Urinary Phthalate Metabolite Concentrations and Breast Cancer Incidence and Survival following Breast Cancer: The Long Island Breast Cancer Study Project

Parada, Humberto; Gammon, Marilie D.; Chen, Jia; Calafat, Antònia M.; Neugut, Alfred I.; Santella, Regina M.; Wolff, Mary S.; Teitelbaum, Susan L.

doi:10.1289/ehp2083

Cited by 44 publications

(34 citation statements)

References 37 publications

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“…The first two case-control studies reported significantly elevated risk in relation to exposure to MEP, mono(2ethyl-5-carboxy-pentyl) phthalate (MECPP) [ 11 ] and MEHP [ 12 ], but they were small studies (75 to 233 breast cancers), and measurements were conducted in post-diagnosis samples. Urinary phthalate exposures were unrelated to risk in two larger studies (~ 400–700 breast cancers) [ 13 , 14 ]; only one investigated exposures before diagnosis [ 14 ]. These studies differed in study design, sample size, inclusion of in situ and invasive breast cancers [ 13 , 14 ], and race/ethnicity composition.…”

Section: Introductionmentioning

confidence: 99%

Urinary phthalate exposures and risk of breast cancer: the Multiethnic Cohort study

Franke

Wilkens

et al. 2021

Breast Cancer Res

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Background The epidemiologic evidence from observational studies on breast cancer risk and phthalates, endocrine disrupting chemicals, has been inconsistent. In the only previous study based on pre-diagnostic urinary phthalates and risk of breast cancer, results were null in mostly white women. Methods We examined the association between pre-diagnostic urinary phthalates and breast cancer in a nested case-control study within the Multiethnic Cohort (MEC) study, presenting the first data from five major racial/ethnic groups in the USA. We measured 10 phthalate metabolites and phthalic acid, using a sensitive liquid chromatography mass spectrometry assay on 1032 women with breast cancer (48 African Americans, 77 Latinos, 155 Native Hawaiians, 478 Japanese Americans, and 274 Whites) and 1030 matched controls. Conditional logistic regression was used to examine risk with individual metabolites and ratios of primary (MEHP, mono-2-ethylhexyl-phthalate) to secondary (MEHHP, mono(2-ethyl-5-hydroxyhexyl); MEOHP, mono(2-ethyl-5-oxohexy)) metabolites of di-2-ethylhexyl phthalate (DEHP), a widely used plasticizer. In addition, we investigated risk associations with high (∑HMWP) and low molecular weight (∑LMWP) phthalates, as well as total phthalates which included high and low molecular weight phthalates with phthalic acid (∑LMHMPA) or without phthalic acid in molar ratios (∑LMHMmolar) and adjusted for creatinine and potential confounders. Results Among all women, breast cancer risk was higher for those in tertile 2 and tertile 3 of primary to secondary metabolites of DEHP (MEHP/(MEHHP + MEOHP)) in comparison to those in tertile 1; the respective odds ratios were 1.32 (95% CI 1.04–1.68) and 1.26 (95% CI 0.96–1.66) (Ptrend = 0.05). Risk among Native Hawaiian women increased with exposures to eight of ten individual phthalates and total phthalates (∑LMHMPA ORT3 vs T1 = 2.66, 95% CI 1.39–5.12, Ptrend = 0.001). In analysis by hormone receptor (HR) status, exposure above the median of ∑LMWP was associated with an increased risk of HR-positive breast cancer (OR = 1.30, 95% CI 1.05–1.60) while above the median exposure to phthalic acid was associated with an increased risk of HR-negative breast cancer (ORabove vs below median = 1.59, 95% CI 1.01–2.48). Conclusions Further investigations of suggestive associations of elevated breast cancer risk with higher ratios of primary to secondary metabolites of DEHP, and differences in risk patterns by race/ethnicity and HR status are warranted.

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Section: Introductionmentioning

confidence: 99%

Urinary phthalate exposures and risk of breast cancer: the Multiethnic Cohort study

Franke

Wilkens

et al. 2021

Breast Cancer Res

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“…Recently, phthalates have shown anti-estrogenic effect in breast cancer cell lines [7] and induced cell proliferation in normal breast cells [8]. However, recent epidemiological studies reported no significant association between phthalate exposure and breast cancer [9, 10].…”

Section: Introductionmentioning

confidence: 99%

Use of skincare products and risk of cancer of the breast and endometrium: a prospective cohort study

et al. 2019

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BackgroundConcerns have been raised that extensive use of personal care products that contain endocrine disrupting compounds increase the risk of hormone sensitive cancers.ObjectiveTo assess the effect of skincare product use on the risk of pre- and postmenopausal breast cancer, estrogen receptor positive (ER+) and negative (ER-) breast cancer and cancer of the endometrium.MethodsWe used data from 106,978 participants in the population-based Norwegian Women and Cancer cohort. Participants were categorized into non-, light, moderate, frequent and heavy users of skincare products based on self-reported use of hand and facial cream and body lotion. Cancer incidence information from the Cancer Registry of Norway was linked to individual data through the unique identity number of Norwegian citizens. Multivariable Cox proportional hazard regression was used to assess the effect of skincare product use on the risk of cancer of the breast and endometrium. We used multiple imputation by chained equations to evaluate the effect of missing data on observed associations.ResultsWe found no associations between use of skincare products and incidence of premenopausal breast cancer (frequent/heavy versus non−/light use: hazard ratio [HR] =1.10, 95% confidence interval [CI]: 0.92–1.32), postmenopausal breast cancer (heavy versus light use: HR = 0.87, 95% CI: 0.65–1.18, frequent versus light use: HR = 0.97, 95% CI: 0.88, 1.07) or endometrial cancer (frequent/heavy versus non−/light use: HR = 0.97, 95% CI: 0.79–1.20). Use of skincare products did not increase the risk of ER+ or ER- breast cancer and there was no difference in effect across ER status (0.58 ≤ pheterogeneity ≤ 0.99). The magnitude and direction of the effect estimates based on complete case analyses and multiple imputation were similar.ConclusionHeavy use of skincare products, i.e. creaming the body up to two times per day during mid-life, did not increase the risk of cancer of the breast or endometrium.

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“…A total of 311 full-text articles were carefully read and assessed for data eligibility, and 302 studies were removed on account of conference abstract, review, and no available data. Eventually, the remaining nine articles were included in the final meta-analysis [ 38 , 39 , 40 , 43 , 44 , 45 , 46 , 47 , 48 ]. Amongst these articles, five focused on BPA, whereas six paid attention to phthalates, and two studies investigated both of the EDCs.…”

Section: Resultsmentioning

confidence: 99%

The Association of Bisphenol A and Phthalates with Risk of Breast Cancer: A Meta-Analysis

Liu

Cai

Liu

et al. 2021

IJERPH

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Background: Breast cancer is the most common cancer and the second leading cause of cancer-related death amongst American women. Endocrine-disrupting chemicals (EDCs), especially bisphenol A (BPA) and phthalates, have adverse effects on human health. However, the association of BPA and phthalates with breast cancer remains conflicting. This study aims to investigate the association of BPA and phthalates with breast cancer. Methods: Correlative studies were identified by systematically searching three electronic databases, namely, PubMed, Web of Sciences, and Embase, up to November 2020. All data were analyzed using Stata 15.0. Results: A total of nine studies, consisting of 7820 breast cancer cases and controls, were included. The urinary phthalate metabolite mono-benzyl phthalate (MBzP) and mono-2-isobutyl phthalate (MiBP) were negatively associated with breast cancer (OR = 0.73, 95% CI: 0.60–0.90; OR = 0.75, 95% CI: 0.58–0.98, respectively). However, the overall ORs for BPA, mono-ethyl phthalate (MEP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-2-ethylhexyl phthalate (MEHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono-(3-carboxypropyl) phthalate (MCPP), and mono-butyl phthalate (MBP) were 0.85 (95% CI: 0.69–1.05), 0.96 (95% CI: 0.62–1.48), 1.12 (95% CI: 0.88–1.42), 1.13 (95% CI: 0.74–1.73), 1.01 (95% CI: 0.74–1.40), 0.74 (95% CI: 0.48–1.14), and 0.80 (95% CI: 0.55–1.15), respectively, suggesting no significant association. The sensitivity analysis indicated that the results were relatively stable. Conclusion: Phthalate metabolites MBzP and MiBP were passively associated with breast cancer, whereas no associations were found between BPA, MEP, MEHHP, MEHP, MEOHP, MCPP, and MBP and breast cancer. More high-quality case-control studies or persuasive cohort studies are urgently needed to draw the best conclusions.

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Urinary Phthalate Metabolite Concentrations and Breast Cancer Incidence and Survival following Breast Cancer: The Long Island Breast Cancer Study Project

Cited by 44 publications

References 37 publications

Urinary phthalate exposures and risk of breast cancer: the Multiethnic Cohort study

Urinary phthalate exposures and risk of breast cancer: the Multiethnic Cohort study

Use of skincare products and risk of cancer of the breast and endometrium: a prospective cohort study

The Association of Bisphenol A and Phthalates with Risk of Breast Cancer: A Meta-Analysis

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