Exposure to environmental pollutants, such as Cadmium (Cd), plays a role in the development of breast (BC) and ovarian (OC) cancers. Cd acts as an endocrine disruptor through its binding to the estrogen receptor, promoting cell proliferation. Population may be exposed to Cd through cigarette smoke, dust fumes inhalation, contaminated food and drinking water. Pathogenetic variants (PVs) in the BRCA1/2 genes can be found in about 20% of patients (pts) with BC and serous OC. In these pts, absence in repair of DNA damage causes its accumulation and neoplasm development. Our aim was to evaluate the potential interference of environmental factors in the onset of BC or OC in women carrying PVs in BRCA1/2 genes.
We conducted an observational, multicentric, case-control, retrospective study of pts with a PV in BRCA1/2 genes and with BC, OC, or both diagnosed from 2012 to 2020 (Group 1, G1), or without cancer (Group 2, G2). Demographics, body mass index (BMI), occupation, type of mBRCA, and estroprogestinic (EP) use data were collected. Logistic regression was applied to investigate the relationship between adherence to Mediterranean diet (using PREDIMED questionnaire), physical activity (using IPAQ questionnaire), Cd exposure through smoking habits (SH), patients work environment, and cancer development.
We evaluated 91 patients, 52 (57.1%) in Group 1 and 39 (42.9%) in Group 2. 57 (62.6%) had a BRCA1 PV, and 34 (37.4%) a BRCA2 PV. The two groups showed significative differences regarding age (49.3 vs 39.6 yrs in G1 and G2, respectively; p<.0001); BMI (23.6 vs 18.4-p=.03); SH (p=.042); EP use (p=.001);. At univariate analysis, predictive factors for cancer incidence were: SH (OR 2.750; 95% CI 1.059 – 7.142-p=.038); BMI (OR 1.093; 95% CI 1.024 – 1,167-p=.007); EP use (0.278; 95% CI 0.120 – 0.646-p=.003). No relationship was found with adherence to Mediterranean diet and physical activity. At multivariate analysis, SH (OR 3.058; 95% CI 1.034 – 9.041-p=.043) and EP use (0.297; 95% CI 0.089 – 0.989-p=0.048) were predictive of cancer onset.
In this preliminary analysis, the development of cancer in patients with BRCA mutation was influenced by smoking habits and EP use.
Fabi Alessandra.
Has not received any funding.
All authors have declared no conflicts of interest.