Plasma organochlorine levels and the risk of breast cancer

N Engl J Med. 1997 Oct 30;337(18):1253-8. doi: 10.1056/NEJM199710303371801.


Background: Exposure to "environmental estrogens" such as organochlorines in pesticides and industrial chemicals has been proposed as a cause of increasing rates of breast cancer. Several studies have reported higher blood levels of 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDE) and polychlorinated biphenyls (PCBs) in patients with breast cancer than in controls.

Methods: We measured plasma levels of DDE and PCBs prospectively among 240 women who gave a blood sample in 1989 or 1990 and who were subsequently given a diagnosis of breast cancer before June 1, 1992. We compared these levels with those measured in matched control women in whom breast cancer did not develop. Data on DDE were available for 236 pairs, and data on PCBs were available for 230 pairs.

Results: The median level of DDE was lower among case patients than among controls (4.71 vs. 5.35 parts per billion, P=0.14), as was the median level of PCBs (4.49 vs. 4.68 parts per billion, P=0.72). The multivariate relative risk of breast cancer for women in the highest quintile of exposure as compared with women in the lowest quintile was 0.72 for DDE (95 percent confidence interval, 0.37 to 1.40) and 0.66 for PCBs (95 percent confidence interval, 0.32 to 1.37). Exposure to high levels of both DDE and PCBs was associated with a nonsignificantly lower risk of breast cancer (relative risk for women in the highest quintiles of both DDE and PCBs as compared with women in the lowest, 0.43; 95 percent confidence interval, 0.13 to 1.44).

Conclusions: Our data do not support the hypothesis that exposure to DDT and PCBs increases the risk of breast cancer.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / blood*
  • Breast Neoplasms / chemically induced
  • Case-Control Studies
  • Dichlorodiphenyl Dichloroethylene / adverse effects
  • Dichlorodiphenyl Dichloroethylene / blood*
  • Female
  • Humans
  • Insecticides / adverse effects
  • Insecticides / blood*
  • Middle Aged
  • Multivariate Analysis
  • Polychlorinated Biphenyls / adverse effects
  • Polychlorinated Biphenyls / blood*
  • Prospective Studies
  • Risk Factors


  • Insecticides
  • Dichlorodiphenyl Dichloroethylene
  • Polychlorinated Biphenyls