Breast Cancer and Exposure to Organochlorines in the CECILE Study: Associations with Plasma Levels Measured at the Time of Diagnosis and Estimated during Adolescence
Abstract
:1. Introduction
2. Methods
2.1. Recruitment of Cases and Controls
2.2. Data and Sample Collection
2.3. Organochlorine Quantification
2.4. PCB153 Lifetime Toxicokinetic Profiles
2.5. Statistical Analyses
3. Results
4. Discussion
4.1. PBPK Model for Critical Exposure Windows
4.2. Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix A. Imputation of Values below the Limit of Detection (LOD)
Appendix B. The Daily Oral Dose
- A first simulation of the toxicokinetic profile is done by arbitrarily setting a maximal dose (MD1). We thus obtain a PCB153 level estimated at the time of enrollment (PCB153estimated)
- The maximal dose in the definitive model (MD2) is calculated as follows:
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Organochlorine a | Detection Frequency (%) | 25th Percentile | 50th Percentile | 75th Percentile | 90th Percentile | Max |
---|---|---|---|---|---|---|
Controls | ||||||
<50 years (N = 357) | ||||||
p.p’-DDE | 38.1 | <LOD | <LOD | 131.5 | 209.1 | 839.6 |
PCB138 | 7.0 | <LOD | <LOD | <LOD | <LOD | 230.7 |
PCB153 | 36.1 | <LOD | <LOD | 103.1 | 165.1 | 496.8 |
PCB180 | 12.6 | <LOD | <LOD | <LOD | 131.7 | 353.0 |
≥50 years (N = 698) | ||||||
p.p’-DDE | 61.7 | <LOD | 105.7 | 196.0 | 342.3 | 2440.0 |
PCB138 | 26.1 | <LOD | <LOD | 79.1 | 155.0 | 748.0 |
PCB153 | 70.9 | <LOD | 106.2 | 161.7 | 239.4 | 1218.0 |
PCB180 | 27.8 | <LOD | <LOD | 100.0 | 170.8 | 654.2 |
Cases | ||||||
<50 years (N = 162) | ||||||
p.p’-DDE | 40.1 | <LOD | <LOD | 141.3 | 288.0 | 2051.0 |
PCB138 | 11.1 | <LOD | <LOD | <LOD | 113.0 | 224.5 |
PCB153 | 42.0 | <LOD | <LOD | 110.6 | 210.3 | 440.8 |
PCB180 | 15.4 | <LOD | <LOD | <LOD | 177.8 | 384.2 |
≥50 years (N = 533) | ||||||
p.p’-DDE | 58.2 | <LOD | 93.7 | 201.4 | 374.2 | 2196.0 |
PCB138 | 21.6 | <LOD | <LOD | <LOD | 140.3 | 756.2 |
PCB153 | 66.2 | <LOD | 94.7 | 146.2 | 205.4 | 559.0 |
PCB180 | 23.3 | <LOD | <LOD | <LOD | 158.0 | 798.1 |
Matching Variables and Breast Cancer Risk Factors | Cases (n = 695) | Controls (n = 1055) | OR a | 95% CI | |||
---|---|---|---|---|---|---|---|
n | % | n | % | ||||
Age | <40 | 28 | 4 | 114 | 11 | ||
(Years) | 40–49 | 134 | 19 | 243 | 23 | ||
50–59 | 245 | 35 | 318 | 30 | |||
≥60 | 288 | 41 | 380 | 36 | |||
Study Area | Côte d’Or | 210 | 30 | 368 | 35 | ||
Ille-et-Vilaine | 485 | 70 | 687 | 65 | |||
Age at menarche | <14 | 434 | 63 | 652 | 62 | 1.00 | reference |
(Years) | 14 | 131 | 19 | 204 | 20 | 0.91 | [0.74, 1.13] |
15+ | 121 | 18 | 189 | 18 | 0.89 | [0.71, 1.11] | |
missing | 9 | 10 | |||||
Parity | 0 | 76 | 11 | 72 | 7 | 1.00 | reference |
1 | 106 | 15 | 134 | 13 | 0.76 | [0.53, 1.08] | |
2 | 281 | 40 | 373 | 35 | 0.69 | [0.51, 0.94] | |
3 | 167 | 24 | 324 | 31 | 0.45 | [0.32, 0.62] | |
4+ | 65 | 9 | 152 | 14 | 0.34 | [0.23, 0.50] | |
Age at first full term | <22 | 152 | 25 | 284 | 29 | 0.80 | [0.64, 1.01] |
Pregnancy among parous | 22–24 | 189 | 31 | 297 | 30 | 1.00 | reference |
Women (years) | 25–27 | 132 | 21 | 235 | 24 | 0.92 | [0.72, 1.17] |
28+ | 146 | 24 | 167 | 17 | 1.48 | [1.15, 1.90] | |
Duration of breastfeeding | never breastfed | 301 | 49 | 458 | 47 | 1.00 | reference |
Among parous women | <26 | 224 | 37 | 370 | 38 | 1.00 | [0.82, 1.21] |
(Weeks) | 26–52 | 56 | 9 | 95 | 10 | 1.00 | [0.73, 1.36] |
53+ | 31 | 5 | 57 | 6 | 0.88 | [0.59, 1.30] | |
missing | 7 | 3 | |||||
Body mass index | <50 years | ||||||
(kg/m²) | <18.5 | 11 | 7 | 8 | 2 | 2.61 | [1.16, 6.06] |
18.5–24.9 | 118 | 73 | 231 | 65 | 1.00 | reference | |
25–34.9 | 24 | 15 | 80 | 22 | 0.56 | [0.36, 0.86] | |
35+ | 9 | 6 | 37 | 10 | 0.46 | [0.23, 0.86] | |
missing | 1 | ||||||
≥50 years | |||||||
<18.5 | 14 | 3 | 16 | 2 | 1.12 | [0.6, 2.1] | |
18.5–24.9 | 284 | 54 | 358 | 51 | 1.00 | reference | |
25–34.9 | 153 | 29 | 217 | 31 | 0.89 | [0.71, 1.11] | |
35+ | 78 | 15 | 106 | 15 | 0.92 | [0.69, 1.22] | |
missing | 4 | 1 | |||||
Hormonal replacement therapy (current intake) | No | 570 | 87 | 904 | 90 | 1.00 | reference |
Yes | 85 | 13 | 96 | 10 | 1.31 | [1.00, 1.72] | |
missing | 40 | 55 | |||||
Family history of breast | |||||||
Cancer in first-degree | No | 574 | 83 | 953 | 90 | 1.00 | reference |
Relatives | Yes | 121 | 17 | 102 | 10 | 1.93 | [1.51, 2.45] |
Benign breast disease | No | 404 | 58 | 743 | 70 | 1.00 | reference |
Yes | 290 | 42 | 311 | 29 | 1.62 | [1.37, 1.93] | |
missing | 1 | 1 |
Cases | Controls | OR a | 95% CI | p-Trend | ||
---|---|---|---|---|---|---|
DDE (ng/g lipids) | ||||||
All | <LOD | 310 | 480 | 1.00 | reference | 0.11 |
51.3–131.5 | 125 | 186 | 0.97 | [0.76, 1.24] | ||
131.5–212.4 | 91 | 185 | 0.64 | [0.49, 0.83] | ||
≥212.4 | 150 | 189 | 0.93 | [0.73, 1.18] | ||
<50 years | <LOD | 96 | 215 | 1.00 | reference | 0.85 |
53.1–130.6 | 18 | 45 | 0.75 | [0.42, 1.30] | ||
130.6–181.1 | 15 | 45 | 0.71 | [0.39, 1.25] | ||
≥181.1 | 32 | 46 | 1.48 | [0.90, 2.41] | ||
≥50 years | <LOD | 214 | 265 | 1.00 | reference | 0.06 |
51.3–132.8 | 107 | 141 | 0.97 | [0.73, 1.28] | ||
132.8–222.2 | 80 | 140 | 0.63 | [0.47, 0.85] | ||
≥222.2 | 114 | 143 | 0.81 | [0.61, 1.07] | ||
PCB153 (ng/g lipids) | ||||||
All | <LOD | 265 | 424 | 1.00 | reference | 0.28 |
36.6–110.0 | 156 | 202 | 1.14 | [0.90, 1.46] | ||
110.0–162.6 | 133 | 204 | 0.89 | [0.69, 1.14] | ||
≥162.6 | 122 | 210 | 0.75 | [0.57, 0.97] | ||
<50 years | <LOD | 93 | 223 | 1.00 | reference | 0.32 |
59.4–110.1 | 27 | 42 | 1.72 | [1.01, 2.90] | ||
110.1–155.4 | 13 | 42 | 0.65 | [0.33, 1.22] | ||
≥155.4 | 28 | 44 | 1.46 | [0.85, 2.49] | ||
≥50 years | <LOD | 172 | 201 | 1.00 | reference | 0.09 |
36.6–110.0 | 129 | 161 | 1.00 | [0.76, 1.32] | ||
110.0–163.4 | 116 | 161 | 0.85 | [0.64, 1.13] | ||
≥163.4 | 98 | 166 | 0.65 | [0.48, 0.89] |
Birth Cohort | PCB153 at Diagnosis (ng/g lipids) | Cases | Controls | OR a | 95% CI | Calendar Years When Aged 11–20 Years | PCB153 at Age 11–20 Years b(ng/g lipids) | Cases | Controls | OR a | 95% CI |
---|---|---|---|---|---|---|---|---|---|---|---|
1930–1940 | <98.1 | 70 | 69 | 1.00 | reference | 1941–1960 | <1.5 | 88 | 69 | 1.00 | reference |
98.1–173.7 | 69 | 68 | 1.14 | [0.73, 1.75] | 1.5–2.8 | 59 | 68 | 0.51 | [0.32, 0.82] | ||
≥173.7 | 41 | 70 | 0.58 | [0.35, 0.89] | ≥2.8 | 33 | 70 | 0.24 | [0.13, 0.42] | ||
1941–1950 | <LOD | 73 | 102 | 1.00 | reference | 1952–1970 | <6.4 | 71 | 99 | 1.00 | reference |
LOD–134.2 | 79 | 99 | 1.34 | [0.91, 1.97] | 6.4–12.5 | 63 | 98 | 0.65 | [0.42, 0.99] | ||
≥134.2 | 51 | 100 | 0.62 | [0.40, 0.94] | ≥12.5 | 69 | 104 | 0.53 | [0.32, 0.85] | ||
1951–1960 | <LOD | 103 | 138 | 1.00 | reference | 1962–1980 | <35.0 | 94 | 107 | 1.00 | reference |
LOD–124.9 | 62 | 92 | 0.99 | [0.67, 1.46] | 35.0–63.0 | 69 | 106 | 0.67 | [0.45, 0.99] | ||
≥124.9 | 48 | 93 | 0.52 | [0.34, 0.79] | ≥63.0 | 50 | 110 | 0.38 | [0.24, 0.60] | ||
1961–1981 | <LOD | 51 | 150 | 1.00 | reference | 1972–1990 | <47.1 | 29 | 70 | 1.00 | reference |
LOD–127.7 | 11 | 29 | 1.13 | [0.52, 2.41] | 47.1–83.6 | 23 | 66 | 0.73 | [0.39, 1.36] | ||
≥127.7 | 18 | 30 | 1.15 | [0.56, 2.30] | ≥83.6 | 28 | 73 | 0.71 | [0.38, 1.34] |
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Bachelet, D.; Verner, M.-A.; Neri, M.; Cordina Duverger, É.; Charlier, C.; Arveux, P.; Haddad, S.; Guénel, P. Breast Cancer and Exposure to Organochlorines in the CECILE Study: Associations with Plasma Levels Measured at the Time of Diagnosis and Estimated during Adolescence. Int. J. Environ. Res. Public Health 2019, 16, 271. https://doi.org/10.3390/ijerph16020271
Bachelet D, Verner M-A, Neri M, Cordina Duverger É, Charlier C, Arveux P, Haddad S, Guénel P. Breast Cancer and Exposure to Organochlorines in the CECILE Study: Associations with Plasma Levels Measured at the Time of Diagnosis and Estimated during Adolescence. International Journal of Environmental Research and Public Health. 2019; 16(2):271. https://doi.org/10.3390/ijerph16020271
Chicago/Turabian StyleBachelet, Delphine, Marc-André Verner, Monica Neri, Émilie Cordina Duverger, Corinne Charlier, Patrick Arveux, Sami Haddad, and Pascal Guénel. 2019. "Breast Cancer and Exposure to Organochlorines in the CECILE Study: Associations with Plasma Levels Measured at the Time of Diagnosis and Estimated during Adolescence" International Journal of Environmental Research and Public Health 16, no. 2: 271. https://doi.org/10.3390/ijerph16020271