Wolff M S, Collman G W, Barrett J C, Huff J
Mount Sinai School of Medicine, New York, New York 10029, USA.
Annu Rev Pharmacol Toxicol. 1996;36:573-96. doi: 10.1146/annurev.pa.36.040196.003041.
Breast cancer has long been associated with reproductive hormone exposures. Recently, greater attention has been focused on environmental exposures that may be responsible for some proportion of breast cancer incidence. Several etiologic aspects are discussed. A number of chemicals induce breast cancer in rodents--including solvents, pesticides, and polycyclic aromatic hydrocarbons--and these might serve as leads for studies in humans. In women, strong links have been established between breast cancer risk and ionizing radiation. Evidence for nonionizing radiation (electromagnetic field) exposures and breast cancer is suggestive, albeit limited. Occupational exposures have not been identified as breast cancer risks, but several associations need further study, including solvents and pesticides. Time of life when exposures take place is important, and this claim is strongly supported by data on cigarette smoking and radiation. Also, basic research has demonstrated that mammary tissue is more susceptible to carcinogenesis at certain periods of breast development. Likewise, prenatal, neonatal, and adolescent exposures deserve continuing attention. Research on etiology of breast cancer should measure environmental exposures and take into account the time of life at which these occur. Complex interactions between exogenous and endogenous carcinogenic agents need further focus, as modulated by varying genetically determined individual susceptibilities.
长期以来,乳腺癌一直与生殖激素暴露有关。最近,人们更加关注可能导致一定比例乳腺癌发病率的环境暴露。本文讨论了几个病因学方面。一些化学物质可在啮齿动物中诱发乳腺癌,包括溶剂、杀虫剂和多环芳烃,这些可能为人类研究提供线索。在女性中,乳腺癌风险与电离辐射之间已建立了紧密联系。非电离辐射(电磁场)暴露与乳腺癌的证据虽有提示作用,但较为有限。职业暴露尚未被确定为乳腺癌风险因素,但包括溶剂和杀虫剂在内的一些关联需要进一步研究。暴露发生的生命时期很重要,吸烟和辐射的数据有力地支持了这一观点。此外,基础研究表明,乳腺组织在乳腺发育的某些时期更容易发生癌变。同样,产前、新生儿期和青春期的暴露值得持续关注。乳腺癌病因学研究应测量环境暴露,并考虑这些暴露发生的生命时期。外源性和内源性致癌因素之间的复杂相互作用需要进一步关注,因为它们会受到不同基因决定的个体易感性的调节。