title: DDT Exposure in Utero and Breast Cancer.
abstract: BACKGROUND
  Currently no direct evidence links in utero dichlorodiphenyltrichloroethane (DDT) exposure to human breast cancer. However, in utero exposure to another xenoestrogen, diethylstilbestrol, predicts an increased breast cancer risk. If this finding extends to DDT, it could have far-reaching consequences. Many women were heavily exposed in utero during widespread DDT use in the 1960s. They are now reaching the age of heightened breast cancer risk. DDT exposure persists and use continues in Africa and Asia without clear knowledge of the consequences for the next generation.
  
  
  OBJECTIVE
  In utero exposure to DDT is associated with an increased risk of breast cancer.
  
  
  METHODS
  This was a case-control study nested in a prospective 54-year follow-up of 9300 daughters in the Child Health and Development Studies pregnancy cohort (n = 118 breast cancer cases, diagnosed by age 52 y and 354 controls matched on birth year).
  
  
  METHODS
  Kaiser Foundation Health Plan members who received obstetric care in Alameda County, California, from 1959 to 1967, and their adult daughters participated in the study.
  
  
  METHODS
  Daughters' breast cancer diagnosed by age 52 years as of 2012 was measured.
  
  
  RESULTS
  Maternal o,p'-DDT predicted daughters' breast cancer (odds ratio fourth quartile vs first = 3.7, 95% confidence interval 1.5-9.0). Mothers' lipids, weight, race, age, and breast cancer history did not explain the findings.
  
  
  CONCLUSIONS
  This prospective human study links measured DDT exposure in utero to risk of breast cancer. Experimental studies are essential to confirm results and discover causal mechanisms. Findings support classification of DDT as an endocrine disruptor, a predictor of breast cancer, and a marker of high risk.
authors.affiliation: Child Health and Development Studies (B.A.C., N.Y.K., L.Z., P.M.C.), Public Health Institute, Berkeley, California 94709; Department of Environmental Toxicology (M.L.M.), University of California, Davis, California 95616; Environmental Chemistry Laboratory (G.Y., J.-S.P.), California Department of Toxic Substances Control, Berkeley, California 94710; and Public Health Institute (G.Y.), Oakland, California 94607.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Cohn
authors.affiliation: Child Health and Development Studies (B.A.C., N.Y.K., L.Z., P.M.C.), Public Health Institute, Berkeley, California 94709; Department of Environmental Toxicology (M.L.M.), University of California, Davis, California 95616; Environmental Chemistry Laboratory (G.Y., J.-S.P.), California Department of Toxic Substances Control, Berkeley, California 94710; and Public Health Institute (G.Y.), Oakland, California 94607.
authors.forename: Michele
authors.initials: M
authors.lastname: La Merrill
authors.affiliation: Child Health and Development Studies (B.A.C., N.Y.K., L.Z., P.M.C.), Public Health Institute, Berkeley, California 94709; Department of Environmental Toxicology (M.L.M.), University of California, Davis, California 95616; Environmental Chemistry Laboratory (G.Y., J.-S.P.), California Department of Toxic Substances Control, Berkeley, California 94710; and Public Health Institute (G.Y.), Oakland, California 94607.
authors.forename: Nickilou Y
authors.initials: NY
authors.lastname: Krigbaum
authors.affiliation: Child Health and Development Studies (B.A.C., N.Y.K., L.Z., P.M.C.), Public Health Institute, Berkeley, California 94709; Department of Environmental Toxicology (M.L.M.), University of California, Davis, California 95616; Environmental Chemistry Laboratory (G.Y., J.-S.P.), California Department of Toxic Substances Control, Berkeley, California 94710; and Public Health Institute (G.Y.), Oakland, California 94607.
authors.forename: Gregory
authors.initials: G
authors.lastname: Yeh
authors.affiliation: Child Health and Development Studies (B.A.C., N.Y.K., L.Z., P.M.C.), Public Health Institute, Berkeley, California 94709; Department of Environmental Toxicology (M.L.M.), University of California, Davis, California 95616; Environmental Chemistry Laboratory (G.Y., J.-S.P.), California Department of Toxic Substances Control, Berkeley, California 94710; and Public Health Institute (G.Y.), Oakland, California 94607.
authors.forename: June-Soo
authors.initials: JS
authors.lastname: Park
authors.affiliation: Child Health and Development Studies (B.A.C., N.Y.K., L.Z., P.M.C.), Public Health Institute, Berkeley, California 94709; Department of Environmental Toxicology (M.L.M.), University of California, Davis, California 95616; Environmental Chemistry Laboratory (G.Y., J.-S.P.), California Department of Toxic Substances Control, Berkeley, California 94710; and Public Health Institute (G.Y.), Oakland, California 94607.
authors.forename: Lauren
authors.initials: L
authors.lastname: Zimmermann
authors.affiliation: Child Health and Development Studies (B.A.C., N.Y.K., L.Z., P.M.C.), Public Health Institute, Berkeley, California 94709; Department of Environmental Toxicology (M.L.M.), University of California, Davis, California 95616; Environmental Chemistry Laboratory (G.Y., J.-S.P.), California Department of Toxic Substances Control, Berkeley, California 94710; and Public Health Institute (G.Y.), Oakland, California 94607.
authors.forename: Piera M
authors.initials: PM
authors.lastname: Cirillo
mesh_terms: D000328:Adult; D032721:Adult Children / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D016022:Case-Control Studies; D003634:DDT / Q000097:blood / Q000633:toxicity*; D004781:Environmental Exposure / Q000009:adverse effects / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008875:Middle Aged; D009367:Neoplasm Staging; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology*; D011379:Prognosis; D055815:Young Adult
chemical_list: D003634:DDT; C016340:o,p'-DDT