TY - JOUR
T1 - Long-term PM2.5 exposure before diagnosis is associated with worse outcome in breast cancer
AU - Prada, Diddier
AU - Baccarelli, Andrea A.
AU - Terry, Mary Beth
AU - Valdéz, Leonora
AU - Cabrera, Paula
AU - Just, Allan
AU - Kloog, Itai
AU - Caro, Haydee
AU - García-Cuellar, Claudia
AU - Sánchez-Pérez, Yesennia
AU - Cruz, Rodrigo
AU - Diaz-Chávez, Jose
AU - Cortés, Carlo
AU - Pérez, Delia
AU - Meneses-García, Abelardo
AU - Cantú-de-León, David
AU - Herrera, Luis A.
AU - Bargalló, Enrique
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2021/7/1
Y1 - 2021/7/1
N2 - Purpose: Increasingly epidemiological evidence supports that environmental factors are associated with breast cancer (BC) outcomes after a BC diagnosis. Although evidence suggests that air pollution exposure is associated with higher mortality in women with BC, studies investigating potential mechanisms have been lacking. Methods: We evaluated women with BC (N = 151) attended at the National Cancer Institute–Mexico from 2012 to 2015. We calculated 1-year average exposures to particulate matter < 2.5 μm (PM2.5) at home address before diagnosis. We used linear and logistic regression models to determine the associations between PM2.5 exposure and BC aggressiveness (tumor size, molecular phenotype). Results: Average annual PM2.5 exposure of this population was 23.0 μg/m3 [standard deviation (SD)]: 1.90 μg/m3]. PM2.5 levels were positively correlated with tumor size at diagnosis (r = 0.22; p = 0.007). Multivariable linear models had a similar inference [risk ratio (RR): 1.32; 95% confidence interval (95% CI): 1.04, 1.674]. We did not observe differences in this association by age or menopause status. Further, women with triple-negative BC (TNBC) had significantly higher PM2.5 levels compared with other phenotypes (p = 0.015). Multivariable-adjusted logistic regression models assessing the association between PM2.5 and tumor size had a similar inference (RR 1.41; 95% CI 1.05, 1.89) overall for all ages and also for women who were ≤ 50 years old at diagnosis (RR 1.63; 95% CI 1.036, 2.57). Conclusions: Our findings suggest a significant association between long-term PM2.5 exposure and BC aggressiveness based on tumor size and phenotype, as well as a worse outcome.
AB - Purpose: Increasingly epidemiological evidence supports that environmental factors are associated with breast cancer (BC) outcomes after a BC diagnosis. Although evidence suggests that air pollution exposure is associated with higher mortality in women with BC, studies investigating potential mechanisms have been lacking. Methods: We evaluated women with BC (N = 151) attended at the National Cancer Institute–Mexico from 2012 to 2015. We calculated 1-year average exposures to particulate matter < 2.5 μm (PM2.5) at home address before diagnosis. We used linear and logistic regression models to determine the associations between PM2.5 exposure and BC aggressiveness (tumor size, molecular phenotype). Results: Average annual PM2.5 exposure of this population was 23.0 μg/m3 [standard deviation (SD)]: 1.90 μg/m3]. PM2.5 levels were positively correlated with tumor size at diagnosis (r = 0.22; p = 0.007). Multivariable linear models had a similar inference [risk ratio (RR): 1.32; 95% confidence interval (95% CI): 1.04, 1.674]. We did not observe differences in this association by age or menopause status. Further, women with triple-negative BC (TNBC) had significantly higher PM2.5 levels compared with other phenotypes (p = 0.015). Multivariable-adjusted logistic regression models assessing the association between PM2.5 and tumor size had a similar inference (RR 1.41; 95% CI 1.05, 1.89) overall for all ages and also for women who were ≤ 50 years old at diagnosis (RR 1.63; 95% CI 1.036, 2.57). Conclusions: Our findings suggest a significant association between long-term PM2.5 exposure and BC aggressiveness based on tumor size and phenotype, as well as a worse outcome.
KW - Long-term exposure
KW - PM
KW - Triple-negative phenotype
KW - Tumor size
UR - http://www.scopus.com/inward/record.url?scp=85102239622&partnerID=8YFLogxK
U2 - 10.1007/s10549-021-06167-x
DO - 10.1007/s10549-021-06167-x
M3 - Article
C2 - 33683522
AN - SCOPUS:85102239622
SN - 0167-6806
VL - 188
SP - 525
EP - 533
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
IS - 2
ER -