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Breast Cancer UK is dedicated to achieving the primary prevention of breast cancer by reducing public exposure to carcinogenic and other hazardous chemicals in our environment and everyday products.
Our missionContents
Our mission 1 Our vision 2Our charitable objectives 3Our work 4Founding principles 6Breast cancer incidence rates 8Why are more of us getting breast cancer? 10About Breast Cancer UK 22Support us 24
1
Our vision is a world in which the environmental and chemical causes of breast cancer have been eliminated so that fewer people have to live in fear, suffer the trauma of diagnosis, treatment, illness and potential death which results from the disease.
Our vision Our charitable objectivesFounded in 1999, Breast Cancer UK’s charitable objectives are:
Advancing health and saving lives by seeking to reduce the incidence of breast cancer by identifying its causes and encouraging a preventative approach.
Advancing the education of the public
(including patients, their families, the medical research establishment and others) about the causes, impact and prevention of breast cancer.
Collating, conducting or commissioning
research (including the analysis of clinical data and research) into the causes and treatment of breast cancer, and to publish the results thereof.
2 3
Our work
We campaign to encourage a preventative approach by calling for improvements in legislation and public health policies that reduce our exposure to chemicals associated with breast cancer. www.breastcanceruk.org.uk/policy-advocacy
We raise awareness amongst members of the public about the links between exposure to harmful chemicals and breast cancers; and provide practical solutions to help reduce exposure. www.breastcanceruk.org.uk/reduce-your-risk
We support scientific research into the links between breast cancer and exposure to carcinogenic, endocrine disrupting and other hazardous chemicals. www.breastcanceruk.org.uk/science-and-research
4
Founding principlesOur work is guided by the following principles:
The number of breast cancer cases in the UK can be reduced by addressing exposure to carcinogenic, environmental and chemical pollutants.
The public have a right to know about the
associations between carcinogenic and toxic chemicals used in everyday products and the risks of developing breast cancer, and that everything possible should be done to empower and enable people to make choices that improve their health.
There is enough scientific data on the harmful effects of certain carcinogenic and endocrine disrupting chemicals to justify immediate action to ban them and where there is little or no scientific data, there should not be a presumption that those chemicals are safe.
All claims and campaign messages must be backed up and referenced with sound scientific data.
We will not knowingly enter into any partnership
with any company that may directly or indirectly profit from chemicals associated with an increased risk of breast cancer.
Find out more about us at www.breastcanceruk.org.uk
6 7
Breast cancer incidence rates Over 53,000 breast
cancer cases were diagnosed in the UK in 2013.
Breast cancer accounts for 32% of women’s cancers.
Most breast cancers are diagnosed in women, although around 350 men are also diagnosed every year.
Between 2004 and 2014 age standardised incidence rates increased by 7.7%.
1 in 8 women will get breast cancer at some point in their lives. (This statistic used to be 1 in 9 in 2001 and before that, 1 in 12 in 1996).
1 in 5 of these cases will be in women under the age of 50.
Rising incidence rates are a global trend.
Breast cancer incidence is generally higher in wealthier nations.
Women who move from countries with lower breast cancer rates to countries with higher rates will acquire the higher risk profile of their adopted country.
Trends in incidence of female breast cancer in selected countries
Estimates of attributable causes of breast cancer
1% Alcohol
1% Overweight and obesity
3% Lack ofphysical exercise
3% Post menopausal hormones
3% Ionising radiation
5% Occupation
6% HRT
9% Oral contraception
25% Genetic/family
44% Other
120
100
80
60
40
20
0 1975
1980
1985
1990
1995
2000
2005
2010
1975
1980
1985
1990
1995
2000
2005
2010
1975
1980
1985
1990
1995
2000
2005
2010
Europe Asia Rest of the world
Australia
Canada
Colombia
Costa Rica
New Zealand
USA
China
India
Japan
Philippines
Singapore
Thailand
Denmark
Finland
France
Slovakia
Spain
England
Data source: Globocan (2012) IARC, WHO
8 9
Is it because we are living longer?
Whilst living longer does increase the risk of breast cancer, this alone cannot account for the increase in age standardised incidence rates, which continue to rise.
Is it because we are diagnosing more cases earlier due to improved awareness and screening rates?
The uptake of mammogram screening in the UK has not altered significantly since 2009 and recent figures may even suggest a slight downward trend.
Why are more of us getting breast cancer?
Risk of developing breast cancer before age 40 for BRCA2 carriers
0%
20%
40%
60%
46%
Women born after 1958
11%
Women born before 1958
One study showed that women with an inherited BRCA2 mutation born after 1958 have a higher risk of developing breast cancer by age 40 compared to those born before 1958. This suggests our modern lifestyles and environments could be making us more vulnerable to the disease.
Tea, M. K. et al. (2014). Central European BRCA2 mutation carriers: Birth cohort status correlates with onset of breast cancer. Maturitas 77: 68-72
10 11
Estimates of attributable causes of breast cancer
Lifestyle factors
Lack of exercise, increased alcohol consumption, diet, obesity, women having fewer children and at a later age, night-shift work and smoking are all risk factors for breast cancer.
Environmental factors
Ionising radiation (medical, industrial and naturally occurring), air pollution and other chemical pollutants have also been linked with an increased risk of breast cancer. However, it is simply not known what causes around 44% of breast cancer cases.
Estimates based on work by: Parkin, D. and Boyd, L. (2011). The Fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. British Journal of Cancer 105: S77-S81; and Economopoulou, P. et al. (2015). Beyond BRCA: New hereditary breast cancer susceptibility genes. Cancer Treatment reviews 41: 1-8.
44% Other
6% Alcohol
9% Overweight and obesity
3% Physical exercise
3% Post menopausal hormones
1% Ionising radiation5% Occupation
3% HRT
1% Oral contraception
25% Genetic/family
12
Oestrogen and cancer
Cancer occurs when abnormal cells grow in an uncontrolled manner.
High oestrogen levels are associated with an increased risk of breast cancer. This is because oestrogen encourages a high rate of cell division which means there is less time for DNA repair and an increased risk of mutations.
Find our more www.breastcanceruk.org.uk/science-and-research/biology-of-breast-cancer
1
2
Normalcell
DNAdamage
Natural responseresults in cell death
Cancer arises from DNA mutations in cells
How oestrogens and EDCs interact with breast cells
Oestrogensenter breast cells
1Oestrogen mimics (EDCs)are also able to enter cells
Bind with oestrogenreceptors
3 Enter the nucleus and bind to DNA
4 Cell proliferationis triggered.
4 Oestrogen and oestrogen mimics trigger increase in cell proliferation.
Cell divisionsand furthermutations Uncontrolled
cell growth (cancer)
2Bind with oestrogenreceptors
3 Enter the nucleus and bind to DNA
14
EDCs and Cancer
Scientific data suggest that exposure to endocrine disrupting chemicals or “EDCs” could provide an explanation as to why more and more of us are getting breast cancer.
EDCs interfere with the body’s hormones, e.g. female sex hormones, (oestrogens and progesterone), males sex hormones (androgens), insulin and thyroid hormones.
Some EDCs can mimic the actions of hormones – these are known as “agonists” or “mimics”. They bind to specific hormone receptors which induces the response normally associated with natural hormones. For example oestrogen mimics bind to oestrogen receptors. Others prevent natural hormones binding to their target receptor; these are known as antagonists.
1
2
Normalcell
DNAdamage
Natural responseresults in cell death
Cancer arises from DNA mutations in cells
How oestrogens and EDCs interact with breast cells
Oestrogensenter breast cells
1Oestrogen mimics (EDCs)are also able to enter cells
Bind with oestrogenreceptors
3 Enter the nucleus and bind to DNA
4 Cell proliferationis triggered.
4 Oestrogen and oestrogen mimics trigger increase in cell proliferation.
Cell divisionsand furthermutations Uncontrolled
cell growth (cancer)
2Bind with oestrogenreceptors
3 Enter the nucleus and bind to DNA
Some EDCs can alter whether genes are switched on or off; this is known as “epigenetic” control. This may increase cancer risk if, for example, a gene that helps to prevent a cell becoming cancerous (a tumour suppressor gene) is turned off.
Find out more at www.breastcanceruk.org.uk/science-and-research/endocrine-disrupting-chemicals
16 17
Combination effects
Some EDCs have been reported to cause adverse effects at very low dose levels. Exposure to multiple EDCs may also cause combination effects that are especially harmful. Even when each individual chemical is present at a level below the threshold considered to cause harm, in combination with others they could form a hazardous cocktail in the human body.
Early exposures
Exposure to EDCs during critical moments of development, for example in the womb, during early infancy, childhood or during puberty, could also increase the risk of developing breast cancer later in life.
Find our more at www.breastcanceruk.org.uk/science-and-research/in-utero-exposures
Other concerns about EDCs
EDCs are not only linked to breast cancer. They are also linked to widespread environmental pollution and adverse effects on wildlife as well as other human disease and illnesses. These include reproductive disorders, cancers, adrenal and bone disorders, reduced biodiversity, neurotoxicity and thyroid problems.
Whilst, it should be noted that not all scientists believe EDCs contribute to breast cancer incidence, the evidence that they play some part in increasing our vulnerability to the disease is starting to mount up.
18 19
Compound(s) Uses Source (examples)
Hormone disrupting effect
Bisphenol A (BPA) Plastics component; epoxy resin component
Linings in food cans; polycarbonate plastics, thermal receipt paper
Oestrogenic; Anti-androgenic; thyroid hormone antagonist; inhibits *aromatase
Parabens Preservatives (to promote shelf life)
Food, cosmetics, shampoo
Oestrogenic
Phthalates Plasticiser (soften plastics); fragrance; alcohol denaturant
PVC plastic, fragrance in air fresheners, cosmetics, detergents
Oestrogenic; anti-androgenic
Heavy metals e.g. cadmium
Industrial products (e.g. batteries); electroplating
Soil and water contaminants
Oestrogenic, anti-androgenic
Polychlorinated biphenyls (PCBs)
Banned (once used as component in insulating fluids; paints; as a plasticisers)
Soil contaminants
Many disrupt thyroid hormones; some oestrogenic; some anti-oestrogenic
Aluminium salts Control sweating
Antiperspirants Oestrogenic
Compound(s) Uses Source (examples)
Hormone disrupting effect
Triclosan Preservative (antimicrobial agent)
Toothpaste, antibacterial soaps
Decreases thyroid hormone levels; oestrogenic/ anti-oestrogenic; androgenic/ anti-androgenic
Pesticides e.g. glyphosate
herbicide (weed killer)
Agriculture, domestic use
Oestrogenic
UV filters e.g. benzophenones
Protection against UV rays; prevent product degradation
Sunscreens, face creams
Oestrogenic; interfere with thyroid hormones
Flame retardants e.g. tetrabromobisphenol A
Protection against fire
General appliancesElectrical equipment (most widely used in EU)
Interferes with oestrogen metabolism; thyroid
* Enzyme that converts testosterone to the oestrogen, oestradioll
Almost 1,000 compounds are known or suspected to be EDCs. Only a small fraction of these have been investigated in tests capable of identifying endocrine effects in intact organisms.
Endocrine disrupting chemicals
20 21
About Breast Cancer UK
Trustees
Dr Caroline Seddon ChairElspeth Mackeggie Gurney TreasurerMary DaviesKevin DimmerJill Giddins LLB
Income and expenditure
Dr Alison Giles Dr Athina KakavouliGeoff PageStephanie Reeves
Staff
Lynn Ladbrook Chief Executive OfficerDr Margaret Wexler Science Policy OfficerJack Brown Policy and Campaigns OfficerLouise Bowers Communications ManagerAmanda Smith Fundraising ManagerJacquie Fagan Administrator
2015 income
2% Trusts and grants
7% Gift Aid
8% Individual donations
1% Other
6% Legacies
14% Donations in memory
3% Corporate partners
59% Community fundraising
2015 expenditure
£32,593.66 Support
£37,287.46 Education
£3,593.45 Governance
£106,392.78 Science
£42,652.59 Fundraising
£47,870.59 Campaigns
In 2015 we raised over £288,000 and spent just over £270,000. 72% of funds went directly towards the charitable programme. The rest was used to help raise money and provide administrative support.
22 23
Support us
Breast Cancer UK is completely independent and relies largely on the generous support of members of the public – every penny raised will help us in our mission to help prevent breast cancer and put a stop to the environmental and chemical causes of the disease.
Make a regular donation
Set up a standing order to contribute monthly to Breast Cancer UK. Regular giving enables us to plan more effectively for the future.
Volunteer
We are always on the lookout for dedicated volunteers who might be able to help by collecting collection tins, becoming a local ambassador or supporting local events.
Leave a gift in your Will
After providing for your family, you may like to consider leaving Breast Cancer UK a gift in your will.
Become a corporate supporter
There are many ways in which businesses can support us: by making a corporate donation, selecting us as charity of the year or payroll giving.
Find out more
Call us on 0845 680 1322, email [email protected] or visit our website www.breastcanceruk.org.uk
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1 in 8 womenwill get breast cancer
at some point in their lives
Breast Cancer UK works to tackle the environmental and chemical causes of breast cancer.
Breast Cancer UKBM Box 7767London WC1N 3XXTel: 0845 680 1322
Breast Cancer UK Reg. Charity no: 1138866 | Reg. Company no. 7348408
DisclaimerThis work in no way claims to be a comprehensive treatment of the subject of all risk factors or chemicals associated with breast cancer. Breast Cancer UK has used all reasonable endeavours to ensure that the content of this leaflet is correct at the time of publishing, but no warranty is given to that effect nor any liability accepted for any loss or damage arising from the use of this leaflet.
Full references for this document are available from Breast Cancer UK
[email protected] @breastcancer_uk breastcancerukwww.breastcanceruk.org.uk