Skip to main content
         

June 2002 Forum Summary
Cancer and Environment Forums

The Ad Hoc Discussion Group meeting took place on June 28, 2002 with over 50 people attending. We were happy to be hosted by Hillary Rutter and the Adelphi New York Statewide Breast Cancer Hotline and Support Program, and welcomed by Senator Carl Marcellino. We met in the Alumni House at Adelphi University, in Garden City, Long Island. The agenda for this program was based on a needs assessment conducted by Cornell student Bonnie Berger, who touched base with many Long Island stakeholders to find out what they were interested in having BCERF address. Based on this valuable feedback from approximately 30 individuals representing diverse groups, we organized the following program:
• Local Updates,with six short presentations
• Breast Imaging and the Mammography Debate,Dr. Corrine Tobin,Nassau Radiologic Group
• Long Island Breast Cancer Study Update,Dr.Steve Stellman,Columbia University
• Why Are There Concerns About Chemicals and Breast Cancer Risk?Dr.Suzanne Snedeker,BCERF
• Panel Discussion,with Drs.Stellman and Snedeker, plus Dr.Barbour Warren and Dr.Sandra Steingraber, both of BCERF.

Some local updates and special guest. Although there is never enough time to hear about all the valuable projects and the concerns of participants, we do try to organize at least six updates by participants at the beginning of the program. At this meeting we heard from Barbara Balaban of the National Breast Cancer Coalition (NBCC), Neal Lewis of the Neighborhood Network, Laura Weinberg of the Great Neck Breast Cancer Coalition, Christine Mancuso of the Nassau County Breast Health Partnership, and Gail Frankel, the Long Island field coordinator for NBCC. In addition, were very fortunate to be joined by Danny Meneses of the Phillipine Breast Cancer Network who is carrying on the critical work of his late wife Rosa in the Phillipines.

Breast imaging and the mammography debate. BCERF frequently provides a forum for information exchange and discussion on topics which may not be those we ourselves directly work on. Breast imaging and the mammography debate is an example. This topic was widely requested in the needs assessment conducted prior to the meeting. We called upon a Long Island practitioner, Dr. Corrine Tobin, Director of Mammography at the Nassau Radiologic Group in Garden City to make a presentation to the group. Dr. Tobin reviewed all the technologies currently in use including diagnostic mammography, breast ultrasound, digital mammography, computer-aided diagnosis and breast MRI. She then reviewed the "mammography debate," i.e. the discussion generated after recent scientific papers questioned whether mammography does indeed reduce breast cancer mortality. Dr.Tobin's assessment is that the randomized trials may underestimate screening benefits due to shortcomings in the study, as well as improvements that have been made to the protocol since the time of the studies.

Long Island Breast Cancer Study Update. As most readers are aware, in the past weeks, many more results of the Long Island Breast Cancer Study have been made available. We were very fortunate in our June meeting to be joined by Dr.Steven Stellman, Professor of Epidemiology at Columbia University, to share background, results, and current dilemmas in environmental exposure/breast cancer risk research. For example, Dr. Stellman discussed some of the possible explanations for the negative findings in some of the previous organochlorine and breast cancer risk studies. He mentioned the possibility of too few cases and controls, the narrow range of exposures examined, not enough attention paid to multiple exposures, and inadequate or incomplete exposure assessment. Clearly there is also the possibility that these exposures are not related to breast cancer risk; since all women have measurable levels of organochlorines in their fat and blood, this is a very challenging area of research. Gammon et al. write in their very recently published results ("Environmental Toxins and Breast Cancer on Long Island. II. Organochlorine Compound Levels in Blood, "Cancer Epidemiology Biomarkers and Prevention. Vol.11, 686-697, August 2002 and also available on line at http://cebp.aacrjournals.org/cgi/content/full/11/8/686), "in conclusion, in this large population-based case-control study among women on Long Island, breast cancer risk was not increased in relation to serum organochlorine levels." They go on to point out, "these data do not rule out the possibility, however, that breast cancer risk is elevated by high organochlorine exposures several decades earlier that, through variations in individual metabolism, now measure as low body-burden levels," as well as some other directions for needed future research.

Why Are There Concerns About Chemicals and Breast Cancer Risk? BCERF staff are pleased to now have fact sheet #45, "Environmental Chemicals and Breast Cancer Risk:Why is there Concern?" now available. In it, BCERF Associate Director for Translational Research Dr. Suzanne Snedeker outlines existing, emerging, and needed data on this question. Suzanne was able to present this information at this Ad Hoc meeting, in a session very complementary to Steven Stellman's. Because the BCERF translational research project brings into consideration all types of research-epidemiologic (human), animal and other lab studies - Suzanne is able to provide an overview of all the scientific knowledge available on risk factors that her project has examined. But, as she points out in the fact sheet, "while human studies are given the greatest weight when deciding whether or not a chemical causes cancer, there is little or no information on the cancer-causing potential of most chemicals in people." She mentions that of the 509 chemicals tested by the National Toxicology Program for their cancer-causing potential, 42 were found to cause breast tumors in laboratory animals. In addition, human studies in these areas are needed, as are studies of critical windows of exposure, and studies to further understanding of endocrine-disrupting chemicals and gene-environment interactions.

Panel Discussion with Drs. Stellman and Snedeker, plus Dr.Barbour Warren and Dr. Sandra Steingraber, both of BCERF. Many interesting questions were posed to the group, including questions for Sandra on breastfeeding with regard to the chemical contamination of breast milk. A question was posed to Dr. Stellman - who also works on issues related to the chemical Agent Orange - about the wide-scale testing of Agent Orange in the Phillipines. The meeting ran behind-schedule, but many of the participants were eager to stay extra to provide this panel more time. Clearly this kind of interactive time with scientists is valuable to Ad Hoc meeting participants.

Evaluation and next meeting. We were able to prepare brief mail-back evaluation cards for this meeting. These evaluations inquired as to whether participants thought adequate time was allowed for discussion, whether they would have preferred more or less time for local updates, and which of the various presentations were of value. At the time of this writing we received nineteen responses, all of which were overwhelmingly positive on most questions. We hope to receive more, and then draw conclusions. We are currently working on plans for an October meeting in Rochester. The Breast Cancer Coalition of Rochester (BCCR) is seeking proposals for breast cancer research. One grant will be awarded in December 2002 in the amount of $25,000. The competition is open to researchers based in the Greater Finger Lakes Region of Upstate New York. BCCR priorities include exposures, causation, prevention and risk assessment. Applications due October 18,2002.

Last Update 08.04.05