not had breast cancer.