Abstract

COMMENTARY People and our planet Science for environmental education LETTERS I BOOKS I POLICY FORUM I EDUCATION FORUM I PERSPECTIVES LETTERS edited by Jennifer Sills CREDIT: THOMAS BROWN/WIKIMEDIA COMMONS CHRISTOPHER WILD, DIRECTOR OF THE INTERNATIONAL AGENCY FOR RESEARCH ON CANCER, introduced the concept of the “exposome,” encompassing a person’s environmental exposures across a lifetime, with an image of a fi ddler crab, warning against science walking sideways with one powerful “genome” claw and a second, radically smaller body of knowledge about environmental exposure (1). In this regard, the special section on Breast Cancer (28 March, p. 1451) suffers from a grave imbalance. Discoveries of the BRCA gene are important sci- ence and interesting history, and additional low- penetrance breast cancer genes are noteworthy, too. However, given that “most cases of breast cancer have no inherited component” (p. 1462), it’s trou- bling to see a special section on breast cancer that ignores substantial discoveries in environmental breast cancer studies over the same 20 years. Three compelling themes have emerged from studies of environmental factors. First, breast can- cer is now recognized as a developmental dis- ease, with windows of susceptibility across the life course, beginning in the womb, during puberty and the early reproductive years, and up to the 5 years Is cancer research walking sideways? before diagnosis (2). Second, laboratory studies reveal hundreds of common chemicals that activate relevant biological pathways, including genotoxic chemicals that cause mammary gland tumors in rodents (3), hormone disruptors that interact with the estrogen receptor and promote tumor proliferation (4), and developmen- tal toxicants that alter mammary gland development in rodents in ways that later affect lac- tation and cancer susceptibility (5). Third, the U.S. National Report on Human Exposure to Environmental Chemicals and other exposure studies show that these suspect chemicals are widespread in air and water pollution (6), consumer products (7), house dust and air (8, 9), and human tissues (10). Three authoritative reports—by the President’s Cancer Panel (6), Institute of Medicine (2), and Interagency Breast Cancer and Environmental Research Coordinating Committee (11)— highlight the importance of such research. Because the exposures are so widespread and breast cancer is so common, addressing environmental factors has the potential to save thousands of women each year, even though the relative risks are vastly smaller than for the BRCA genes. JULIA GREEN BRODY, 1 MARGARET L. KRIPKE, 2 MARION H. KAVANAUGH-LYNCH, 3 JEANNE RIZZO, 4 MICHELE R. FORMAN 5 Silent Spring Institute, Newton, MA 02458, USA. 2 President’s Cancer Panel 2003–2011, Houston, TX 77030, USA. California Breast Cancer Research Program, Oakland, CA 94612, USA. 4 Breast Cancer Fund, San Francisco, CA 94109, USA. School of Human Ecology, University of Texas at Austin, Austin, TX 78712, USA. *Corresponding author. E-mail: brody@silentspring.org

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