Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, 27709-2233, USA.
Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, USA.
Breast Cancer Res. 2019 Feb 13;21(1):24. doi: 10.1186/s13058-019-1110-7.
Breast density is strongly related to breast cancer. Identifying associations between environmental exposures and density may elucidate relationships with breast cancer. Metals and polycyclic aromatic hydrocarbons (PAHs) may influence breast density via oxidative stress or endocrine disruption.
Study participants (n = 222,581) underwent a screening mammogram in 2011 at a radiology facility in the Breast Cancer Surveillance Consortium. Zip code residential levels of airborne PAHs and metals (arsenic, cadmium, chromium, cobalt, lead, manganese, mercury, nickel, and selenium) were assessed using the 2011 EPA National Air Toxics Assessment. Breast density was measured using the Breast Imaging-Reporting and Data System (BI-RADS) lexicon. Logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CI) for the individual air toxics and dense breasts (BI-RADS 3 or 4). Weighted quantile sum (WQS) regression was used to model the association between the air toxic mixture and density.
Higher residential levels of arsenic, cobalt, lead, manganese, nickel, or PAHs were individually associated with breast density. Comparing the highest to the lowest quartile, higher odds of having dense breasts were observed for cobalt (OR = 1.60, 95% CI 1.56-1.64) and lead (OR = 1.56, 95% CI 1.52-1.64). Associations were stronger for premenopausal women. The WQS index was associated with density overall (OR = 1.22, 95% CI 1.20-1.24); the most heavily weighted air toxics were lead and cobalt.
In this first study to evaluate the association between air toxics and breast density, women living in areas with higher concentrations of lead and cobalt were more likely to have dense breasts.
乳腺密度与乳腺癌密切相关。确定环境暴露与密度之间的关联可能有助于阐明与乳腺癌的关系。金属和多环芳烃（PAHs）可能通过氧化应激或内分泌干扰影响乳腺密度。
研究参与者（n=222581）于 2011 年在乳腺癌监测联盟的放射学机构进行了乳房 X 光筛查。使用 2011 年 EPA 国家空气毒物评估评估了空气中 PAHs 和金属（砷、镉、铬、钴、铅、锰、汞、镍和硒）的邮政编码居住水平。使用乳房成像报告和数据系统（BI-RADS）词汇表测量乳腺密度。使用逻辑回归估计个别空气毒物和致密乳房（BI-RADS 3 或 4）的调整比值比（OR）和 95%置信区间（CI）。加权分位数总和（WQS）回归用于对空气毒物混合物与密度之间的关联进行建模。
较高的住宅砷、钴、铅、锰、镍或 PAHs 水平与乳腺密度单独相关。与最低四分位数相比，较高的致密乳房的可能性更高钴（OR=1.60，95%CI 1.56-1.64）和铅（OR=1.56，95%CI 1.52-1.64）。在绝经前妇女中，关联更强。WQS 指数与密度总体相关（OR=1.22，95%CI 1.20-1.24）；权重最大的空气毒物是铅和钴。
在这项评估空气毒物与乳腺密度之间关联的第一项研究中，生活在铅和钴浓度较高地区的女性更有可能拥有致密的乳房。
