On February 12, 2013, the congressionally mandated Interagency Breast Cancer and Environmental Research Coordinating Committee (IBCERCC) report made seven clear recommendations to enhance research to focus on breast cancer prevention by clearly building the evidence base for environmental exposures across the lifespan that cause the disease.
The report includes the largest-to-date analysis of peer-reviewed science on breast cancer and the environment, including many animal and human studies which provide plausible evidence that environmental factors like toxic chemical exposure increase breast cancer risk. Many gaps in research and policies were identified. It calls for a national, comprehensive, cross-governmental breast cancer prevention strategy.
On this call Michele Forman, PhD, and Jeanne Rizzo, RN, chair and co-chair of the IBCERCC Committee present the report, and Linda Birnbaum, PhD, director of the National Institute of Environmental Health Sciences, provided her agency’s perspective. Julia Brody, PhD, executive director of the Silent Spring Institute, and Karen Miller, president of the Huntington Breast Cancer Action Coalition, commented as responders to the primary presentations.
Featured Speakers
Michele Forman, PhD, is the Bruton Professor of Nutritional Sciences at the University of Texas Austin. She has a doctorate in epidemiology, masters degree in nutrition, Master of Science in public health and Master of Arts in anthropology. She has developed and conducted 10 longitudinal cohort studies in the US and overseas. She is currently the study location principal investigator for the Harris County National Children’s Study (NCS) and the Travis County site and is also conducting formative research in nutritional status for the NCS. For over 30 years, her research has focused on women’s health throughout the life course, with an emphasis on the effect of pregnancy, early childhood, puberty, and the reproductive years on risk of breast and other hormonal cancers. She seeks to understand how a woman’s nutritional status in pregnancy influences the newborn’s health and the mother’s health after pregnancy and the effects of each on intermediate markers of and on cancer risk in the offspring and mother, respectively. Her work focuses on how pre-pregnancy body mass index, diet, weight gain and physical activity in pregnancy—all of which are captured under the term "energy balance"—are associated with the ages at onset of puberty and at menarche of the daughter/female offspring as well as risk for obesity and cancer in the mother and daughter. Her research has led to an understanding that women who exercise in pregnancy have daughters who delay the age of menarche by three months on average, that excessive weight gain in pregnancy leads to a higher risk for obesity in the offspring by age 18, and that eating four or more salads a week and gardening reduce risk of lung cancer across smoking groups. Her research explores why preeclampsia in pregnancy is associated with lower risk of breast cancer in the mother and index daughter and later age at onset of puberty in the daughter. She has over 130 peer-reviewed publications, is on the editorial boards of several journals, has numerous book chapters and invited presentations nationally and internationally, and is on many institutional committees. She has mentored 25 graduate students and 15 postdoctoral fellows and junior faculty. She is the chair of the Interagency Committee for Breast Cancer and the Environment for the National Institutes of Health within the Department of Health and Human Services.
Jeanne Rizzo, RN, president and CEO of the Breast Cancer Fund, leads the organization’s strategic initiatives to remove the chemical bisphenol A, or BPA, from food packaging; to ensure cosmetics are nontoxic; and to overhaul the broken chemicals-management system that allows tens of thousands of toxic and untested chemicals to be used in consumer products. She also guides scientific initiatives, including the 2011 publication of a groundbreaking BPA dietary study. Recent legislative victories include the passage of a federal law banning toxic chemicals linked to breast cancer from toys and California laws creating the first statewide biomonitoring program, advancing the safety of cosmetics and regulating chemicals in consumer products. Recent victories in the marketplace include a commitment from Campbell Soup Company to remove BPA from its can linings and from Johnson & Johnson to globally reformulate its cosmetics products to remove harmful chemicals.
Linda Birnbaum, PhD, became the director of the National Institute of Environmental Health Sciences (NIEHS), one of the National Institutes of Health (NIH), and the National Toxicology Program (NTP) on January 18, 2009. In these roles Dr. Birnbaum oversees federal funding for biomedical research to discover how the environment influences human health and disease. Several advisory boards and councils provide Birnbaum and NIEHS/NTP staff with input to accomplish this large task. Dr. Birnbaum is the first toxicologist and the first woman to lead the NIEHS/NTP. She has spent most of her career as a federal scientist. She has received numerous awards and recognitions, including being elected in October 2010 to the Institute of Medicine of the National Academies, one of the highest honors in the fields of medicine and health. Dr. Birnbaum’s own research and many of her publications focus on the pharmacokinetic behavior of environmental chemicals; mechanisms of actions of toxicants, including endocrine disruption; and linking of real-world exposures to health effects.
Call Responders
Julia Brody, PhD, executive director of Silent Spring Institute, is a leader in research on breast cancer and the environment and in community-based research and public engagement in science. Dr. Brody’s current research focuses on methods for reporting to people on their own exposures to hormone disruptors and other emerging contaminants when the health effects are uncertain. She also recently led a project connecting breast cancer advocacy and environmental justice in a study of household exposures to endocrine disruptors and air pollutants through a collaboration of Silent Spring Institute, Communities for a Better Environment (a California-based environmental justice organization), and researchers at Brown University and the University of California, Berkeley. Since 1996, Dr. Brody has been the principal investigator of the Cape Cod Breast Cancer and Environment Study, a case-control study of 2,100 women that includes testing for 89 endocrine disruptors in homes and historical exposure mapping. The study was the first to measure estrogenic activity in groundwater and drinking water. Results have been published in Environmental Health Perspectives and elsewhere. Dr. Brody led a two-year review of scientific review of evidence on animal mammary gland carcinogens and epidemiologic studies of breast cancer and environmental pollutants, diet, body size, and physical activity, which was published in a special supplement to the American Cancer Society peer-reviewed journal Cancer.
Karen Joy Miller is founder and president of Huntington Breast Cancer Action Coalition, Inc., a grassroots community organization established in 1992. Ms. Miller was diagnosed in 1987 with breast cancer, and for nearly 20 years has been an advocate for public health. Her primary focus has been on environmental triggers that contribute to the onset of disease. She is a founding member of the New York State Breast Cancer Network and Long Island Breast Cancer Network, which collectively represent 30 breast cancer organizations. She serves on the executive board of the Children’s Environmental Health Center at the Icahn School of Medicine at Mount Sinai. She served as an advisor on the following New York State boards: Breast Cancer Detection and Cervical Education Council, Governor’s Sustainability & Green Procurement Council and the Pollution Prevention Institute. Ms. Miller contributed to the recent report, Breast Cancer and the Environment: Prioritizing Prevention, serving the Interagency Breast Cancer and Environmental Research Coordinating Committee (IBCERCC) as a advocate non-federal member.
The call was moderated by Steve Heilig, MPH, CHE director of public health & education, and director of public health and education at the San Francisco Medical Society.