title: Organochlorine exposures influence on breast cancer risk and survival according to estrogen receptor status: a Danish cohort-nested case-control study.
abstract: BACKGROUND
  The relationship between breast cancer and organochlorine exposure is controversial and complex. As estrogen receptor positive and negative breast cancer may represent different entities of the disease, this study was undertaken to evaluate organochlorines influence on breast cancer risk and survival according to receptor status.
  
  
  METHODS
  The background material stems from the Copenhagen City Heart Study (Denmark 1976-78). The breast cancer risk was investigated in a cohort nested case-control design including 161 cases and twice as many breast cancer free controls. The cases served as a cohort in the survival analysis. Serum organochlorine concentrations were determined by gaschromotography.
  
  
  RESULTS
  The observed increased breast cancer risk associated with exposure to dieldrin derived from women who developed an estrogen receptor negative (ERN) tumor (Odds ratio [OR] I vs. IV quartile, 7.6, 95% confidence interval [95% CI] 1.4-46.1, p-value for linear trend 0.01). Tumors in women with the highest dieldrin serum level were larger and more often spread at the time of diagnosis than ERP tumors. The risk of dying was for the remaining evaluated compounds higher among patients with ERP breast cancer when compared to those with ERN. In the highest quartile of polychlorinated biphenyls (SigmaPCB) it was more than 2-fold increased (Relative risk [RR] I vs. IV quartile, 2.5, 95% CI 1.1-5.7), but no dose-response relation was apparent.
  
  
  CONCLUSIONS
  The results do not suggest that exposure to potential estrogenic organochlorines leads to development of an ERP breast cancer. A possible adverse effect on prognosis of hormone-responsive breast cancers needs to be clarified.
authors.affiliation: The Copenhagen Center for Prospective Population Studies, Harsdorffsvej 1B, 2tv, DK-1874 Frederiksberg C, Denmark. aph@post8.tele.dk
authors.forename: A P
authors.initials: AP
authors.lastname: Høyer
authors.forename: T
authors.initials: T
authors.lastname: Jørgensen
authors.forename: F
authors.initials: F
authors.lastname: Rank
authors.forename: P
authors.initials: P
authors.lastname: Grandjean
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000097:blood / Q000139:chemically induced* / Q000401:mortality; D016022:Case-Control Studies; D015331:Cohort Studies; D003718:Denmark; D004781:Environmental Exposure / Q000009:adverse effects / Q000706:statistics & numerical data; D004785:Environmental Pollutants / Q000009:adverse effects / Q000097:blood; D005260:Female; D006801:Humans; D006843:Hydrocarbons, Chlorinated; D007306:Insecticides / Q000009:adverse effects* / Q000097:blood; D008875:Middle Aged; D011446:Prospective Studies; D011960:Receptors, Estrogen / Q000502:physiology*; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D004785:Environmental Pollutants; D006843:Hydrocarbons, Chlorinated; D007306:Insecticides; D011960:Receptors, Estrogen