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Risk and Aggressiveness of Breast Cancer in Relation to Plasma Organochlorine Concentrations¹

Unité de Recherche en Santé Publique, Centre de Recherche du Centre Hospitalier de l’Université Laval, Centre Hospitalier Universitaire de Québec, Beauport, Québec, G1E 7G9 Canada [A. D., P. A., S. D., É. D.]; Groupe de Recherche en Épidémiologie et Centre des Maladies du Sein, Pavillon Saint-Sacrement, Centre Hospitalier Affilié Universitaire de Québec, Québec, G1S 4L8 Canada [J. B., J. R.]; Département de Médecine Sociale et Préventive, Faculté de Médecine, Université Laval, Ste-Foy, G1K 7P4 Canada [P. A., J. B., É. D.]; and Unité de Recherche en Endocrinologie de la Reproduction, Centre de Recherche du Pavillon Saint-François-d’Assise, Québec, G1L 3L5 Canada [S. D.]

Several organochlorines identified as "hormone mimics" were proposed as possible risk factors for breast cancer. We conducted a case-control study to assess breast cancer risk and disease aggressiveness in relation to plasma concentrations of several organochlorine compounds.

Plasma lipid concentrations of 11 chlorinated pesticides and 14 polychlorinated biphenyl congeners were measured in 315 women newly diagnosed with breast cancer, 219 hospital-based controls, and 307 population controls from the Quebec City area (Canada). Concentrations of hormonally active organochlorines or their surrogates were compared between cases and controls as well as between groups of cases defined according to tumor size and axillary-lymph-node involvement.

We found similar levels of organochlorines in cases and controls and no relationship between the relative risk of breast cancer and organochlorine exposure. However, the probability of lymph-node invasion among cases increased with exposure to 1,1-dichloro-2,2-bis(4- chlorophenyl)ethylene [p,p'-DDE; odds ratio, 2.54; 95% confidence interval (CI), 1.20–5.35; between the highest and the lowest tertiles]. Furthermore, p,p'-DDE exposure was associated with a dose-related increased relative risk of exhibiting both lymph-node involvement and a large tumor. Indeed odds ratio raised to 2.33 (95% CI, 0.94–5.77) for the second tertile relative to the first tertile and reached 3.51 (95% CI, 1.41–8.73) for the third tertile relative to the first tertile. Similar associations were noted with ß-hexachlorocyclohexane, oxychlordane, and trans-nonachlor.

We conclude that exposure to persistent, hormonally active organochlorines during adulthood is not associated with breast cancer risk. The possibility that some organochlorines and especially p,p'-DDE may increase breast cancer aggressiveness deserves further attention.

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