Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Breast Cancer Research
Published in: Breast Cancer Research 1/2015

Open Access 01-12-2015 | Research article

Estimated dietary dioxin exposure and breast cancer risk among women from the French E3N prospective cohort

Authors: Aurélie MN Danjou, Béatrice Fervers, Marie-Christine Boutron-Ruault, Thierry Philip, Françoise Clavel-Chapelon, Laure Dossus

Published in: Breast Cancer Research | Issue 1/2015

Login to get access

Abstract

Introduction

Dioxins are environmental and persistent pollutants mostly emitted from combustion facilities (e.g. waste incinerators, metal and cement industries). Known to be endocrine disrupting chemicals, dioxins are suspected to increase breast cancer (BC) risk. Although diet is considered the primary source of dioxin exposure, no previous study has been published on dietary dioxin exposure in relation to BC risk. We aimed to assess dietary dioxin exposure among women from the E3N cohort and estimate BC risk associated with this exposure.

Methods

The study included 63,830 women from the E3N cohort who completed a diet history questionnaire (DHQ) in 1993 and were followed until 2008. Dietary dioxin exposure was estimated by combining consumption data from the E3N DHQ and food dioxin contamination data from a French national monitoring program. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated by Cox models adjusted for BC risk factors.

Results

Mean dietary dioxin exposure was estimated at 1.3 ± 0.4 pg/kg body weight (BW)/day. A 0.4 pg/kg BW/d increase in dioxin intake was not associated with overall BC risk (HR = 1.00; 95% CI: 0.96, 1.05). A significant decrease in risk of estrogen receptor negative (ER-)/progesterone receptor negative (PR-) tumors was observed among post-menopausal women in the upper quartile of estimated dioxin intake (HR for Q4 vs. Q1: 0.65; 95% CI: 0.45, 0.96; P for trend across quartiles = 0.0463).

Conclusions

Overall, no association between estimated dietary dioxin exposure and BC risk was found among E3N women. Further studies should include both dietary and environmental exposures to determine whether low-dose dioxin exposure is associated with BC risk.
Appendix
Available only for authorised users
Literature
1.
Fries GF. A review of the significance of animal food products as potential pathways of human exposures to dioxins. J Anim Sci. 1995;73:1639–50.CrossRefPubMed
2.
Kogevinas M. Human health effects of dioxins: cancer, reproductive and endocrine system effects. Hum Reprod Update. 2001;7:331–9.CrossRefPubMed
3.
Liem AK, Furst P, Rappe C. Exposure of populations to dioxins and related compounds. Food Addit Contam. 2000;17:241–59.CrossRefPubMed
4.
Schug TT, Janesick A, Blumberg B, Heindel JJ. Endocrine disrupting chemicals and disease susceptibility. J Steroid Biochem Mol Biol. 2011;127:204–15.CrossRefPubMedPubMedCentral
5.
Baan R, Grosse Y, Straif K, Secretan B, El GF, Bouvard V, et al. A review of human carcinogens–Part F: chemical agents and related occupations. Lancet Oncol. 2009;10:1143–4.CrossRefPubMed
6.
U.S. EPA. Exposure and Human Health Reassessment of 2,3,7,8-Tetrachlorodibenzo-P-dioxin (TCDD) and Related Compounds National Academy Sciences (External Review Draft). Washington, D.C: U.S. Environmental Protection Agency; 2004. EPA/600P-00/001Cb.
7.
Bertazzi A, Pesatori AC, Consonni D, Tironi A, Landi MT, Zocchetti C. Cancer incidence in a population accidentally exposed to 2,3,7,8-tetrachlorodibenzo-para-dioxin. Epidemiology. 1993;4:398–406.CrossRefPubMed
8.
Pesatori AC, Consonni D, Rubagotti M, Grillo P, Bertazzi PA. Cancer incidence in the population exposed to dioxin after the “Seveso accident”: twenty years of follow-up. Environ Health. 2009;8:39.CrossRefPubMedPubMedCentral
9.
Warner M, Eskenazi B, Mocarelli P, Gerthoux PM, Samuels S, Needham L, et al. Serum dioxin concentrations and breast cancer risk in the Seveso Women's Health Study. Environ Health Perspect. 2002;110:625–8.CrossRefPubMedPubMedCentral
10.
Warner M, Mocarelli P, Samuels S, Needham L, Brambilla P, Eskenazi B. Dioxin exposure and cancer risk in the Seveso Women's Health Study. Environ Health Perspect. 2011;119:1700–5.CrossRefPubMedPubMedCentral
11.
Brody JG, Moysich KB, Humblet O, Attfield KR, Beehler GP, Rudel RA. Environmental pollutants and breast cancer: epidemiologic studies. Cancer. 2007;109:2667–711.CrossRefPubMed
12.
Manuwald U, Velasco GM, Berger J, Manz A, Baur X. Mortality study of chemical workers exposed to dioxins: follow-up 23 years after chemical plant closure. Occup Environ Med. 2012;69:636–42.CrossRefPubMed
13.
Revich B, Aksel E, Ushakova T, Ivanova I, Zhuchenko N, Klyuev N, et al. Dioxin exposure and public health in Chapaevsk. Russia Chemosphere. 2001;43:951–66.CrossRefPubMed
14.
Fabre P, Daniau C, Goria S, de Crouy-Chanel P, Empereur-Bissonnet P. Etude d'incidence des cancers à proximité des usines d'incinération d'ordures ménagères [in French]. In: Rapport d'étude et synthèse. Saint-Maurice: Institut de veille sanitaire; 2008. p. 136.
15.
Viel JF, Clement MC, Hagi M, Grandjean S, Challier B, Danzon A. Dioxin emissions from a municipal solid waste incinerator and risk of invasive breast cancer: a population-based case–control study with GIS-derived exposure. Int J Health Geogr. 2008;7:4.CrossRefPubMedPubMedCentral
16.
Clavel-Chapelon F, van Liere MJ, Giubout C, Niravong MY, Goulard H, Le CC, et al. E3N, a French cohort study on cancer risk factors. E3N Group. Etude Epidémiologique auprès de femmes de l'Education Nationale. Eur J Cancer Prev. 1997;6:473–8.CrossRefPubMed
17.
18.
van Liere MJ, Lucas F, Clavel F, Slimani N, Villeminot S. Relative validity and reproducibility of a French dietary history questionnaire. Int J Epidemiol. 1997;26:S128–36.CrossRefPubMed
19.
Lucas F, Niravong M, Villeminot S, Kaaks R, Clavel-Chapelon F. Estimation of food portion size using photographs: validity, strengths, weaknesses and recommendations. J Hum Nutr Diet. 1995;8:65–74.CrossRef
20.
Favier J, Ireland-Ripert J, Toque C, Feinberg M. Répertoire général des aliments: Table de composition. Composition tables. CIQUAL-REGAL. Paris, France: INRA Editions; 1995. French.
21.
CSHPF. Dioxines: données de contamination et d'exposition de la population française. France: Agence française de sécurité sanitaire des aliments (Afssa); 2000. French
22.
FAO/WHO. Dietary exposure assessment of chemicals in food. Report of a joint FAO/WHO consultation. World Health Organization and the Food Agriculture Organization of the United Nations: Annapolis, MA; 2005
23.
NATO. Scientific basis for the development of the international toxicity equivalency factor (i-tef) method of risk assessment for complex mixtures of dioxins and related compounds. comittee on the challenges of modern society. 178. Washington, D.C: U.S. Environmental Protection Agency; 1988.
24.
JEFCA. Joint FAO/WHO Expert Committee on Food Additives, fifty-seventh meeting. summary and conclusions. World Health Organization and the Food Agriculture Organization of the United Nations: Rome; 2001.
25.
van Leeuwen FX, Feeley M, Schrenk D, Larsen JC, Farland W, Younes M. Dioxins: WHO's tolerable daily intake (TDI) revisited. Chemosphere. 2000;40:1095–101.CrossRefPubMed
26.
Tehard B, Lahmann PH, Riboli E, Clavel-Chapelon F. Anthropometry, breast cancer and menopausal status: use of repeated measurements over 10 years of follow-up-results of the French E3N women's cohort study. Int J Cancer. 2004;111:264–9.CrossRefPubMed
27.
Cottet V, Touvier M, Fournier A, Touillaud MS, Lafay L, Clavel-Chapelon F, et al. Postmenopausal breast cancer risk and dietary patterns in the E3N-EPIC prospective cohort study. Am J Epidemiol. 2009;170:1257–67.CrossRefPubMed
28.
Schecter A, Ryan JJ, Papke O. Decrease in levels and body burden of dioxins, dibenzofurans, PCBS, DDE, and HCB in blood and milk in a mother nursing twins over a thirty-eight month period. Chemosphere. 1998;37:1807–16.CrossRefPubMed
29.
Uemura H, Arisawa K, Hiyoshi M, Satoh H, Sumiyoshi Y, Morinaga K, et al. PCDDs/PCDFs and dioxin-like PCBs: recent body burden levels and their determinants among general inhabitants in Japan. Chemosphere. 2008;73:30–7.CrossRefPubMed
30.
Arisawa K, Uemura H, Hiyoshi M, Kitayama A, Takami H, Sawachika F, et al. Dietary patterns and blood levels of PCDDs, PCDFs, and dioxin-like PCBs in 1656 Japanese individuals. Chemosphere. 2011;82:656–62.CrossRefPubMed
31.
Domingo JL, Schuhmacher M, Granero S, Llobet JM. PCDDs and PCDFs in food samples from Catalonia, Spain. An assessment of dietary intake. Chemosphere. 1999;38:3517–28.CrossRefPubMed
32.
Harrison N, Wearne S, Gem MG, Gleadle A, Startin J, Thorpe S, et al. Time trends in human dietary exposure to PCDDs, PCDFs and PCBs in the UK. Chemosphere. 1998;37:1657–70.CrossRefPubMed
33.
Jimenez B, Hernandez LM, Eljarrat E, Rivera J, Gonzalez MJ. Estimated intake of PCDDs, PCDFs and co-planar PCBs in individuals from Madrid (Spain) eating an average diet. Chemosphere. 1996;33:1465–74.CrossRefPubMed
34.
35.
Schecter A, Startin J, Wright C, Kelly M, Papke O, Lis A, et al. Dioxins in U.S. food and estimated daily intake. Chemosphere. 1994;29:2261–5.CrossRefPubMed
36.
Bilau M, Matthys C, Bellemans M, De NM, Willems JL, De HS. Reproducibility and relative validity of a semi-quantitative food frequency questionnaire designed for assessing the intake of dioxin-like contaminants. Environ Res. 2008;108:327–33.CrossRefPubMed
37.
Raaschou-Nielsen O, Pavuk M, Leblanc A, Dumas P, Philippe WJ, Olsen A, et al. Adipose organochlorine concentrations and risk of breast cancer among postmenopausal Danish women. Cancer Epidemiol Biomarkers Prev. 2005;14:67–74.PubMed
38.
Gammon MD, Wolff MS, Neugut AI, Eng SM, Teitelbaum SL, Britton JA, et al. Environmental toxins and breast cancer on Long Island. II. Organochlorine compound levels in blood. Cancer Epidemiol Biomarkers Prev. 2002;11:686–97.PubMed
39.
Wang WL, Porter W, Burghardt R, Safe SH. Mechanism of inhibition of MDA-MB-468 breast cancer cell growth by 2,3,7,8-tetrachlorodibenzo-p-dioxin. Carcinogenesis. 1997;18:925–33.CrossRefPubMed
40.
Zhang S, Lei P, Liu X, Li X, Walker K, Kotha L, et al. The aryl hydrocarbon receptor as a target for estrogen receptor-negative breast cancer chemotherapy. Endocr Relat Cancer. 2009;16:835–44.CrossRefPubMedPubMedCentral
41.
Yoshioka H, Hiromori Y, Aoki A, Kimura T, Fujii-Kuriyama Y, Nagase H, et al. Possible aryl hydrocarbon receptor-independent pathway of 2,3,7,8-tetrachlorodibenzo-p-dioxin-induced antiproliferative response in human breast cancer cells. Toxicol Lett. 2012;211:257–65.CrossRefPubMed
42.
Lew BJ, Collins LL, O'Reilly MA, Lawrence BP. Activation of the aryl hydrocarbon receptor during different critical windows in pregnancy alters mammary epithelial cell proliferation and differentiation. Toxicol Sci. 2009;111:151–62.CrossRefPubMedPubMedCentral
43.
Kociba RJ, Keyes DG, Beyer JE, Carreon RM, Wade CE, Dittenber DA, et al. Results of a two-year chronic toxicity and oncogenicity study of 2,3,7,8-tetrachlorodibenzo-p-dioxin in rats. Toxicol Appl Pharmacol. 1978;46:279–303.CrossRefPubMed
44.
45.
Ashida H, Fukuda I, Yamashita T, Kanazawa K. Flavones and flavonols at dietary levels inhibit a transformation of aryl hydrocarbon receptor induced by dioxin. FEBS Lett. 2000;476:213–7.CrossRefPubMed
46.
Kandaswami C, Lee LT, Lee PP, Hwang JJ, Ke FC, Huang YT, et al. The antitumor activities of flavonoids. In Vivo. 2005;19:895–909.PubMed
47.
Moon YJ, Wang X, Morris ME. Dietary flavonoids: effects on xenobiotic and carcinogen metabolism. Toxicol In Vitro. 2006;20:187–210.CrossRefPubMed
Metadata
Title
Estimated dietary dioxin exposure and breast cancer risk among women from the French E3N prospective cohort
Authors
Aurélie MN Danjou
Béatrice Fervers
Marie-Christine Boutron-Ruault
Thierry Philip
Françoise Clavel-Chapelon
Laure Dossus
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Breast Cancer Research / Issue 1/2015
Electronic ISSN: 1465-542X
DOI
https://doi.org/10.1186/s13058-015-0536-9

Other articles of this Issue 1/2015

Breast Cancer Research 1/2015 Go to the issue

Research article

Combined histone deacetylase inhibition and tamoxifen induces apoptosis in tamoxifen-resistant breast cancer models, by reversing Bcl-2 overexpression

Research article

Mammographic density and breast cancer in women from high risk families

Research article

Long non-coding RNA expression profiles predict metastasis in lymph node-negative breast cancer independently of traditional prognostic markers

Research article

The sialyl-glycolipid stage-specific embryonic antigen 4 marks a subpopulation of chemotherapy-resistant breast cancer cells with mesenchymal features

Erratum

Erratum to: “A novel role for ezrin in breast cancer angio/lymphangiogenesis”

Research article

Anti-HER2 CD4+ T-helper type 1 response is a novel immune correlate to pathologic response following neoadjuvant therapy in HER2-positive breast cancer
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits