By Jennifer Beeman, Executive Director, Breast Cancer Action Quebec

The month of October, aka Breast Cancer Awareness Month, is an odd time of year for us at Breast Cancer Action Quebec (BCA-Qc). We are exceedingly aware of breast cancer, and the trauma, upheaval, and profound fear it burns through women’s lives. We also keenly feel the precious lives lost to this disease. And finally, we are all too aware of the wide range of tough, unanswered questions surrounding breast cancer.

Proponents of Breast Cancer Awareness Month are unrelenting in their message of awareness. In their view, awareness is achieved when women take care of their own health by getting mammograms, staying trim, exercising, and limiting alcohol consumption. In other words, risk reduction equates with personal responsibility—rarely is there any mention of the environmental causes of breast cancer that individuals have almost no control over. Women are only encouraged to raise large amounts of money to find a cure while the root causes of this ubiquitous disease are ignored by this campaign.  

The problem for us at Breast Cancer Action Quebec is that this message has become hegemonic. It is the only message that reaches many women. It pushes all other voices that are asking important and difficult questions to the margins of discussions about breast cancer, including ours at BCA-Qc. The following are just a few examples of the issues that concern us.

Research on environmental links to breast cancer is marginalized

Many breast cancer researchers agree that direct environmental exposures to carcinogens and toxic substances are the cause of breast cancer in at least 20% of cases. Only 5-10% of breast cancer is attributable to genetic causes. Yet environmental causes receive only 2per cent of breast cancer research funds and only 3-4% of those funds go to breast cancer prevention.[1] Furthermore, those studying breast cancer now recognize that its causes are most likely multifactorial—that is, most breast cancers are caused by certain genetic predispositions interacting with environmental as well as lifestyle factors. Given this complexity, we need to look at the following tough questions:

Breast cancer and endocrine disrupting chemicals

The problems created by endocrine disrupting chemicals (EDCs), which comprise a wide range of substances that interfere with our bodies’ delicate hormonal system, require us to completely rethink our current definitions of toxicity and exposure. Many EDCs are estrogenic (act like estrogens in the body), and increased exposure to estrogen in any form is a major risk factor for breast cancer.  And yet, while money is raised for the cure, funding for research on EDCs is slim.

Breast cancer and workplace exposures

Researchers James Brophy and Margaret Keith published ground breaking research showing significantly increased rates of breast cancer—most following occupational exposures to endocrine disrupting chemicals—for women involved in the farming sector, plastics manufacturing, food canning, metal working, and in bars and gambling establishments[2].  Brophy and Keith were refused funding to further their research. However, the American Public Health Association recently published a policy statement saying that research on occupational and other environmental causes of breast cancer must become a national priority[3].

Breast cancer and pesticides

The researcher Luc Gaudreault, professor in the Department of Biology at the University of Sherbrooke, is studying the link between pesticides that are known endocrine disrupters and certain cancers, in particular breast cancer and prostate cancer. Finding funding for this research has proven difficult[4].

Breast cancer and traffic-related air pollution

On another question concerning the link between environmental toxicants and breast cancer, researchers from the Research Institute of the McGill University Health Centre published results of their study showing that post-menopausal women living in areas with the highest levels of traffic-related air pollution in Montreal were twice as likely to develop breast cancer as those living in the least polluted areas[5].  Researchers in California furthered this research and identified the mammary gland carcinogens in traffic-related air pollutants[6].  Yet, very few groups—including the major breast cancer foundations—are looking at or funding research into this issue.

Breast cancer and the social inequalities affecting health

Concerning the issues surrounding women’s health justice, the Public Health Directorate of Montreal has identified breast cancer as an important example of the impact of social inequality affecting health because poorer women tend to have slightly lower rates of diagnosis of the disease, but higher rates of mortality[7].

The overall trend of breast cancer incidence (how many women are diagnosed with the disease) is relatively stable. But within that trend, different populations of women experience very different rates of incidence (getting the disease) and mortality (dying from the disease). Some populations of women, for example certain women who are recent immigrants, have incidence rates of breast cancer that have risen significantly; other populations of women, particularly Black women, have disproportionately high mortality rates. We need to better understand these trends, learn from them, and inform women who may need specific information about their health and screening.

These are just some of the issues driving our work at Breast Cancer Action Quebec. As a society, we are already highly aware of breast cancer. Now, we must move the discussion significantly forward to tackle the most complex breast cancer issues. Frankly, the pervasive message of awareness is insulting to women’s intelligence and undermines any momentum toward substantive change. Powerful interests working to resist basic research on environmental issues, such as the links between cancer and EDCs, prevent changing the dominant paradigm concerning toxicity and chemical regulation—an approach that allows chemicals to enter all products, unless or until they are proven harmful. Therefore, rather than FIRST establishing that a chemical is safe for humans and the environment (see precautionary principle), activists and academics must fight to have harmful chemicals removed from products already in the marketplace. In addition, risk assessment is based on looking at individual chemicals without studying their interactions with other chemicals; also generally ignored are assessments concerning long exposure periods or age-related exposure.

Breast Cancer Action Quebec works diligently to ensure that more funding is used for fundamental research on preventing breast cancer. We also focus on addressing the existing social inequalities affecting health—and their impacts on breast cancer—to make these a public health priority.

We are working with a wide range of groups to get harmful chemicals, and those suspected of being dangerous, out of our environment. And, we are working toward the implementation of a national strategy for endocrine disrupting chemicals comparable to the Strategy developed by the French Government[8].

Enough is enough. We are all thoroughly aware of breast cancer—BCAM was established 24 years ago.  We need action on the tough questions facing us today. And we need it now.

[1]International Cancer Research Partnership (2012). Cancer Research Funding from an International Perspective: Report from the International Cancer Research Partnership, 2012.

[2]Brophy, James, Margaret Keith, et al. (2012). Breast Cancer risk in relation to occupations with exposure to carcinogens and endocrine disrupters: A Canadian case-control study. Environmental Health. 11:87.

[3]American Public Health Association (2014). Breast Cancer and Occupation: The Need for Action. Policy Number: 20146.

[4]Radio-Canada (2015). “Un chercheur de l'Université de Sherbrooke s'intéresse à l'impact des pesticides sur les cancers.” June 29, 2015.

[5]Crouse, Dan L., Mark S. Goldberg, Nancy A. Ross, Hong Chen and France Labrèche (2010). Postmenopausal Breast Cancer Is Associated with Exposure to Traffic-Related Air Pollution in Montreal, Canada: A Case–Control Study. Environmental Health Perspective. 118 (11) 1578-1583. 

[6]Garcia, Erika, Susan Hurley, David O. Nelson, Andrew Hertz and Peggy Reynolds (2015). Hazardous air pollutants and breast cancer in California teachers: a cohort study. Environmental Health. 14:14.

[7]Agence de la santé et des services sociaux de Montréal (2011). Rapport du Directeur de santé publique 2011 : Les inégalités sociales de santé à Montréal. Montréal, Direction de la santé publique. pp. 80-82.