Breast cancer is a complex disease, resulting from both genomic and environmental influences. In 2002, in order to address the interaction of these factors on disease development, the National Institute of Environmental Health Sciences (NIEHS) convened a Brainstorming Workshop of expert researchers, clinicians, and advocates to identify data gaps, bottlenecks and research needs. The major cross-cutting recommendation was to promote research that would characterize environmental exposures over the lifetime that could alter the risk of breast cancer development. To address these issues, the NIEHS and the National Cancer Institute (NCI) established the Breast Cancer and the Environment Research Centers (BCERC) Network in 2003. It was created to study the impact of prepubertal exposures that may affect pubertal development and predispose a woman to breast cancer. Pubertal development is one period of the lifespan considered to be a “window of susceptibility,” where the developing breast may be more vulnerable to environment exposures (chemicals, diet, social factors). The BCERC program spanned seven years (2003 - 2010) for a total commitment of $35 million.
The goals of the BCERC Program were to:
- Compare the molecular changes that occur in normal breast development across the life-span to changes that occur when environmental exposures are introduced;
- Conduct epidemiologic studies of the timing of female pubertal events, including the onset of breast development, age at menarche, and environmental and genetic factors that may affect pubertal maturation; and
- Integrate scientific information on the development of the mammary gland and exposure-induced changes in order to construct public health messages for young girls and women who may be at increased risk for breast cancer.
Breast Cancer and the Environment Research Program
In 2009, the NIEHS and NCI leadership agreed to extend the program to complete the initial population studies, expand upon recent findings, and continue efforts to include and inform the engaged breast cancer community. Additionally, efforts are made to stimulate novel dimensions in basic and applied research to exploit the latest theories about the nature of breast cancer and environmental health.
The new Breast Cancer and the Environment Research Program (BCERP) has several complementary components. One component enables continued and focused epidemiologic research on puberty in young girls. Another component affords greater flexibility to broader multidisciplinary teams of investigators to examine other windows of susceptibility that could be informative, especially in light of novel findings of the effects of diet, hormone replacement therapy, and long-term exposure to agents such as endocrine disruptors in adults, as well as children. New epidemiological and biological research is conducted on other developmental periods through the life-span including in utero and menopause.
The cohorts of young girls will continue to be followed, which is essential to maximize opportunities for data collection and produce a comprehensive model of the pubertal transitional period. While the Program has established that detectable levels of environmental chemicals exist in girls, continued follow up is necessary to determine if these chemicals are associated with changes during important developmental periods that have previously been implicated with increased risk for breast cancer later in life. Furthermore, continued follow up provides an opportunity for further data collection, including the measurement of biomarkers at multiple times, in order to assess persistence of chemicals of interest and serial collection of urine samples to estimate variation in sex hormone levels and ovulatory cycles. Learn more about the Puberty Study.
The investigators are pursuing novel experimental and epidemiological and population studies. The projects focus on the windows of susceptibility concept – the likelihood that individuals are more susceptible to exposure at specific developmental times in their lives - and consider gene-environment interactions as well as molecular mechanisms of breast cancer risk of an organism.. Learn more about the Windows of Susceptibility studies.
Investigators in all studies are collaborating with breast cancer advocate(s)s and/or members of the engaged community to build and promote partnerships among researchers, community members, and other stakeholders; ensuring bi-directional communication between researchers and the engaged community regarding environmental exposures of high and relevant importance; assisting with participant retention in epidemiologic studies; and developing and implementing tools and materials to communicate study findings to the public and policy makers.