What is our path to breast cancer prevention?

As part of our Prevention Week 2022, Breast Cancer Prevention Partners (BCPP),  a U.S.-based nonprofit, have written a guest blog for us. They talk about the situation in the U.S. And ask the question, what can we do to stop the increase in breast cancer cases?

We have 3.8 million survivors of breast cancer in the U.S. This year, an estimated 287,500 women and 2710 men will be diagnosed. An estimated 43,000 U.S. women will die of the disease this year. What’s creating these horrifically large numbers of cases and deaths, and what can we do about it?

More than a decade ago, the United States President’s Cancer Panel reported that “the true burden of environmentally induced cancer has been grossly underestimated”. While cancer prevention efforts have focused narrowly on lifestyle behaviours. Such as smoking and exercise, and early detection (i.e. mammograms). The report noted the scientific evidence on environmental exposures that lead to cancer. And the resulting health and social costs “are not adequately integrated into national policy decisions and strategies.”

In short: the appalling rate of one in eight women being diagnosed during their lifetime is not happening solely due to inherited risk. Breast cancer risk arises from complex and interrelated causes. We must go beyond diet, smoking and exercise to address other risk factors we can control.

A neglected part of the prevention spectrum is the policies and practices that allow exposure to hazardous chemicals and radiation. These chemical exposures are not equally distributed. The impact of race, power and inequities result in higher impacts on disadvantaged communities. Both race and ethnicity, along with social and economic status, are related to the risk of being diagnosed with breast cancer and mortality rates in the US.

To effectively tackle breast cancer, we need to address our exposure to toxic chemicals in our indoor and outdoor environments. As well as discriminatory and unjust social conditions. This holds true even for women who carry a higher genetic risk of breast cancer. We can’t change our genes – whereas we can reduce, if not eliminate, toxic chemicals in our environment.

BCPP was founded in 1992 by Andrea Ravinett Martin.  Andrea received 2 breast cancer diagnoses within 18 months. She became very passionate about eliminating the environmental and other preventable causes of the disease.

Now celebrating our 30^th year, we at BCPP base our public education, policy advocacy and corporate campaign work on careful and high-quality scientific research about the links between various chemicals in our environment. Increasingly now, about the impacts of race, ethnicity, and socioeconomic status on the high incidence of breast cancer.

Our scientific understanding of breast cancer and environmental risk factors has grown over the last two decades. We’ve learned that low doses of some chemicals and the timing of exposures to hazardous chemicals and radiation may increase the risk of disease. Those combinations of chemicals (mixtures) affect our bodies that differ from those of single chemicals alone. Different types of breast cancer may be impacted differently by chemical exposures.

What else are risk factors?

We’ve also learned that different racial groups have varying risks for different types of breast cancer. For example, in the U.S., black women are twice as likely as white women to be diagnosed with triple-negative breast cancer, a more aggressive disease subtype. Black women also have the highest mortality rate of any U.S. racial or ethnic group at 31%. At the same time, some communities have disproportionate, more concentrated exposures to harmful chemicals.

Key chemicals of concern for breast cancer risk include bisphenol A, parabens, phthalates and the PFAS forever chemicals. As well as some which may be new to you, such as certain UV (sunscreen) filtering chemicals, ethylene oxide, and more.

Some of these chemicals are direct carcinogens (cancer-causing). And others disrupt our hormone system, often at critical times of our development, such as during pregnancy, which can increase our risk of breast cancer later in life.

It’s important to make informed consumer purchases. But so is your participation in getting policies changed so that everyone is protected. Chemicals can pollute communities where they are manufactured or disposed of. Your participation in policy change can be as simple as writing a letter to a corporate CEO about their products. Or speaking to an elected representative requesting their support for a law to stop a particular use of a harmful chemical when safer alternatives exist.  BCPP facilitates these contacts through Actions on our website and BCUK campaigns on UK policy change here.

We’ve accomplished a lot in our 30 years. But there’s much, much more to do so that far fewer women hear the words “you have breast cancer.” We invite you to get more informed and to join in – here in the U.S. (our corporate campaigns are open to non-US residents), as well as working with BCUK or with other organisations that work to eliminate toxic exposures and end unjust social conditions.

It’s people that make change happen, and you can do as little or as much as you’re able. You’ve already started by reading this far!

References: 

1. https://www.bcpp.org/resource/breast-cancer-statistics/
2. Cover letter to the President, https://deainfo.nci.nih.gov/advisory/pcp/annualreports/pcp08-09rpt/pcp_report_08-09_508.pdf
3. https://deainfo.nci.nih.gov/advisory/pcp/annualreports/pcp08-09rpt/pcp_report_08-09_508.pdf  p. vii
4. For a history of the environmental breast cancer movement (in the US) in the book From Pink to Green: Disease Prevention and the Environmental Breast Cancer Movement
5.  Our recent scientific publications include the 2017 State of the Evidence: An Update on the Connection Between Breast Cancer and the Environment, published in the peer-reviewed scientific journal Environmental Health; Work and Female Breast Cancer: The State of the Evidence, 2002–2017; and the first-ever comprehensive primary prevention plan for breast cancer for the state of California, Paths to Prevention. This action plan to reduce 23 risk factors offers systemic (societal) interventions, rather than individual actions, to stem rising breast cancer rates.

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