Advancing the search for preventable causes of breast cancer

Troubled by higher rates of breast cancer on Cape Cod, Massachusetts, and high rates of breast cancer worldwide, leaders of the Massachusetts Breast Cancer Coalition decided they needed “a lab of their own.” They were frustrated that the traditional cancer establishment paid little attention to prevention, the best way to end the epidemic; and they founded Silent Spring Institute to tackle prevention in a new way, as a partnership of scientists and activists with a mission to study – and change – the links between the environment and women’s health, especially breast cancer. Since then, the Institute has risen to become a national leader in breast cancer and environment research.

As a nonprofit research organization of only fourteen employees, our laboratory costs necessitate significant financial resources, so the rest of our operations must run as leanly as possible. The donation of MS Office products has been instrumental in allowing us to pursue cutting-edge research and convey results to the public. An excellent example is our new interactive web-based tool, Breast Cancer and the Environment: Science Review http://www.silentspring.org/sciencereview, which includes two powerful databases developed using Microsoft Access and Excel. These databases resulted from a two year project conducted in partnership with Roswell Park Cancer Institute, Harvard University, and the University of Southern California to determine where there is consensus within the scientific community on the relationship between environmental factors and breast cancer and where additional research or improved research methods are needed. Study results were published in Cancer, the journal of the American Cancer Society; however, we also wished to make the findings easily accessible to individuals who want to make healthy lifestyle choices, policymakers, scientists, activists, and funding organizations all who need the information to target breast cancer prevention alongside screening and treatment. In addition, we hoped to reach regulators considering chemical policy reform and manufacturers contemplating product reformulation.

To share the project’s findings on modifiable influences on breast cancer, we created the Epidemiology Reviews Database, which includes critical reviews of 450 human studies of physical activity, body size, diet, and environmental pollutants, as well as interactions of these factors with inherited genes.

Since the vast majority of chemicals in common use have not been included in human studies, we also created the largest online database—the Mammary Carcinogens Database—of chemicals shown to cause mammary gland tumors in animal studies. Referencing 900 studies, the database offers detailed information for each chemical, including sources, uses, carcinogenic potential, mutagenicity, and regulation.

Our analysis revealed that exposure is widespread for many of the 216 mammary carcinogens identified, and that the overwhelming majority of chemicals people are exposed to have never been tested for cancer risk, necessitating expanded and improved chemical testing worldwide. Because breast cancer is so common and mammary carcinogens are pervasive throughout society, reducing exposures would have a profound effect on public health, sparing thousands of women.

Extensive news media coverage ensured the databases reached a wide audience. Stories appeared on the front page of the Los Angeles Times and the Dallas Morning News, in an editorial in the San Francisco Chronicle and Boston Globe, in the Washington Post and in numerous other major daily news outlets, and on several newswires. The project was covered in a 10-minute interview on ABC.com and other online television and radio sites, and featured in a feature MSNBC story, with a slideshow on everyday products with chemicals of concern. It was included as a “Net watch” item in Science, one of the world’s most prestigious scientific publications. And the project was the subject of a half-hour program (Living on Earth) on National Public Radio and was featured on news and talk shows on numerous local stations from Florida to California.

The number of website visitors has been substantial and include researchers, policymakers, industry, and health organizations, showing that the site is on-target to be widely used by audiences we hoped to reach. Since its launch in summer 2007, we’ve received 789,126 page views and 114,408 visitors; the majority from the US, but also from 162 other countries including South Korea, Slovakia, China, and France. Users represent numerous colleges and universities; federal agencies, including the US Centers for Disease Control, US Environmental Protection Agency, and National Institutes of Health; breast cancer advocacy organizations; hospitals and health insurers; and corporations and industry associations, including Boeing, Dow, Exxon Mobil, Merck, Merrill Lynch, Proctor & Gamble, and many others.

We’ve seen the databases be used by breast cancer advocacy organizations, such as Breast Cancer Action and Breast Cancer Fund in California, New Hampshire Breast Cancer Coalition, Maine Breast Cancer Coalition, and the Canadian Breast Cancer Foundation, to draw public attention to the lack of prevention-oriented breast cancer research by authoring letters to the editor, featuring the databases in their newsletters and e-alerts, and recommending the work to scientific panels involved in research funding prioritization.

In the scientific arena, the work has already been used in 32 scientific articles, including a study out of California’s Kaiser Permanente Medical Care Program that followed up on our identification of 47 pharmaceuticals that caused mammary gland tumors in animal studies. Their analysis showed increased breast cancer risk in women who used several common pharmaceuticals (furosemide, a diuretic; griseofulvin, an anti-fungal; and metronidazole, an antibiotic). Our study was supported by Susan G. Komen for the Cure and after the launch of the results Komen announced a $5 million grants program to pursue issues we had identified in the review.

The donation of the Microsoft Office suite to Silent Spring Institute through Techsoup has greatly enhanced our ability to conduct cost-effective research for many years. We appreciate the Microsoft Corporation’s commitment to providing NGOs access to essential technology to further their goals. With our Microsoft products, we have been gratified to see our mission advance with the creation of publicly accessible databases and their use by advocates, policymakers, and by researchers to generate and test hypotheses that could inform medical practice and, ultimately, reduce breast cancer risk.