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Am J Epidemiol. 2019 Apr 1;188(4):646-655. doi: 10.1093/aje/kwy283.

Toenail-Based Metal Concentrations and Young-Onset Breast Cancer.

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Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina.
Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina.
Department of Earth Sciences, Dartmouth College, Hanover, New Hampshire.
Department of Epidemiology and Children's Environmental Health and Disease Prevention Research Center at Dartmouth, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.


Several metals have carcinogenic properties, but their associations with breast cancer are not established. We studied cadmium, a metalloestrogen, and 9 other metals-arsenic, cobalt, chromium, copper, mercury, molybdenum, lead, tin, and vanadium--in relation to young-onset breast cancer (diagnosis age <50 years), which tends to be more aggressive than and have a different risk profile from later-onset disease. Recent metal exposure was measured by assessing element concentrations, via inductively coupled plasma mass spectrometry, in toenail clippings of 1,217 disease-discordant sister pairs in the US-based Sister (2003-2009) and Two Sister (2008-2010) studies. Conditional logistic regression was used to calculate odds ratios and 95% confidence intervals. After correcting for differential calendar time of sample collection, no statistically significant associations were observed between any metals and breast cancer. Vanadium had the largest odds ratio (for fourth vs. first quartile, odds ratio = 1.36, 95% confidence interval: 0.84, 2.21; P for trend = 0.17). Cadmium was associated with a small increase in risk, with no evidence of a dose-response relationship (for fourth vs. first quartile, odds ratio = 1.15, 95% confidence interval: 0.82, 1.60; P for trend = 0.67). Positive associations between urinary cadmium concentrations and breast cancer have been reported in case-control studies, but we observed no such association between young-onset breast cancer and toenail concentrations of any assessed metals.


breast cancer; cadmium; metals; toenails; young-onset breast cancer

[Available on 2020-04-01]

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