Aničić Radomir, Zeković Milica, Kocić Milan, Gluvić Zoran, Manojlović Dragan, Ščančar Janez, Stojsavljević Aleksandar
Clinic for Gynecology and Obstetrics "Narodni front", Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Group for Nutrition and Metabolism, Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia.
Ecotoxicol Environ Saf. 2025 Jun 15;298:118331. doi: 10.1016/j.ecoenv.2025.118331. Epub 2025 May 14.
Breast cancer (BC) is a multifactorial disease with unresolved etiology. Environmental pollutants, primarily trace metals, play a pivotal role in the pathophysiological cascade of malignant tumors, including BC. In this up-to-date review, we comprehensively and critically examined the relationship between cadmium (Cd) and BC. For this purpose, peer-reviewed studies from relevant databases (PubMed, SCOPUS, and Cochrane Library) over the last 40 years were retrieved and analyzed. We found that in vitro and in vivo studies strongly support the view that Cd has harmful effects on breast health. According to the human studies, we found that Cd could be responsible for the development and progression of malignant breast tumors due to markedly higher levels in clinical matrices of cases (whole blood, urine, breast tissue, keratin materials) than in clinical matrices of controls. Cadmium does not appear to affect BC density. In contrast, Cd has been found to have a detrimental effect on sex hormones, disrupting the balance of estrogen and androgen. We found that studies looking at dietary Cd intake and BC risk generally (without measuring urine or blood Cd) do not support the association between dietary Cd intake and BC risk. In notable contrast, studies looking at dietary Cd intake and BC risk by measuring Cd in urine or blood generally support this association. The effect of airborne Cd on BC risk was weak, but in favor of specific histological forms, primarily ER-/PR- invasive tubular breast carcinomas. Regardless of the intake route of Cd into the body, it can be concluded that Cd has a harmful effect on breast health. However, well-designed longitudinal, mechanistic, meta-analytic, and other studies are urgently needed to confirm the exact role of environmental Cd in breast carcinogenesis.
乳腺癌（BC）是一种病因尚未明确的多因素疾病。环境污染物，主要是微量金属，在包括乳腺癌在内的恶性肿瘤的病理生理级联反应中起关键作用。在这篇最新综述中，我们全面且批判性地研究了镉（Cd）与乳腺癌之间的关系。为此，我们检索并分析了过去40年相关数据库（PubMed、SCOPUS和Cochrane图书馆）中经过同行评审的研究。我们发现，体外和体内研究有力地支持了镉对乳腺健康有害的观点。根据人体研究，我们发现，由于病例（全血、尿液、乳腺组织、角蛋白材料）临床样本中的镉水平明显高于对照组临床样本，镉可能与恶性乳腺肿瘤的发生和发展有关。镉似乎不影响乳腺癌密度。相反，已发现镉对性激素有有害影响，会破坏雌激素和雄激素的平衡。我们发现，一般研究膳食镉摄入量与乳腺癌风险（未测量尿液或血液中的镉）并不支持膳食镉摄入量与乳腺癌风险之间的关联。显著不同的是，通过测量尿液或血液中的镉来研究膳食镉摄入量与乳腺癌风险的研究通常支持这种关联。空气中镉对乳腺癌风险的影响较弱，但有利于特定的组织学类型，主要是雌激素受体/孕激素受体阴性的浸润性管状乳腺癌。无论镉进入人体的途径如何，可以得出结论，镉对乳腺健康有有害影响。然而，迫切需要精心设计的纵向、机制性、荟萃分析及其他研究来证实环境镉在乳腺癌发生中的确切作用。
