Advocating a "life-course approach," the report called for future research to focus on the many stages of breast development, which begins in utero and undergoes substantial changes through puberty, pregnancy, breast-feeding and menopause. Most research has concentrated on the several years before women develop breast cancer, but environmental exposures during their other life stages may have a profound influence on chances of developing the malignancy, which is diagnosed in about 230,000 American women each year.
"The most interesting thing the committee does a little differently, and is certainly useful, is explicitly recommending that we have to think about a life-course approach and the difficulties that come with that," said IOM committee member Dr. David Hunter, dean for academic affairs and a professor of cancer prevention at Harvard School of Public Health. "We're really calling for attention to developing methods that would give us information about exposures that would have happened in the distant past . . . and inevitably, that's going to take quite some time to develop and to come up with newer information. We don't really say we have the answers here, but we're calling on people to be more creative and look harder."
Along with the report, the committee released a brochure offering women information gleaned from the review in a simple question-and-answer format, which Dr. Stephanie Bernik said will help increase public understanding of the environmental issues surrounding breast cancer.
"They're putting it together in a way that's easy for women to access and understand," said Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City. "I think a lot of women want to understand what they can do, and this is something physicians can easily give to their patients."
The American Cancer Society has more on breast cancer risk factors.
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