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Exploring the link between breast cancer and environment
Tuesday, October 16, 2001 By Virginia Linn, Post-Gazette Staff Writer
Do you have any history of breast cancer in your family?
This is a common question that health agencies ask to assess a person's risk of developing breast cancer.
But in actuality, fewer than 1 out of 10 people who develop breast cancer are born with a defect in the genes.
"That surprises most people," said Devra Lee Davis, a leading environmental epidemiologist who is a visiting professor at the Heinz School of Public Policy and Management at Carnegie Mellon University.
"This means that most people are born with healthy genes. Something happens to them in their lifetime. There are some known factors, whether you have children and how many you have. But even those risk factors do not explain more than half of the cases," she said.
Davis will be one of the presenters exploring this issue Thursday night at the public lecture, "Unearthing the Link: Between the Environment and Breast Cancer," in the Eddy Theatre at Chatham College.
She will be joined by Dr. Susan J. Blumenthal, U.S. assistant surgeon general, rear admiral and senior science advisor in the Department of Health and Human Services.
In the 1940s, 1 in 20 people were diagnosed with breast cancer. Today 1 in 8 people are diagnosed.
"In part we live longer," Blumenthal said in phone interview from her Washington office last week. "But epidemiologists believe there is something else going on. A search is under way for a better understanding."
Strides are being made, and breast cancer death rates have dropped 14 percent over the past six years, she said. But it still is diagnosed in 182,000 women and 1,500 men a year.
Blumenthal's mother died of breast cancer shortly after her daughter became a doctor, which spurred her interest in women's health issues.
In 1994, the Palo Alto, Calif. native was appointed as the country's first Deputy Assistant Secretary for Women's Health, where she worked to ensure national health and research programs targeted to women.
Blumenthal's work led to the establishment of National Centers of Excellence on Women's Health at 18 academic centers, including one at Magee-Womens Hospital.
She also initiated a collaboration with the CIA, NASA and Department of Defense called "From Missiles to Mammograms" that transferred imaging technology used for military and space purposes to improve the early detection of breast cancer.
Davis, who grew up in Donora, also had her life touched by cancer. Her father, a machinist and mill worker, developed bone cancer and later died of multiple myeloma, a blood cancer. While she can't say definitively that environmental factors led to his disease, he was exposed to toxic chemicals.
She's now into her second year as visiting professor at the Heinz School and has examined environmental trends on health for the World Resources Institute.
Because it still is not known why most breast cancer cases develop, much more research must be done on prevention and lifestyle, she said. There also needs to be a better understanding of the role of hormones on the body -- including naturally occurring estrogen, synthetic estrogens in hormone replacement therapy or birth control pills, and xenohormones, which can be found in weed killers, pesticides, polychlorinated biphenyls and plastics.
"We have been so focused on research priorities on treatment, we have missed an important number of opportunities for prevention," Davis said.
She's cautions against the long-term use of HRT. Many of the women who first tried HRT years ago were health conscious and tended to exercise and eat wisely, so the pills appeared to benefit them, she said. But Davis said the results of more recent studies have shown a rise in breast cancer risk.
She believes using HRT for "short periods of time" is OK if severe menopause symptoms cannot be relieved in other ways.
"What I'm concerned about is long-term use," she said. "Menopause is not a disease. It's not a form of illness to grow old. We have to change our mindset."
Eating vegetables, fruit and calcium, reducing fat intake, getting moderate exercise and limiting alcohol consumption can go a long way in reducing breast cancer risk, she said.
"We can't give you a cookbook that if you follow this, you can't get breast cancer," she said. "But we can tell you how you can reduce the risk."
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