Child Health and Development Studies, Public Health Institute, Berkeley, CA 94709, USA.
Herbert Irving Comprehensive Cancer Center and Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
Int J Environ Res Public Health. 2019 Nov 27;16(23):4731. doi: 10.3390/ijerph16234731.
State legislation in many U.S. states, including California, mandates informing women if they have dense breasts on screening mammography, meaning over half of their breast tissue is comprised of non-adipose tissue. Breast density is important to interpret screening sensitivity and is an established breast cancer risk factor. Environmental chemical exposures may play an important role in this, especially during key windows of susceptibility for breast development: in utero, during puberty, pregnancy, lactation, and the peri-menopause. There is a paucity of research, however, examining whether environmental chemical exposures are associated with mammographic breast density, and even less is known about environmental exposures during windows of susceptibility. Now, with clinical breast density scoring being reported routinely for mammograms, it is possible to find out, especially in California, where there are large study populations that can link environmental exposures during windows of susceptibility to breast density. Density scores are now available throughout the state through electronic medical records. We can link these with environmental chemical exposures via state-wide monitoring. Studying the effects of environmental exposure on breast density may provide valuable monitoring and etiologic data to inform strategies to reduce breast cancer risk.
美国许多州的州立法，包括加利福尼亚州，要求在筛查乳房 X 光检查时告知女性她们是否有致密的乳房，这意味着她们一半以上的乳房组织由非脂肪组织组成。乳房密度对于解释筛查的敏感性很重要，并且是已确立的乳腺癌危险因素。环境化学暴露可能在此中起重要作用，尤其是在乳房发育的关键易感期：子宫内、青春期、怀孕、哺乳期和围绝经期。然而，关于环境化学暴露是否与乳房 X 光检查中的乳房密度有关的研究很少，而关于易感期的环境暴露的知识就更少了。现在，由于常规报告临床乳房密度评分用于乳房 X 光检查，因此可以发现，特别是在加利福尼亚州，那里有大量的研究人群可以将易感期的环境暴露与乳房密度联系起来。通过电子病历，全州范围内都可以获得密度评分。我们可以通过全州范围的监测来将这些与环境化学暴露联系起来。研究环境暴露对乳房密度的影响可能为减少乳腺癌风险的策略提供有价值的监测和病因数据。
