Connie Engel, Ph.D., Science & Education Manager, Breast Cancer Fund

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1 CHE-AK Call May 28 th, 2014 Breast Cancer Prevention: Beyond Pink Ribbons Karuna Jaggar, Executive Director, Breast Cancer Action Janet Ackerman, Staff Scientist, Silent Spring Institute Connie Engel, Ph.D., Science & Education Manager, Breast Cancer Fund

2 Breast Cancer Action: Stop Breast Cancer Before It Starts! Karuna Jaggar Executive 1 Karuna Jaggar, Breast Cancer Action

3 Breast Cancer A leading Women s health issue Most common cancer after skin cancer Nearly 1 in 3 cancers diagnosed in women 2 nd leading cause of cancer deaths in women 2 Karuna Jaggar, Breast Cancer Action

4 Public Health Crisis Each Year: Nearly a quarter million women diagnosed Approximately 40,000 women die Another 60,000 non-invasive (DCIS) Approx. 2.6 million women alive today have been treated for breast cancer 3 Karuna Jaggar, Breast Cancer Action

5 Unequal Burden of Disease Highest incidence among white women 28% of Alaskan & Native American women s cancers Black women are 40% more likely to die Latina women are 20% more likely to die WOC also experience greater financial decline Can t explain these differences due to screening 4 Karuna Jaggar, Breast Cancer Action

6 Canary in the Coal Mine? 5 Karuna Jaggar, Breast Cancer Action

7 Are you aware? 6 Karuna Jaggar, Breast Cancer Action

8 Main messages re: breast cancer Eat healthy. Maintain a healthy weight. Exercise. Early detection is your best protection. Breast feed. 7 Karuna Jaggar, Breast Cancer Action

9 Known Risk Factors : just 30-50% 8 Family history: just 5-10% Early menarche/ late menopause Late first child birth / no children Hormone replacement therapy Alcohol consumption Weight gain after menopause Being tall Higher birth weight as a baby AGE Karuna Jaggar, Breast Cancer Action

10 50-70% Have No Known Risk Factor 9 Karuna Jaggar, Breast Cancer Action

11 Science on Environmental Links 10 Karuna Jaggar, Breast Cancer Action

12 Chemicals in Consumer Products Over 80,000 chemicals in commercial use today Regulated by 1976 Toxic Substance Control Act (TSCA) ¾ of chemicals grandfathered only 200 safety tested EPA has few resources to test & little power Use of only 5 chemicals restricted under TSCA 11 Karuna Jaggar, Breast Cancer Action

13 The President s Cancer Panel The Panel was particularly concerned to find that the true burden of environmentally induced cancer has been grossly underestimated Annual Report 12 Karuna Jaggar, Breast Cancer Action

14 Lifetime risk of Breast Cancer 1964: 1 in : 1 in 14 Today: 1 in 8 13 Karuna Jaggar, Breast Cancer Action

15 Lifelong Toll of Breast Cancer 14 Karuna Jaggar, Breast Cancer Action

16 The Precautionary Principle Act to prevent harm before it occurs 15 Stop Cancer Before it Starts! Karuna Jaggar, Breast Cancer Action

17 Limits of Consumer Activism Focus on high-profile chemicals Many exposures we can t control Puts unfair burden on consumers Women may blame themselves Widening health gap 16 Karuna Jaggar, Breast Cancer Action

18 Yes, Live Healthy 17 Karuna Jaggar, Breast Cancer Action

19 Demand Systemic Change No more whack a mole Need comprehensive chemical reform Complex disease with complex causes Exposures over lifetime to many chemicals Refuse to be our own EPA / FDA Protect all of us, including the most vulnerable Stop blaming women for their cancers 18 Karuna Jaggar, Breast Cancer Action

20 19 Karuna Jaggar, Breast Cancer Action

21 Stop Breast Cancer Before it Starts 20 Karuna Jaggar, Breast Cancer Action

22 Join BCAction! Challenging Assumptions. Inspiring Change. Signup for BCActions s newsletter and e-alerts Join us on Facebook Follow us 21 Karuna Jaggar, Breast Cancer Action

23 Breast cancer prevention: Beyond pink ribbons Janet Ackerman Staff Scientist Silent Spring Institute Janet Ackerman, Silent Spring Institute 1

24 How might chemicals increase breast cancer risk? Damaging DNA Ionizing radiation Promoting tumor growth HRT Disrupting development -> vulnerability DES 2

25 Example mammary carcinogen and endocrine disruptor exposures Benzene 1,3-butadiene PAHs PFOA 3

26 What kinds of studies reveal cancer causes? High, well-defined exposures among large groups No disease Disease Not exposed Exposed 4

27 What kinds of studies reveal cancer causes? Occupational studies Men, chemicals, cancers (not breast) And Accidents/disasters (e.g. ionizing radiation) Pharmaceuticals (e.g. HRT) Janet Ackerman, Silent Spring Institute 5

28 Human studies Other differences between groups? HRT Appropriate measurements taken at an appropriate time? DDT Other factors interacting with the exposure being studied? PCBs Janet Ackerman, Silent Spring Institute 6

29 Animal Studies 216 chemicals found to cause mammary tumors in rodents Animals typically exposed only as adults Rudel et. al 2007 Cancer Janet Ackerman, Silent Spring Institute 7

30 Animal Studies Rats aren t people! But rodent and human results are generally Rudel et. al 2014 Environmental Health Perspectives consistent Exposure Human Breast Cancer Rodent Mammary Tumors HRT (E + P) + + HRT (E) (+) + Oral Contraceptives (E + P) + + DES + + Griseofulvin, Furosamide, Metronidazole (+) + Indomethacin, Nitrofurantin (-) + Ionizing radiation + + Alcohol + (+) Heterocyclic amines (meat) (+) + Sleep disruption (+) + Ethylene oxide (+) + PAH (+) + Solvents (+) + DDE (tested in adult) - - DDT (early exposure) (+) Not tested PCBs (testing adults, entire population) - - PCBs (polymorphism) (+) Not tested Dioxin (early exposure) (+) (+) 8

31 Rudel et. al 2014 Environmental Health Perspectives 9

32 In vitro tests 10

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56 Breast Cancer Prevention Tour In Anchorage, June 4 th, at the Loussac Library Karuna Jaggar, Executive Director, Breast Cancer Action Janet Ackerman, Staff Scientist, Silent Spring Institute Connie Engel, Ph.D., Science & Education Manager, Breast Cancer Fund