title: Personal care products that contain estrogens or xenoestrogens may increase breast cancer risk.
abstract: Established models of breast cancer risk, such as the Gail model, do not account for patterns of the disease in women under the age of 35, especially in African Americans. With the possible exceptions of ionizing radiation or inheriting a known genetic mutation, most of the known risk factors for breast cancer are related to cumulative lifetime exposure to estrogens. Increased risk of breast cancer has been associated with earlier onset of menses or later age at menopause, nulliparity or late first parity, use of hormonal contraceptives or hormone replacement therapy, shorter lactation history, exposure to light at night, obesity, and regular ingestion of alcohol, all of which increase circulating levels of unbound estradiol. Among African Americans at all ages, use of hormone-containing personal care products (PCPs) is more common than among whites, as is premature appearance of secondary sexual characteristics among infants and toddlers. We hypothesize that the use of estrogen and other hormone-containing PCPs in young African American women accounts, in part, for their increased risk of breast cancer prior to menopause, by subjecting breast buds to elevated estrogen exposure during critical windows of vulnerability in utero and in early life. These early life and continuing exposures to estrogenic and xenoestrogenic agents may also contribute to the increased lethality of breast cancer in young women in general and in African American women of all ages. Public disclosure by manufacturers of proprietary hormonally active ingredients is required for this research to move forward.
authors.affiliation: Center for Environmental Oncology, University of Pittsburgh Cancer Institute, University of Pittsburgh, Graduate School of Public Health, Department of Epidemiology, UPMC Cancer Pavilion, Pittsburgh, PA 15232, USA.
authors.forename: Maryann
authors.initials: M
authors.lastname: Donovan
authors.forename: Chandra M
authors.initials: CM
authors.lastname: Tiwary
authors.forename: Deborah
authors.initials: D
authors.lastname: Axelrod
authors.forename: Annie J
authors.initials: AJ
authors.lastname: Sasco
authors.forename: Lovell
authors.initials: L
authors.lastname: Jones
authors.forename: Richard
authors.initials: R
authors.lastname: Hajek
authors.forename: Erin
authors.initials: E
authors.lastname: Sauber
authors.forename: Jean
authors.initials: J
authors.lastname: Kuo
authors.forename: Devra L
authors.initials: DL
authors.lastname: Davis
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D001943:Breast Neoplasms / Q000139:chemically induced* / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D004967:Estrogens / Q000009:adverse effects*; D005260:Female; D006203:Hair Preparations / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D008598:Menstruation; D011629:Puberty, Precocious / Q000139:chemically induced* / Q000150:complications; D012306:Risk; D012307:Risk Factors
chemical_list: D004967:Estrogens; D006203:Hair Preparations