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• References - Air Pollution

  1. International Agency for Research on Cancer. IARC Monographs on the Identification of Carcinogenic Hazards to Humans https://monographs.iarc.who.int/list-of-classifications/ (accessed October 23, 2024).
  2. Office for Health Improvements and Disparities. Air pollution: applying All Our Health 2022. https://www.gov.uk/government/publications/air-pollution-applying-all-our-health/air-pollution-applying-all-our-health (accessed October 23, 2024).
  3. Praud D, Deygas F, Amadou A, Bouilly M, Turati F, Bravi F, et al. Traffic-Related Air Pollution and Breast Cancer Risk: A Systematic Review and Meta-Analysis of Observational Studies. Cancers (Basel) 2023;3:15. https://doi.org/10.3390/cancers15030927.
  4. Gabet S, Lemarchand C, Guénel P, Slama R. Breast Cancer Risk in Association with Atmospheric Pollution Exposure: A Meta-Analysis of Effect Estimates Followed by a Health Impact Assessment. Environ Health Perspect 2024;129:057012. https://doi.org/10.1289/EHP8419.
  5. White AJ, Bradshaw PT, Hamra GB. Air Pollution and Breast Cancer: a Review. Curr Epidemiol Rep 2018;5:92–100. https://doi.org/10.1007/s40471-018-0143-2.
  6. Smotherman C, Sprague B, Datta S, Braithwaite D, Qin H, Yaghjyan L. Association of air pollution with postmenopausal breast cancer risk in UK Biobank. Breast Cancer Research 2023;25:83. https://doi.org/10.1186/s13058-023-01681-w.
  7. Amadou A, Praud D, Coudon T, Deygas F, Grassot L, Faure E, et al. Risk of breast cancer associated with long-term exposure to benzo[a]pyrene (BaP) air pollution: Evidence from the French E3N cohort study. Environ Int 2021;149:106399. https://doi.org/10.1016/j.envint.2021.106399.
  8. Madrigal JM, Pruitt CN, Fisher JA, Liao LM, Graubard BI, Gierach GL, et al. Carcinogenic industrial air pollution and postmenopausal breast cancer risk in the National Institutes of Health AARP Diet and Health Study. Environ Int 2024;191:108985. https://doi.org/10.1016/j.envint.2024.108985.
  9. Rhee J, Medgyesi DN, Fisher JA, White AJ, Sampson JN, Sandler DP, et al. Residential proximity to dioxin emissions and risk of breast cancer in the sister study cohort. Environ Res 2023;222:115297. https://doi.org/10.1016/j.envres.2023.115297.
  10. Darbre PD. Overview of air pollution and endocrine disorders. Int J Gen Med 2018;11:191–207. https://doi.org/10.2147/IJGM.S102230.

• References - Alcohol

  [1] Drinkaware. What is alcohol? Ingredients, chemicals and manufacture 2023. https://www.drinkaware.co.uk/facts/information-about-alcohol/alcohol-and-the-facts/what-is-alcohol-ingredients-chemicals-and-manufacture (accessed August 6, 2025). 

  ​[2] International Agency for Research on Cancer. Alcohol Drinking. IARC Monographs on the Evaluation of the Carcinogenic Risks to Humans 1988;44. https://publications.iarc.who.int/Book-And-Report-Series/Iarc-Monographs-On-The-Identification-Of-Carcinogenic-Hazards-To-Humans/Alcohol-Drinking-1988

  ​[3] NHS. Alcohol units 2024. https://www.nhs.uk/live-well/alcohol-advice/calculating-alcohol-units/ (accessed August 6, 2025). 

  ​[4] Drinkaware. What is an alcohol unit? 2023. https://www.drinkaware.co.uk/facts/information-about-alcohol/alcoholic-drinks-and-units/what-is-an-alcohol-unit/ (accessed August 6, 2025). 

  ​[5] UK Chief Medical Officers. UK Chief Medical Officers’ Low Risk Drinking Guidelines 2016. https://assets.publishing.service.gov.uk/media/5a80b7ed40f0b623026951db/UK_CMOs__report.pdf (accessed August 6, 2025). 

  ​[6] Cancer Research UK. How does alcohol cause cancer? 2023. https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/alcohol-and-cancer/how-does-alcohol-cause-cancer#alcoholrefs0 (accessed August 6, 2025). 

  ​[7] Rumgay H, Shield K, Charvat H, Ferrari P, Sornpaisarn B, Obot I, et al. Global burden of cancer in 2020 attributable to alcohol consumption: a population-based study. Lancet Oncol 2021;22:1071–80. https://doi.org/10.1016/S1470-2045(21)00279-5. 

  ​[8] Brown KF, Rumgay H, Dunlop C, Ryan M, Quartly F, Cox A, et al. The fraction of cancer attributable to modifiable risk factors in England, Wales, Scotland, Northern Ireland, and the United Kingdom in 2015. Br J Cancer 2018;118:1130–41. https://doi.org/10.1038/s41416-018-0029-6. 

  ​[9] Sohi I, Rehm J, Saab M, Virmani L, Franklin A, Sánchez G, et al. Alcoholic beverage consumption and female breast cancer risk: A systematic review and meta‐analysis of prospective cohort studies. Alcohol, Clinical and Experimental Research 2024;48:2222–41. https://doi.org/10.1111/acer.15493. 

  ​[10] World Cancer Research Fund/ American Institute for Cancer Research. Alcoholic drinks and the risk of cancer. Continuous Project Expert Report 2018. https://www.wcrf.org/wp-content/uploads/2024/10/Alcoholic-Drinks.pdf

  ​[11] Sun Q, Xie W, Wang Y, Chong F, Song M, Li T, et al. Alcohol Consumption by Beverage Type and Risk of Breast Cancer: A Dose-Response Meta-Analysis of Prospective Cohort Studies. Alcohol and Alcoholism 2020;55:246–53. https://doi.org/10.1093/alcalc/agaa012. 

  ​[12] Mostofsky E, Lee I-M, Buring JE, Mukamal KJ. Impact of Alcohol Consumption on Breast Cancer Incidence and Mortality: The Women’s Health Study. J Womens Health 2024;33:705–14. https://doi.org/10.1089/jwh.2023.1021. 

  ​[13] Shield KD, Soerjomataram I, Rehm J. Alcohol Use and Breast Cancer: A Critical Review. Alcohol Clin Exp Res 2016;40:1166–81. https://doi.org/10.1111/acer.13071. 

  ​[14] Coles CE, Earl H, Anderson BO, Barrios CH, Bienz M, Bliss JM, et al. The Lancet Breast Cancer Commission. The Lancet 2024;403:1895–950. https://doi.org/10.1016/S0140-6736(24)00747-5. 

  ​[15] World Cancer Research Fund/ American Institute for Cancer Research. Diet, Nutrition, Physical Activity and Cancer: a Global Perspective. Continuous Update Project Report 2018. https://www.wcrf.org/wp-content/uploads/2024/11/Summary-of-Third-Expert-Report-2018.pdf

  ​[16] Sánchez-Bayona R, Gea A, Gardeazabal I, Romanos-Nanclares A, Martínez-González MÁ, Bes-Rastrollo M, et al. Binge Drinking and Risk of Breast Cancer: Results from the SUN (‘Seguimiento Universidad de Navarra’) Project. Nutrients 2020;12:731. https://doi.org/10.3390/nu12030731. 

  ​[17] Cook MB, Guénel P, Gapstur SM, van den Brandt PA, Michels KB, Casagrande JT, et al. Tobacco and Alcohol in Relation to Male Breast Cancer: An Analysis of the Male Breast Cancer Pooling Project Consortium. Cancer Epidemiology, Biomarkers & Prevention 2015;24:520–31. https://doi.org/10.1158/1055-9965.EPI-14-1009. 

  ​[18] Guénel P, Cyr D, Sabroe S, Lynge E, Merletti F, Ahrens W, et al. Alcohol Drinking May Increase Risk of Breast Cancer in Men: A European Population-Based Case–Control Study. Cancer Causes & Control 2004;15:571–80. https://doi.org/10.1023/B:CACO.0000036154.18162.43. 

  ​[19] Rumgay H, Murphy N, Ferrari P, Soerjomataram I. Alcohol and Cancer: Epidemiology and Biological Mechanisms. Nutrients 2021;13:3173. https://doi.org/10.3390/nu13093173. 

  ​[20] NHS. Calories in alcohol 2023. https://www.nhs.uk/live-well/alcohol-advice/calories-in-alcohol/ (accessed August 6, 2025). 

  ​[21] Voevodina O, Billich C, Arand B, Nagel G. Association of Mediterranean diet, dietary supplements and alcohol consumption with breast density among women in South Germany: a cross-sectional study. BMC Public Health 2013;13:203. https://doi.org/10.1186/1471-2458-13-203. 

  ​[22] Freudenheim JL. Alcohol’s Effects on Breast Cancer in Women. Alcohol Res 2020;40. https://doi.org/10.35946/arcr.v40.2.11.

• References - Bisphenols

  1. European Chemicals Agency. Bisphenols https://echa.europa.eu/hot-topics/bisphenols (accessed June 17, 2024).
  2. Vandenberg LN, Chahoud I, Heindel JJ, Padmanabhan V, Paumgartten FJR, Schoenfelder G. Urinary, Circulating, and Tissue Biomonitoring Studies Indicate Widespread Exposure to Bisphenol A. Environ Health Perspect 2010;118:1055–70. https://doi.org/10.1289/ehp.0901716.
  3. Gore AC, Chappell VA, Fenton SE, Flaws JA, Nadal A, Prins GS, et al. EDC-2: The Endocrine Society’s Second Scientific Statement on Endocrine-Disrupting Chemicals. Endocr Rev 2015;36:E1–150. https://doi.org/10.1210/er.2015-1010.
  4. Liu G, Cai W, Liu H, Jiang H, Bi Y, Wang H. The Association of Bisphenol A and Phthalates with Risk of Breast Cancer: A Meta-Analysis. Int J Environ Res Public Health 2021;18:2375. https://doi.org/10.3390/ijerph18052375.
  5. Vandenberg LN, Maffini M V, Wadia PR, Sonnenschein C, Rubin BS, Soto AM. Exposure to Environmentally Relevant Doses of the Xenoestrogen Bisphenol-A Alters Development of the Fetal Mouse Mammary Gland. Endocrinology 2007;148:116–27. https://doi.org/10.1210/en.2006-0561.
  6. Liu B, Lu X, Jiang A, Lv Y, Zhang H, Xu B. Influence of maternal endocrine disrupting chemicals exposure on adverse pregnancy outcomes: A systematic review and meta-analysis. Ecotoxicol Environ Saf 2024;270:115851. https://doi.org/10.1016/j.ecoenv.2023.115851.
  7. Guo J, Liu K, Yang J, Su Y. Prenatal exposure to bisphenol A and neonatal health outcomes: A systematic review. Environmental Pollution 2023;335:122295. https://doi.org/10.1016/j.envpol.2023.122295.
  8. Ribeiro CM, Beserra BTS, Silva NG, Lima CL, Rocha PRS, Coelho MS, et al. Exposure to endocrine-disrupting chemicals and anthropometric measures of obesity: a systematic review and meta-analysis. BMJ Open 2020;10:e033509. https://doi.org/10.1136/bmjopen-2019-033509.
  9. Winkler J, Liu P, Phong K, Hinrichs JH, Ataii N, Williams K, et al. Bisphenol A replacement chemicals, BPF and BPS, induce protumorigenic changes in human mammary gland organoid morphology and proteome. Proceedings of the National Academy of Sciences 2022;119:e2115308119. https://doi.org/10.1073/pnas.2115308119.
  10. Algonaiman R, Almutairi AS, Al Zhrani MM, Barakat H. Effects of Prenatal Exposure to Bisphenol A Substitutes, Bisphenol S and Bisphenol F, on Offspring’s Health: Evidence from Epidemiological and Experimental Studies. Biomolecules 2023;13:1616. https://doi.org/10.3390/biom13111616.
  11. Department for Environment Food and Rural Affairs. Rationale for prioritising substances in the UK REACH work programme: 2023 to 2024 2024. https://www.gov.uk/government/publications/uk-reach-rationale-for-priorities/rationale-for-prioritising-substances-in-the-uk-reach-work-programme-2023-to-2024 (accessed June 17, 2024).
  12. EFSA Panel on Food Contact Materials E and PA (CEP), Lambré C, Barat Baviera JM, Bolognesi C, Chesson A, Cocconcelli PS, et al. Re-evaluation of the risks to public health related to the presence of bisphenol A (BPA) in foodstuffs. EFSA Journal 2023;21:e06857. https://doi.org/10.2903/j.efsa.2023.6857.

• References - Breastfeeding

  1. Stordal B. (2022). Breastfeeding reduces the risk of breast cancer: A call for action in high-income countries with low rates of breastfeeding. Cancer medicine, 10.1002/cam4.5288. Advance online publication. https://doi.org/10.1002/cam4.5288
  2. UNICEF. Breastfeeding in the UK. https://www.unicef.org.uk/babyfriendly/about/breastfeeding-in-the-uk/ (Accessed 08/11/2022)
  3. NHS. Infant Feeding Survey - UK, 2010. https://digital.nhs.uk/data-and-information/publications/statistical/infant-feeding-survey/infant-feeding-survey-uk-2010 (Accessed 08/11/2022)
  4. NHS. NHS Maternity Statistics, England - 2020-21. https://digital.nhs.uk/data-and-information/publications/statistical/nhs-maternity-statistics/2020-21 (Accessed 08/11/2022)
  5. NHS. Your breastfeeding questions answered. https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/breastfeeding/your-questions-answered/ (Accessed 08/11/2022)
  6. WHO. Exclusive breastfeeding for six months best for babies everywhere. https://www.who.int/news/item/15-01-2011-exclusive-breastfeeding-for-six-months-best-for-babies-everywhere (Accessed 08/11/2022)

• References - Childhood and teenage years

  1. Emmanuel Mickey, Bokor Brooke R. Tanner Stages. StatPearls 2022. https://www.ncbi.nlm.nih.gov/books/NBK470280/ (accessed October 11, 2023)
  2. Hamajima N, Hirose K, Tajima K, Rohan T, Friedenreich CM, Calle EE, et al. Menarche, menopause, and breast cancer risk: Individual participant meta-analysis, including 118 964 women with breast cancer from 117 epidemiological studies. Lancet Oncol 2012;13:1141–51. https://doi.org/10.1016/S1470-2045(12)70425-4.
  3. Eckert-Lind C, Busch AS, Petersen JH, Biro FM, Butler G, Bräuner E V., et al. Worldwide Secular Trends in Age at Pubertal Onset Assessed by Breast Development Among Girls: A Systematic Review and Meta-analysis. JAMA Pediatr 2020;174:e195881–e195881. https://doi.org/10.1001/JAMAPEDIATRICS.2019.5881.
  4. Lee JE, Jung HW, Lee YJ, Lee YA. Early-life exposure to endocrine-disrupting chemicals and pubertal development in girls. Ann Pediatr Endocrinol Metab 2019;24:78. https://doi.org/10.6065/APEM.2019.24.2.78.
  5. Cancer Research UK. Breast cancer risk. Oral contraceptives https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/breast-cancer/risk-factors#heading-Four (accessed May 17, 2024).
  6. Fitzpatrick D, Pirie K, Reeves G, Green J, Beral V. Combined and progestagen-only hormonal contraceptives and breast cancer risk: A UK nested case–control study and meta-analysis. PLoS Med 2023;20:e1004188-. https://doi.org/10.1371/journal.pmed.1004188.
  7. Kim JH, Moon N, Ji E, Moon HB. Effects of postnatal exposure to phthalate, bisphenol a, triclosan, parabens, and per- and poly-fluoroalkyl substances on maternal postpartum depression and infant neurodevelopment: a Korean mother-infant pair cohort study. Environmental Science and Pollution Research 2023;30:96384–99. https://doi.org/10.1007/s11356-023-29292-0.
  8. Hatzidaki E, Pagkalou M, Katsikantami I, Vakonaki E, Kavvalakis M, Tsatsakis AM, et al. Endocrine-Disrupting Chemicals and Persistent Organic Pollutants in Infant Formulas and Baby Food: Legislation and Risk Assessments. Foods 2023;12:1697. https://doi.org/10.3390/foods12081697.
  9. O’Shaughnessy KL, Fischer F, Zenclussen AC. Perinatal exposure to endocrine disrupting chemicals and neurodevelopment: How articles of daily use influence the development of our children. Best Pract Res Clin Endocrinol Metab 2021;35. https://doi.org/10.1016/j.beem.2021.101568.

• References - Diet

  1. Farvid MS, Chen WY, Rosner BA, Tamimi RM, Willett WC, Eliassen AH. Fruit and vegetable consumption and breast cancer incidence: Repeated measures over 30 years of follow-up. Int J Cancer 2018;144:1496. https://doi.org/10.1002/IJC.31653.
  2. Farvid MS, Barnett JB, Spence ND. Fruit and vegetable consumption and incident breast cancer: a systematic review and meta-analysis of prospective studies. Br J Cancer 2021;125:284. https://doi.org/10.1038/S41416-021-01373-2.
  3. AICR, WCRF. Diet, nutrition, physical activity and breast cancer: a global perspective. Continuous Update Project Report 2018. https://www.wcrf.org/wp-content/uploads/2024/10/Breast-cancer-report.pdf 
  4. Dehnavi MK, Ebrahimpour-Koujan S, Lotfi K, Azadbakht L. The Association between Circulating Carotenoids and Risk of Breast Cancer: A Systematic Review and Dose–Response Meta-Analysis of Prospective Studies. Advances in Nutrition 2024;15. https://doi.org/10.1016/j.advnut.2023.10.007.
  5. Harvard Health. The Nutrition Source - Carbohydrates n.d. https://nutritionsource.hsph.harvard.edu/carbohydrates/ (accessed August 5, 2025).
  6. Ubago-Guisado E, Rodríguez-Barranco M, Ching-López A, Petrova D, Molina-Montes E, Amiano P, et al. Evidence update on the relationship between diet and the most common cancers from the european prospective investigation into cancer and nutrition (Epic) study: A systematic review. Nutrients 2021;13:3582. https://doi.org/10.3390/NU13103582/S1.
  7. Nielsen TG, Olsen A, Christensen J, Overvad K, Tjønneland A. Dietary carbohydrate intake is not associated with the breast cancer incidence rate ratio in postmenopausal Danish women. Journal of Nutrition 2005;135:124–8. https://doi.org/10.1093/jn/135.1.124.
  8. Romieu I, Ferrari P, Rinaldi S, Slimani N, Jenab M, Olsen A, et al. Dietary glycemic index and glycemic load and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC). American Journal of Clinical Nutrition 2012;96:345–55. https://doi.org/10.3945/ajcn.111.026724.
  9. Debras C, Chazelas E, Srour B, Kesse-Guyot E, Julia C, Zelek L, et al. Total and added sugar intakes, sugar types, and cancer risk: Results from the prospective NutriNet-Santé cohort. American Journal of Clinical Nutrition 2020;112:1267–79. https://doi.org/10.1093/ajcn/nqaa246.
  10. Pomares-Millan H, Saxby SM, Al-Mashadi Dahl S, Karagas MR, Passarelli MN. Dietary Glycemic Index, Glycemic Load, Sugar, and Fiber Intake in Association with Breast Cancer Risk: An Updated Meta-analysis. Nutr Rev 2025;83:1171–82. https://doi.org/10.1093/NUTRIT/NUAF038,.
  11. Farvid MS, Spence ND, Holmes MD, Barnett JB. Fiber consumption and breast cancer incidence: A systematic review and meta-analysis of prospective studies. Cancer 2020;126:3061–75. https://doi.org/10.1002/CNCR.32816,.
  12. NHS. Facts about fat n.d. https://www.nhs.uk/live-well/eat-well/food-types/different-fats-nutrition/ (accessed August 6, 2025).
  13. Hanson S, Thorpe G, Winstanley L, Abdelhamid AS, Hooper L, Abdelhamid A, et al. Omega-3, omega-6 and total dietary polyunsaturated fat on cancer incidence: systematic review and meta-analysis of randomised trials. Br J Cancer 2020;122:1260. https://doi.org/10.1038/S41416-020-0761-6.
  14. Buja A, Pierbon M, Lago L, Grotto G, Baldo V. Breast cancer primary prevention and diet: An umbrella review. Int J Environ Res Public Health 2020;17:1–54. https://doi.org/10.3390/IJERPH17134731,.
  15. Wolk A. Potential health hazards of eating red meat. J Intern Med 2017;281:106–22. https://doi.org/10.1111/JOIM.12543,.
  16. Rezaianzadeh A, Ghorbani M, Rezaeian S, Kassani A. Red Meat Consumption and Breast Cancer Risk in Premenopausal Women: A Systematic Review and Meta-Analysis. Middle East J Cancer 2018;9:5–12. https://mejc.sums.ac.ir/article_42096_40e4971f3cfa0d1e3463f9eab76199ba.pdf 
  17. NHS. Meat in your diet 2024. https://www.nhs.uk/live-well/eat-well/food-types/meat-nutrition/ (accessed August 21, 2025).
  18. Huang Y, Cao D, Chen Z, Chen B, Li J, Guo J, et al. Red and processed meat consumption and cancer outcomes: Umbrella review. Food Chem 2021;356. https://doi.org/10.1016/j.foodchem.2021.129697.
  19. World Cancer Research Fund. Limit consumption of red and processed meat | Recommendation evidence n.d. https://www.wcrf.org/research-policy/evidence-for-our-recommendations/limit-red-processed-meat/ (accessed August 19, 2025).
  20. Scott Livingston A, Cudhea F, Wang L, Martinez Steele E, Du M, Claire Wang Y, et al. Effect of reducing ultraprocessed food consumption on obesity among US children and adolescents aged 7-18 years: evidence from a simulation model - Supplemental Materials Supplemental Text. BMJ Nutr Prev Health 2021;0. https://doi.org/10.1136/bmjnph-2021-000303.
  21. Lane MM, Gamage E, Du S, Ashtree DN, McGuinness AJ, Gauci S, et al. Ultra-processed food exposure and adverse health outcomes: umbrella review of epidemiological meta-analyses. BMJ 2024;384. https://doi.org/10.1136/BMJ-2023-077310.
  22. Fiolet T, Srour B, Sellem L, Kesse-Guyot E, Allès B, Méjean C, et al. Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort. BMJ 2018;360:322. https://doi.org/10.1136/BMJ.K322.
  23. Shu L, Zhang X, Zhu Q, Lv X, Si C. Association between ultra-processed food consumption and risk of breast cancer: a systematic review and dose-response meta-analysis of observational studies. Front Nutr 2023;10:1250361. https://doi.org/10.3389/FNUT.2023.1250361/FULL.
  24. Chang K, Gunter MJ, Rauber F, Levy RB, Huybrechts I, Kliemann N, et al. Ultra-processed food consumption, cancer risk and cancer mortality: a large-scale prospective analysis within the UK Biobank. EClinicalMedicine 2023;56:101840. https://doi.org/10.1016/j.eclinm.2023.101840.
  25. Godos J, Tieri M, Ghelfi F, Titta L, Marventano S, Lafranconi A, et al. Dairy foods and health: an umbrella review of observational studies. Int J Food Sci Nutr 2020;71:138–51. https://doi.org/10.1080/09637486.2019.1625035,.
  26. Savaiano DA, Hutkins RW. Yogurt, cultured fermented milk, and health: A systematic review. Nutr Rev 2021;79:599–614. https://doi.org/10.1093/NUTRIT/NUAA013,.
  27. Wei Y, Lv J, Guo Y, Bian Z, Gao M, Du H, et al. Soy intake and breast cancer risk: a prospective study of 300,000 Chinese women and a dose–response meta-analysis. Eur J Epidemiol 2020;35:567–78. https://doi.org/10.1007/S10654-019-00585-4,.
  28. Kazemi A, Barati-Boldaji R, Soltani S, Mohammadipoor N, Esmaeilinezhad Z, Clark CCT, et al. Intake of various food groups and risk of breast cancer: A systematic review and dose-response meta-analysis of prospective studies. Advances in Nutrition 2021;12:809–49. https://doi.org/10.1093/advances/nmaa147.
  29. Boutas I, Kontogeorgi A, Dimitrakakis C, Kalantaridou SN. Soy Isoflavones and Breast Cancer Risk: A Meta-analysis. In Vivo 2022;36:556–62. https://doi.org/10.21873/INVIVO.12737,.
  30. Messina M, McCaskill-Stevens W, Lampe JW. Addressing the soy and breast cancer relationship: Review, commentary, and workshop proceedings. J Natl Cancer Inst 2006;98:1275–84. https://doi.org/10.1093/JNCI/DJJ356,.
  31. Harvard Health. The Nutrition Source - Straight Talk About Soy n.d. https://nutritionsource.hsph.harvard.edu/soy/ (accessed August 7, 2025).
  32. World Health Organisation (WHO). Health Topics - Micronutrients n.d. https://www.who.int/health-topics/micronutrients#tab=tab_1 (accessed August 8, 2025).
  33. Mokbel K, Mokbel K. Chemoprevention of Breast Cancer With Vitamins and Micronutrients: A Concise Review. In Vivo 2019;33:983. https://doi.org/10.21873/INVIVO.11568.
  34. Lopes CM, Dourado A, Oliveira R. Phytotherapy and Nutritional Supplements on Breast Cancer. Biomed Res Int 2017;2017. https://doi.org/10.1155/2017/7207983,.
  35. Forma A, Grunwald A, Zembala P, Januszewski J, Brachet A, Zembala R, et al. Micronutrient Status and Breast Cancer: A Narrative Review. Int J Mol Sci 2024;25:4968. https://doi.org/10.3390/IJMS25094968.
  36. World Cancer Research Fund (WCRF). Do not use supplements for cancer prevention | Recommendation evidence n.d. https://www.wcrf.org/research-policy/evidence-for-our-recommendations/supplements/ (accessed August 8, 2025).
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• References - Endocrine Disrupting Chemicals (EDCs)

  1. Hiller-Sturmhöfel S, Bartke A. The Endocrine System: An Overview. Alcohol Health Res World 1998;22:153–64. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761896/.
  2. Nounu A, Kar SP, Relton CL, Richmond RC. Sex steroid hormones and risk of breast cancer: a two-sample Mendelian randomization study. Breast Cancer Research 2022;24. https://doi.org/10.1186/s13058-022-01553-9.
  3. Trabert B, Sherman ME, Kannan N, Stanczyk FZ. Progesterone and breast cancer. Endocr Rev 2019;41. https://doi.org/10.1210/endrev/bnz001.
  4. Gore AC, Chappell VA, Fenton SE, Flaws JA, Nadal A, Prins GS, et al. EDC-2: The Endocrine Society’s Second Scientific Statement on Endocrine-Disrupting Chemicals. Endocr Rev 2015;36:1–150. https://doi.org/10.1210/er.2015-1010.
  5. Kay JE, Cardona B, Rudel RA, Vandenberg LN, Soto AM, Christiansen S, et al. Chemical Effects on Breast Development, Function, and Cancer Risk: Existing Knowledge and New Opportunities. Curr Environ Health Rep 2022;9:535–62. https://doi.org/10.1007/s40572-022-00376-2.
  6. Howdeshell KL, Hotchkiss AK, Gray LE. Cumulative effects of antiandrogenic chemical mixtures and their relevance to human health risk assessment. Int J Hyg Environ Health 2017;220:179–88. https://doi.org/10.1016/j.ijheh.2016.11.007.

• References - Exercise

  1. WHO (2022). Factsheet - Physical Activity. 5 October 2022. https://www.who.int/news-room/fact-sheets/detail/physical-activity (accessed April 24, 2024)  
  2. WCRF/AICR (2022). Worldwide cancer data. Global cancer statistics for the most common cancers https://www.wcrf.org/cancer-trends/worldwide-cancer-data/ (accessed April 24, 2024)  
  3. BCUK brief Breast Cancer Risk Factors https://cdn.breastcanceruk.org.uk/uploads/2019/08/BCUK_Breast_cancer_risk_factors_brief_v1._12.6.2019.pdf (accessed Oct 4, 2020)   
  4. GOV.UK (2019). Physical Activity guidelines: Physical activity for adults and older adults: 19 years and over. https://www.gov.uk/government/publications/physical-activity-guidelines-infographics (accessed Oct 5, 2020)  
  5. Chan, D. S. M. et al. (2019). WCRF International: Continuous Update Project-Systematic literature review and meta-analysis of observational cohort studies on physical activity, sedentary behavior, adiposity, and weight change and breast cancer risk. Cancer Causes & Control 30: 1183-1200.  https://link.springer.com/article/10.1007/s10552-019-01223-w (accessed Oct 5, 2020)  
  6. Matthews, C. E. et al. (2019). Amount and Intensity of Leisure-Time Physical Activity and Lower Cancer Risk. Journal of Clinical Oncology 38(7): 686-697. https://pubmed.ncbi.nlm.nih.gov/31877085/  
  7. Friedenreich, C. M. et al. (2015). Effects of a High vs Moderate Volume of Aerobic Exercise on Adiposity Outcomes in Postmenopausal Women: A Randomized Clinical Trial. JAMA Oncology 1(6): 766-776. https://pubmed.ncbi.nlm.nih.gov/26181634/  
  8. Guo, W. et al. (2020). Physical Activity and Breast Cancer Risk: Results from the UK Biobank Prospective Cohort. British Journal of Cancer 122: 726-732. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7054300/
  9. Hardefeldt, P. J. et al. (2018). Physical Activity and Weight Loss Reduce the Risk of Breast Cancer: A Meta-analysis of 139 Prospective and Retrospective Studies. Clinical Breast Cancer 18(4): e601-e612. https://pubmed.ncbi.nlm.nih.gov/29223719/  
  10. Kehm, R. D. et al. (2020). Recreational Physical Activity Is Associated with Reduced Breast Cancer Risk in Adult Women at High Risk for Breast Cancer: A Cohort Study of Women Selected for Familial and Genetic Risk. Cancer Research 80(1). https://cancerres.aacrjournals.org/content/80/1/116  
  11. Friedenreich, C. M. et al. (2021). Physical activity, obesity and sedentary behavior in cancer etiology: epidemiologic evidence and biologic mechanisms. Molecular Oncology 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7931121/
  12. NHS England. Benefits of exercise. https://www.nhs.uk/live-well/exercise/exercise-health-benefits/  (accessed Oct 5, 2020).  
  13. Brinton, L. A. (2008). Prospective Evaluation of Risk Factors for Male Breast Cancer. Journal of the National Cancer Institute 100(20): 1477-81. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2720728/ 
  14. WCRF/AICR (2018). Continuous Update Project Expert Report 2018 Physical Activity and Risk of Cancer. Available at https://www.wcrf.org/wp-content/uploads/2021/02/Physical-activity.pdf (accessed Oct 5, 2020)  
  15. Lahart, I. M. et al. (2015). Physical activity, risk of death and recurrence in breast cancer survivors: A systematic review and meta-analysis of epidemiological studies. Acta Oncologica 54 2015 5. https://www.tandfonline.com/doi/full/10.3109/0284186X.2014.998275  (accessed Oct 5, 2020)  
  16. Lee, J. (2018). A Meta-analysis of the Association between Physical Activity and Breast Cancer Mortality. Cancer Nursing 42: 271-285. https://pubmed.ncbi.nlm.nih.gov/29601358/  
  17. Spei,M.-E. et al (2019). Physical Activity in Breast Cancer Survivors: A Systematic Review and Meta-analysis on overall and Breast Cancer Survival. The Breast (2019): 144-152. https://www.sciencedirect.com/science/article/pii/S0960977619300207
  18. Travis, R. C. and Key, T. J. (2003). Oestrogen exposure and breast cancer risk. Breast Cancer Research 5: 239-247. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC314432/
  19. Thomas, H. V. et al (1997). Re: Reversal of Relation Between Body Mass and Endogenous Estrogen Concentrations With Menopausal Status. Journal of the National Cancer Institute, Vol. 89(9): 661-662. https://pubmed.ncbi.nlm.nih.gov/9060964/  
  20. Ennour-Idrissi, K. et al (2015). Effect of Physical Activity on sex hormones in women: a systematic review and meta-analysis of randomized controlled trials. Breast Cancer Research 17: 139. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4635995/
  21. Schmidt, S. et al. (2015). The integrative role of leptin, oestrogen and the insulin family in obesity-associated breast cancer: potential effects of exercise. Obesity reviews 16: 473–487. https://www.ncbi.nlm.nih.gov/pubmed/25875578  
  22. NIH. Insulin resistance and pre-diabetes https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance (accessed Oct 6, 2020)  
  23. Quail, D. F. and Dannenberg, A. J. (2019). The obese adipose tissue microenvironment in cancer development and progression. Nature Reviews Endocrinology 15: 139-154. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374176/   
  24. Bodai, B. and Nakata, T. E. (2020). Breast Cancer: Lifestyle, the Human Gut Microbiota/Microbiome, and Survivorship. The Permanente Journal 24 (19): 129 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319098/
  25. Lee, Y.-M. et al (2020). Can Habitual Exercise Help Reduce Serum Concentrations of Lipophilic Chemical Mixtures? Association between Physical Activity and Persistent Organic Pollutants. Diabetes Metabolism Journal. 2020 Feb 21. Online ahead of print https://pubmed.ncbi.nlm.nih.gov/32174058/  
  26. BCUK brief Endocrine Disrupting Chemicals https://cdn.breastcanceruk.org.uk/uploads/2019/08/BCUK_EDC_brief_v2_20.9.18.pdf (accessed Oct 5 2020).

• References - FAQs

  Facts and figures:

  1. Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2024;74:229–63. https://doi.org/10.3322/caac.21834.  

  2.  Ferlay J, Ervik M, Laversanne M, Colombet M, Mery L, Piñeros M, et al. Global Cancer Observatory: Cancer Today 2024. International Agency for Research on Cancer 2024. https://gco.iarc.who.int/media/globocan/factsheets/populations/900-world-fact-sheet.pdf (accessed July 8, 2025).  

  3. Xu S, Liu Y, Zhang T, Zheng J, Lin W, Cai J, et al. The Global, Regional, and National Burden and Trends of Breast Cancer From 1990 to 2019: Results From the Global Burden of Disease Study 2019. Front Oncol 2021;11:689562. https://doi.org/10.3389/fonc.2021.689562. 

  4. Cancer Research UK. Breast cancer statistics n.d. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/breast-cancer#heading-Zero (accessed July 8, 2025).  

  5. Cancer Research UK. Breast cancer in men 2023. https://www.cancerresearchuk.org/about-cancer/breast-cancer/types/male-breast-cancer (accessed July 8, 2025).  

  6. Cancer Research UK. Breast cancer incidence by age. Breast Cancer Incidence (Invasive) Statistics 2024. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/breast-cancer/incidence-invasive#heading-One (accessed July 8, 2025).  

  7.  Cancer Research UK. In situ breast carcinoma incidence. Breast Cancer Statistics n.d. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/breast-cancer#breastcs1 (accessed July 8, 2025).  

  8. NHS Digital. Cancer incidence by main cancer group. Cancer Registration Statistics, England, 2022 2024. https://digital.nhs.uk/data-and-information/publications/statistical/cancer-registration-statistics/england-2022/incidence-by-main-cancer-group (accessed July 8, 2025).  

  9. NHS Digital. Cancer incidence by stage. Cancer Registration Statistics, England, 2022 2024. https://digital.nhs.uk/data-and-information/publications/statistical/cancer-registration-statistics/england-2022/incidence-by-stage-at-diagnosis (accessed July 8, 2025).  

  10. Cancer Research UK. Breast cancer incidence trends over time. Breast Cancer Incidence (Invasive) Statistics n.d. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/breast-cancer/incidence-invasive#heading-Two (accessed July 8, 2025).  

  11. NHS Digital. Cancer Incidence by Deprivation Profile. Cancer Registration Statistics, England, 2022 2024. https://digital.nhs.uk/data-and-information/publications/statistical/cancer-registration-statistics/england-2022/incidence-by-deprivation-quintile (accessed July 15, 2025).  

  12. Delon C, Brown KF, Payne NWS, Kotrotsios Y, Vernon S, Shelton J. Differences in cancer incidence by broad ethnic group in England, 2013–2017. Br J Cancer 2022;126:1765–73. https://doi.org/10.1038/s41416-022-01718-5.  

  13.  NHS England. Screening and earlier diagnosis n.d. https://www.england.nhs.uk/cancer/early-diagnosis/screening-and-earlier-diagnosis/ (accessed July 16, 2025).  

  14. Breast Cancer UK. Why we say at least 30% 2024. https://www.breastcanceruk.org.uk/about-breast-cancer-uk/why-do-we-say-at-least-30/ (accessed July 15, 2025).  

  15.  Cancer Research UK. Breast cancer mortality. Breast Cancer Statistics n.d. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/breast-cancer#breastcs2 (accessed July 8, 2025).  

  16.  Office for National Statistics. Deaths registered in England and Wales: 2023 2024. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsregistrationsummarytables/2023#leading-causes-of-death (accessed July 8, 2025).  

  17.  Office for National Statistics. Cancer survival in England – adults diagnosed 2019. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/datasets/cancersurvivalratescancersurvivalinenglandadultsdiagnosed (accessed July 8, 2025).  

  18.  NHS Digital. NHS Breast Screening Programme, England 2020-21. Breast Screening Programme 2022. https://digital.nhs.uk/data-and-information/publications/statistical/breast-screening-programme/england—2020-21 (accessed July 8, 2025).  

  19.  Yoshida R. Hereditary breast and ovarian cancer (HBOC): review of its molecular characteristics, screening, treatment, and prognosis. Breast Cancer 2021;28:1167–80. https://doi.org/10.1007/S12282-020-01148-2.  

  20.  Cancer Research UK. Inherited genes and cancer types 2024. https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/inherited-cancer-genes-and-increased-cancer-risk/inherited-genes-and-cancer-types (accessed July 8, 2025). 

  FAQs:

  About breast cancer 

  Q1. What should I do if I think I have breast cancer? 

  NHS. Test and next steps for breast cancer in women[Internet]. [cited 2023 Jul 20]. Available from:  https://www.nhs.uk/conditions/breast-cancer-in-women/tests-and-next-steps-for-breast-cancer-in-women/ 

  Q2. How is breast cancer diagnosed? 

  NHS. Biopsy overview [Internet]. [cited 2023 Jul 21]. Available from: https://www.nhs.uk/conditions/biopsy/ 

  NHS. New imaging technology improving breast cancer diagnosis [Internet]. 2023 [cited 2023 Jul 21]. Available from: https://www.ncic.nhs.uk/news/new-imaging-technology-improving-breast-cancer-diagnosis 

  NICE. Contrast-enhanced spectral mammography for breast cancer Medtech innovation briefing [Internet]. NICE Guidance. 2022 [cited 2023 Jul 20]. Available from: www.nice.org.uk/guidance/mib304 

  Lifestyle risk factors 

  Q1. Is being overweight or obese a risk factor for breast cancer? 

  Dehesh T, Fadaghi S, Seyedi M, Abolhadi E, Ilaghi M, Shams P, et al. The relation between obesity and breast cancer risk in women by considering menstruation status and geographical variations: a systematic review and meta-analysis. BMC Womens Health 2023;23. https://doi.org/10.1186/S12905-023-02543-5 

  Humphries MP, Jordan VC, Speirs V. Obesity and male breast cancer: Provocative parallels? BMC Med 2015;13:1–9. https://doi.org/10.1186/S12916-015-0380-X 

  Reeves GK, Pirie K, Beral V, Green J, Spencer E, Bull D. Cancer incidence and mortality in relation to body mass index in the Million Women Study: cohort study. BMJ 2007;335:1134–9 https://doi.org/10.1136/bmj.39367.495995.AE 

  Q2. Does being overweight or obese increase the risk of breast cancer in premenopausal women? Bokobza E, Hinault C, Tiroille V, Clavel S, Bost F, Chevalier N. The Adipose Tissue at the Crosstalk Between EDCs and Cancer Development. Front Endocrinol (Lausanne) 2021;12:691658. https://doi.org/10.3389/fendo.2021.691658. 

  Darbre PD. Endocrine Disruptors and Obesity. Curr Obes Rep [Internet]. 2017 [cited 2023 Jul 21];6(1):18–27. Available from: https://pubmed.ncbi.nlm.nih.gov/28205155/ 

  Dehesh T, Fadaghi S, Seyedi M, Abolhadi E, Ilaghi M, Shams P, et al. The relation between obesity and breast cancer risk in women by considering menstruation status and geographical variations: a systematic review and meta-analysis. BMC Womens Health 2023;23. https://doi.org/10.1186/S12905-023-02543-5 

  García-Estévez L, Cortés J, Pérez S, Calvo I, Gallegos I, Moreno-Bueno G. Obesity and Breast Cancer: A Paradoxical and Controversial Relationship Influenced by Menopausal Status. Front Oncol. 2021. 11:705911. https://doi.org/10.3389/fonc.2021.705911 

  Schoemaker MJ, Nichols HB, Wright LB, Brook MN, Jones ME, O’Brien KM, et al. Adult weight change and premenopausal breast cancer risk: A prospective pooled analysis of data from 628,463 women. Int J Cancer [Internet]. 2020 [cited 2023 Jul 21];147(5):1306–14. Available from: https://pubmed.ncbi.nlm.nih.gov/32012248/ 

  Torres-De La Roche LA, Steljes I, Janni W, Friedl TWP, De Wilde RL. The Association between Obesity and Premenopausal Breast Cancer According to Intrinsic Subtypes – a Systematic Review. Geburtshilfe Frauenheilkd [Internet]. 2020 [cited 2023 Jul 21];80(6):601. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7299685/ 

  van den Brandt PA, Ziegler RG, Wang M, Hou T, Li R, Adami HO, et al. Body size and weight change over adulthood and risk of breast cancer by menopausal and hormone receptor status: a pooled analysis of 20 prospective cohort studies. Eur J Epidemiol [Internet]. 2021 [cited 2023 Jul 21];36(1):37–55. Available from: https://pubmed.ncbi.nlm.nih.gov/33128203/ 

  World Health Organization (WHO). Obesity and overweight 2024. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight 

  Q3. Is there a link between eating processed meat and breast cancer? 

  Anderson JJ, Darwis NDM, Mackay DF, Celis-Morales CA, Lyall DM, Sattar N, et al. Red and processed meat consumption and breast cancer: UK Biobank cohort study and meta-analysis. European journal of cancer [Internet]. 2018 [cited 2023 Jul 21];90:73–82. Available from: https://pubmed.ncbi.nlm.nih.gov/29274927/ 

  Diallo A, Deschasaux M, Latino-Martel P, Hercberg S, Galan P, Fassier P, et al. Red and processed meat intake and cancer risk: Results from the prospective NutriNet-Santé cohort study. Int J Cancer [Internet]. 2018 [cited 2023 Jul 21];142(2):230–7. Available from: https://pubmed.ncbi.nlm.nih.gov/28913916/ 

  Farvid MS, Stern MC, Norat T, Sasazuki S, Vineis P, Weijenberg MP, et al. Consumption of red and processed meat and breast cancer incidence: A systematic review and meta-analysis of prospective studies. Int J Cancer [Internet]. 2018 [cited 2023 Jul 21];143(11):2787–99. Available from: https://pubmed.ncbi.nlm.nih.gov/30183083/ 

  Farvid MS, Sidahmed E, Spence ND, Mante Angua K, Rosner BA, Barnett JB. Consumption of red meat and processed meat and cancer incidence: a systematic review and meta-analysis of prospective studies. Eur J Epidemiol [Internet]. 2021 [cited 2023 Jul 21];36(9):937–51. Available from: https://pubmed.ncbi.nlm.nih.gov/34455534/ 

  Q4. Can a healthy diet help to prevent breast cancer? 

  AICR, WCRF. Diet, nutrition, physical activity and breast cancer: a global perspective. Continuous Update Project Report. 2018. https://www.wcrf.org/wp-content/uploads/2021/02/Breast-cancer-report.pdf 

  Atoum M, Alzoughool F. Vitamin D and Breast Cancer: Latest Evidence and Future Steps. Breast Cancer (Auckl) [Internet]. 2017 Dec 19 [cited 2023 Jul 21];11. Available from: https://pubmed.ncbi.nlm.nih.gov/29434472/ 

  British Nutrition Foundation. Fibre [Internet]. [cited 2023 Jul 21]. Available from: https://www.nutrition.org.uk/healthy-sustainable-diets/starchy-foods-sugar-and-fibre/fibre/ 

  British Nutrition Foundation. A healthy, balanced diet [Internet]. [cited 2025 April 24]. Available from: https://www.nutrition.org.uk/creating-a-healthy-diet/a-healthy-balanced-diet/ 

  Farvid MS, Spence ND, Holmes MD, Barnett JB. Fiber consumption and breast cancer incidence: A systematic review and meta-analysis of prospective studies. Cancer [Internet]. 2020 Jul 1 [cited 2023 Jul 21];126(13):3061–75. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/cncr.32816 

  Q5. Does drinking alcohol increase my breast cancer risk? 

  AICR, WCRF. Diet, nutrition, physical activity and breast cancer: a global perspective. Continuous Update Project Report. 2018. https://www.wcrf.org/wp-content/uploads/2021/02/Breast-cancer-report.pdf 

  Freudenheim JL. Alcohol’s Effects on Breast Cancer in Women. Alcohol Res. 2020 Jun 18;40(2):11. https://doi.org/10.35946/arcr.v40.2.11 

  Sohi I, Rehm J, Saab M, Virmani L, Franklin A, Sánchez G, Jhumi M, Irshad A, Shah H, Correia D, Ferrari P, Ferreira-Borges C, Lauby-Secretan B, Galea G, Gapstur S, Neufeld M, Rumgay H, Soerjomataram I, Shield K. Alcoholic beverage consumption and female breast cancer risk: A systematic review and meta-analysis of prospective cohort studies. Alcohol Clin Exp Res (Hoboken). 2024 Dec;48(12):2222-2241. https://doi.org/10.1111/acer.15493 

  Q6. What is the ideal diet to decrease my risk of breast cancer? 

  AICR, WCRF. Diet, nutrition, physical activity and breast cancer: a global perspective. Continuous Update Project Report. 2018. https://www.wcrf.org/wp-content/uploads/2021/02/Breast-cancer-report.pdf 

  Kazemi A, Barati-Boldaji R, Soltani S, Mohammadipoor N, Esmaeilinezhad Z, Clark CCT, Babajafari S, Akbarzadeh M. Intake of Various Food Groups and Risk of Breast Cancer: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies. Adv Nutr. 2021 Jun 1;12(3):809-849. https://doi.org/10.1093/advances/nmaa147 

  Xiao Y, Xia J, Li L, Ke Y, Cheng J, Xie Y, et al. Associations between dietary patterns and the risk of breast cancer: A systematic review and meta-analysis of observational studies. Breast Cancer Research [Internet]. 2019 Jan 29 [cited 2023 Jul 21];21(1):1–22. Available from: https://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-019-1096-1 

  Q7. Does eating a vegan or vegetarian diet decrease breast cancer risk? 

  AICR, WCRF. Diet, nutrition, physical activity and breast cancer: a global perspective. Continuous Update Project Report. 2018. https://www.wcrf.org/wp-content/uploads/2021/02/Breast-cancer-report.pdf 

  Gathani T, Barnes I, Ali R, Arumugham R, Chacko R, Digumarti R, et al. Lifelong vegetarianism and breast cancer risk: A large multicentre case control study in India. BMC Womens Health [Internet]. 2017 Jan 18 [cited 2023 Jul 21];17(1):1–6. Available from: https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-016-0357-8 

  Rigi S, Mousavi SM, Benisi-Kohansal S, Azadbakht L, Esmaillzadeh A. The association between plant-based dietary patterns and risk of breast cancer: a case–control study. Scientific Reports 2021 11:1 [Internet]. 2021 Feb 9 [cited 2023 Jul 21];11(1):1–10. Available from: https://www.nature.com/articles/s41598-021-82659-6 

  Romanos-Nanclares A, Willett WC, Rosner BA, Collins LC, Hu FB, Toledo E, et al. Healthful and unhealthful plant-based diets and risk of breast cancer in U.S. women: Results from the nurses’ health studies. Cancer Epidemiology Biomarkers and Prevention [Internet]. 2021 Oct 1 [cited 2023 Jul 21];30(10):1921–31. Available from: https://dx.doi.org/10.1158/1055-9965.EPI-21-0352 

  World Cancer Research Fund. Healthy Living. 2023 [cited 2023 Jul 21]. Are plant-based meat alternatives better for us? Available from: https://www.wcrf-uk.org/our-blog/are-plant-based-meat-alternatives-better-for-us/ 

  Q8. Does eating organic food decrease my risk of getting breast cancer? 

  Bradbury KE, Balkwill A, Spencer EA, Roddam AW, Reeves GK, Green J, et al. Organic food consumption and the incidence of cancer in a large prospective study of women in the United Kingdom. Br J Cancer [Internet]. 2014 Mar 27 [cited 2023 Jul 21];110(9):2321–6. Available from: https://www.nature.com/articles/bjc2014148 

  Baudry J, Assmann KE, Touvier M, Allès B, Seconda L, Latino-Martel P, et al. Association of Frequency of Organic Food Consumption With Cancer Risk: Findings From the NutriNet-Santé Prospective Cohort Study. JAMA Intern Med 2018;178:1597–606. https://doi.org/10.1001/jamainternmed.2018.4357. 

  Park YMM, White A, Niehoff N, O’Brien K, Sandler D. Association Between Organic Food Consumption and Breast Cancer Risk: Findings from the Sister Study (P18-038-19). Curr Dev Nutr. 2019 Jun 1;3:nzz039.P1818-038-19. https://doi.org/10.1093/cdn/nzz039.P18-038-19 

  Rebouillat P, Vidal R, Cravedi JP, Taupier-Letage B, Debrauwer L, Gamet-Payrastre L, et al. Prospective association between dietary pesticide exposure profiles and postmenopausal breast-cancer risk in the NutriNet-Santé cohort. Int J Epidemiol [Internet]. 2021 Aug 1 [cited 2023 Jul 21];50(4):1184–98. Available from: https://pubmed.ncbi.nlm.nih.gov/33720364/ 

  Stur E, Aristizabal-Pachon AF, Peronni KC, Agostini LP, Waigel S, Chariker J, et al. Glyphosate-based herbicides at low doses affect canonical pathways in estrogen positive and negative breast cancer cell lines. PLoS One [Internet]. 2019 Jul 1 [cited 2023 Jul 21];14(7):e0219610. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0219610 

  Yang KJ, Lee J, Park HL. Organophosphate Pesticide Exposure and Breast Cancer Risk: A Rapid Review of Human, Animal, and Cell-Based Studies. Int J Environ Res Public Health [Internet]. 2020 Jul 13 [cited 2023 Jul 21];17(14):5030. Available from: https://www.mdpi.com/1660-4601/17/14/5030/htm 

  Q9. Does drinking cow’s milk increase breast cancer risk? 

  Chen L, Li M, Li H. Milk and yogurt intake and breast cancer risk A meta-analysis. Medicine [Internet]. 2019 [cited 2023 Jul 21];98(12):e14900. Available from: http://dx.doi.org/10.1097/MD.0000000000014900 

  He Y, Tao Q, Zhou F, Si Y, Fu R, Xu B, et al. The relationship between dairy products intake and breast cancer incidence: a meta-analysis of observational studies. BMC Cancer [Internet]. 2021 Oct 15 [cited 2023 Jul 21];21(1):1–12. Available from: https://bmccancer.biomedcentral.com/articles/10.1186/s12885-021-08854-w 

  Jeyaraman MM, Abou-Setta AM, Grant L, Farshidfar F, Copstein L, Lys J, et al. Dairy product consumption and development of cancer: an overview of reviews. BMJ Open [Internet]. 2019 Jan 1 [cited 2023 Jul 21];9(1):e023625. Available from: https://bmjopen.bmj.com/content/9/1/e023625 

  He Y, Tao Q, Zhou F, Si Y, Fu R, Xu B, et al. Diet, insulin-like growth factor-1 and cancer risk. Proceedings of the Nutrition Society [Internet]. 2011 [cited 2023 Jul 21];70(3):385–8. Available from: https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/diet-insulinlike-growth-factor1-and-cancer-risk/DB006BA4B70E896E51DA23BA96A740BB 

  Wu Y, Huang R, Wang M, Bernstein L, Bethea TN, Chen C, et al. Dairy foods, calcium, and risk of breast cancer overall and for subtypes defined by estrogen receptor status: a pooled analysis of 21 cohort studies. Am J Clin Nutr. 2021 Aug 1;114(2):450–61. https://www.sciencedirect.com/science/article/pii/S0002916522003616?via%3Dihub 

  Zang J, Shen M, Du S, Chen T, Zou S. The Association between Dairy Intake and Breast Cancer in Western and Asian Populations: A Systematic Review and Meta-Analysis. J Breast Cancer [Internet]. 2015 Dec 1 [cited 2023 Jul 21];18(4):313–22. Available from: https://pubmed.ncbi.nlm.nih.gov/26770237/ 

  Q10. Can vitamin D supplements reduce my breast cancer risk? 

  Atoum M, Alzoughool F. Vitamin D and Breast Cancer: Latest Evidence and Future Steps. Breast Cancer (Auckl) [Internet]. 2017 Dec 19 [cited 2023 Jul 21];11. Available from: https://pubmed.ncbi.nlm.nih.gov/29434472/ 

  Atoum, M., & Alzoughool, F. (2017). Vitamin D and Breast Cancer: Latest Evidence and Future Steps. Breast cancer : basic and clinical research, 11, 1178223417749816. https://doi.org/10.1177/1178223417749816 

  Li Z, Wu L, Zhang J, Huang X, Thabane L, Li G. Effect of Vitamin D Supplementation on Risk of Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Nutr. 2021 Apr 1;8:655727. https://www.frontiersin.org/articles/10.3389/fnut.2021.655727/full 

  Q11. Does consuming too much sugar increase breast cancer risk? 

  AICR, WCRF. Diet, nutrition, physical activity and breast cancer: a global perspective. Continuous Update Project Report. 2018. https://www.wcrf.org/wp-content/uploads/2021/02/Breast-cancer-report.pdf 

  Debras C, Chazelas E, Srour B, Kesse-Guyot E, Julia C, Zelek L, et al. Total and added sugar intakes, sugar types, and cancer risk: results from the prospective NutriNet-Santé cohort. Am J Clin Nutr. 2020 Nov 1;112(5):1267–79. https://doi.org/10.1093/ajcn/nqaa246 

  Epner M, Yang P, Wagner RW, Cohen L. Understanding the Link between Sugar and Cancer: An Examination of the Preclinical and Clinical Evidence. Cancers (Basel). 2022 Dec 8;14(24):6042. https://doi.org/10.3390/cancers14246042 

  Lu S, Qian Y, Huang X, Yu H, Yang J, Han R, et al. The association of dietary pattern and breast cancer in Jiangsu, China: A population-based case-control study. PLoS One [Internet]. 2017 Sep 1 [cited 2023 Jul 21];12(9):e0184453. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0184453 

  Q12. Does eating products containing artificial sweeteners increase breast cancer risk? 

  Debras C, Chazelas E, Srour B, Druesne-Pecollo N, Esseddik Y, de Edelenyi FS, et al. Artificial sweeteners and cancer risk: Results from the NutriNet-Santé population-based cohort study. PLoS Med [Internet]. 2022 Mar 1 [cited 2023 Jul 21];19(3):e1003950. Available from: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003950 

  Riboli E, Beland FA, Lachenmeier DW, Marques MM, Phillips DH, Schernhammer E, et al. Carcinogenicity of aspartame, methyleugenol, and isoeugenol. Lancet Oncol [Internet]. 2023 Jul [cited 2023 Jul 21];0(0). Available from: http://www.thelancet.com/article/S1470204523003418/fulltext 

  Romanos-Nanclares A, Schernhammer E, Willett WC, Holmes MD, Chen WY, Eliassen AH. Consumption of aspartame and risk of breast cancer in the Nurses’ Health Studies, JNCI: Journal of the National Cancer Institute, Volume 117, Issue 4, April 2025, Pages 795–800, https://doi.org/10.1093/jnci/djae259 

  Yu X, Yu Z, Chen X, Liu M, Yang F, Cheung KCP. Research Progress on the Relationship Between Artificial Sweeteners and Breast Cancer. Biomedicines. 2024 Dec 18;12(12):2871. https://doi.org/10.3390/biomedicines12122871 

  Q13. Can eating soy products increase breast cancer risk? 

  Boutas I, Kontogeorgi A, Dimitrakakis C, Kalantaridou SN. Soy Isoflavones and Breast Cancer Risk: A Meta-analysis. In Vivo [Internet]. 2022 Mar 1 [cited 2023 Jul 21];36(2):556–62. Available from: https://pubmed.ncbi.nlm.nih.gov/35241506/ 

  Kazemi A, Barati-Boldaji R, Soltani S, Mohammadipoor N, Esmaeilinezhad Z, Clark CCT, et al. Intake of Various Food Groups and Risk of Breast Cancer: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies. Advances in Nutrition. 2021 May 1;12(3):809–49. https://doi.org/10.1093/advances/nmaa147 

  Messina M, Mejia SB, Cassidy A, Duncan A, Kurzer M, Nagato C, et al. Neither soyfoods nor isoflavones warrant classification as endocrine disruptors: a technical review of the observational and clinical data. Crit Rev Food Sci Nutr [Internet]. 2022 [cited 2023 Jul 21];62(21):5824–85. Available from: https://pubmed.ncbi.nlm.nih.gov/33775173/ 

  Wei Y, Lv J, Guo Y, Bian Z, Gao M, Du H, et al. Soy intake and breast cancer risk: a prospective study of 300,000 Chinese women and a dose–response meta-analysis. Eur J Epidemiol [Internet]. 2020 Jun 1 [cited 2023 Jul 21];35(6):567–78. Available from: https://link.springer.com/article/10.1007/s10654-019-00585-4 

  Q14. Does physical activity affect my risk of breast cancer? 

  Cannioto RA, Hutson A, Dighe S, McCann W, McCann SE, Zirpoli GR, et al. Physical Activity Before, During, and After Chemotherapy for High-Risk Breast Cancer: Relationships With Survival. JNCI: Journal of the National Cancer Institute [Internet]. 2021 Jan 4 [cited 2023 Jul 21];113(1):54–63. Available from: https://dx.doi.org/10.1093/jnci/djaa046 

  Gonçalves AK, Dantas Florêncio GL, Maissonnete De Atayde Silva MJ, Cobucci RN, Giraldo PC, Cote NM. Effects of physical activity on breast cancer prevention: a systematic review. J Phys Act Health [Internet]. 2014 [cited 2023 Aug 4];11(2):445–54. Available from: https://pubmed.ncbi.nlm.nih.gov/23416687/ 

  Guo W, Fensom GK, Reeves GK, Key TJ. Physical activity and breast cancer risk: results from the UK Biobank prospective cohort. British Journal of Cancer 2020 122:5 [Internet]. 2020 Jan 10 [cited 2023 Aug 4];122(5):726–32. Available from: https://www.nature.com/articles/s41416-019-0700-6 

  Spei ME, Samoli E, Bravi F, La Vecchia C, Bamia C, Benetou V. Physical activity in breast cancer survivors: A systematic review and meta-analysis on overall and breast cancer survival. Breast [Internet]. 2019 Apr 1 [cited 2023 Aug 4];44:144–52. Available from: http://www.thebreastonline.com/article/S0960977619300207/fulltext 

  Xu Y, Rogers CJ. Physical Activity and Breast Cancer Prevention: Possible Role of Immune Mediators. Front Nutr. 2020 Oct 8;7:557997. https://www.frontiersin.org/articles/10.3389/fnut.2020.557997/full 

  World Health Organization (WHO). Physical activity 2024. https://www.who.int/news-room/fact-sheets/detail/physical-activity 

  Q15. Does smoking increase breast cancer risk? 

  Betts K. Breast cancer and smoking: What is the link? https://news.cancerresearchuk.org/2024/07/09/breast-cancer-smoking-link/ (Accessed 7th May 2025) 

  Jones ME, Schoemaker MJ, Wright LB, Ashworth A, Swerdlow AJ. Smoking and risk of breast cancer in the Generations Study cohort. Breast Cancer Res [Internet]. 2017 Nov 22 [cited 2023 Jul 21];19(1). Available from: https://pubmed.ncbi.nlm.nih.gov/29162146/ 

  Park HA, Neumeyer S, Michailidou K, Bolla MK, Wang Q, Dennis J, et al. Mendelian randomisation study of smoking exposure in relation to breast cancer risk. Br J Cancer [Internet]. 2021 Oct 12 [cited 2023 Jul 21];125(8):1135–45. Available from: https://pubmed.ncbi.nlm.nih.gov/34341517/ 

  Scala M, Bosetti C, Bagnardi V, Possenti I, Specchia C, Gallus S, Lugo A. Dose-response Relationships Between Cigarette Smoking and Breast Cancer Risk: A Systematic Review and Meta-analysis. J Epidemiol. 2023 Dec 5;33(12):640-648. https://doi.org/10.2188/jea.JE20220206 

  van den Brandt PA. A possible dual effect of cigarette smoking on the risk of postmenopausal breast cancer. Eur J Epidemiol [Internet]. 2017 Aug 1 [cited 2023 Jul 21];32(8):683–90. Available from: https://pubmed.ncbi.nlm.nih.gov/28710542/ 

  Q16. Does vaping increase breast cancer risk? 

  Cancer Research UK. Is vaping harmful? [Internet]. [cited 2023 Jul 21]. Available from: https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/smoking-and-cancer/is-vaping-harmful 

  National Academies of Sciences Engineering and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice, Committee on the Review of the Health Effects of Electronic Systems Nicotine Delivery. Toxicology of E-Cigarette Constituents. In: Eaton DL, Kwan LY, Stratton K, editors. Public Health Consequences of E-Cigarettes [Internet]. Washington: National Academies Press (US); 2018 [cited 2023 Jul 21]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507171/ 

  Chemicals and the environment 

  Q1. How might exposure to certain chemicals increase breast cancer risk? 

  Gore AC, Chappell VA, Fenton SE, Flaws JA, Nadal A, Prins GS, et al. EDC-2: The Endocrine Society’s Second Scientific Statement on Endocrine-Disrupting Chemicals. Endocr Rev 2015;36:1–150. https://doi.org/10.1210/er.2015-1010. 

  Kay JE, Cardona B, Rudel RA, Vandenberg LN, Soto AM, Christiansen S, et al. Chemical Effects on Breast Development, Function, and Cancer Risk: Existing Knowledge and New Opportunities. Curr Environ Health Rep 2022;9:535–62.https://doi.org/10.1007/s40572-022-00376-2. 

  Nounu A, Kar SP, Relton CL, Richmond RC. Sex steroid hormones and risk of breast cancer: a two-sample Mendelian randomization study. Breast Cancer Research 2022;24. https://doi.org/10.1186/s13058-022-01553-9. 

  Travis RC, Key TJ. Oestrogen exposure and breast cancer risk. Breast Cancer Res [Internet]. 2003 [cited 2023 Jul 21];5(5):239. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC314432/ 

  Q2. Where are endocrine-disrupting chemicals found? 

  Breast Cancer UK. Endocrine disrupting chemicals [Internet]. 2018 [cited 2023 Jul 21]. Available from: https://cdn.breastcanceruk.org.uk/uploads/2019/08/BCUK_EDC_brief_v2_20.9.18.pdf 

  Endocrine Society. Common EDCs and Where They Are Found [Internet]. [cited 2023 Jul 21]. Available from: https://www.endocrine.org/topics/edc/what-edcs-are/common-edcs 

  Q3. Why don’t other cancer charities highlight exposures to harmful chemicals as cancer risk factors? 

  United Nations Environment Programme. Global Chemicals Outlook II: From Legacies to Innovative Solutions Programme [Internet]. 2019 [cited 2023 Jul 21]. Available from: https://www.unep.org/resources/report/global-chemicals-outlook-ii-legacies-innovative-solutions 

  WHO, UNEP. State of the Science of Endocrine Disrupting Chemicals [Internet]. 2012 [cited 2023 Jul 21]. Available from:  https://www.who.int/publications/i/item/state-of-the-science-of-endocrine-disrupting-chemicals 

  Q4. Does drinking water from plastic bottles increase breast cancer risk? 

  Kay JE, Cardona B, Rudel RA, Vandenberg LN, Soto AM, Christiansen S, et al. Chemical Effects on Breast Development, Function, and Cancer Risk: Existing Knowledge and New Opportunities. Curr Environ Health Rep 2022;9:535–62. https://doi.org/10.1007/s40572-022-00376-2. 

  Le HH, Carlson EM, Chua JP, Belcher SM. Bisphenol A is released from polycarbonate drinking bottles and mimics the neurotoxic actions of estrogen in developing cerebellar neurons. Toxicol Lett [Internet]. 2008 Jan 1 [cited 2023 Jul 21];176(2):149. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2254523/ 

  Sax L. Polyethylene terephthalate may yield endocrine disruptors. Environ Health Perspect [Internet]. 2010 Apr [cited 2023 Jul 21];118(4):445–8. Available from: https://pubmed.ncbi.nlm.nih.gov/20368129/ 

  Q5. Do antiperspirants and deodorants increase breast cancer risk? 

  Breast Cancer UK. Aluminium salts as antiperspirants [Internet]. 2019 [cited 2023 Jul 21]. Available from: https://cdn.breastcanceruk.org.uk/uploads/2019/09/short-brief-aluminium-salts-as-antiperspirants-13.9.19.pdf 

  Darbre PD. Endocrine disrupting chemicals and breast cancer cells. Advances in pharmacology [Internet]. 2021 Jan 1 [cited 2023 Jul 21];92:485–520. Available from: https://pubmed.ncbi.nlm.nih.gov/34452695/ 

  Mandriota et al. Genomic Instability Is an Early Event in Aluminium-Induced Tumorigenesis. International Journal of Molecular Sciences 2020; 21(23), 9332. https://doi.org/10.3390/ijms21239332 

  Q6. Does using products containing lavender oil increase my risk of breast cancer? 

  Cancer Research UK. Aromatherapy. https://www.cancerresearchuk.org/about-cancer/treatment/complementary-alternative-therapies/individual-therapies/aromatherapy (Accessed 23rd April 2025) 

  Endocrine Society. Chemicals in lavender and tea tree oil appear to be hormone disruptors | [Internet]. 2018 [cited 2023 Jul 21]. Available from: https://www.endocrine.org/news-and-advocacy/news-room/2018/chemicals-in-lavender-and-tea-tree-oil-appear-to-be-hormone-disruptors 

  Hawkins J, Hires C, Dunne E, Keenan L. Prevalence of endocrine disorders among children exposed to Lavender Essential Oil and Tea Tree Essential Oils. Int J Pediatr Adolesc Med. 2022 Jun 1;9(2):117–24. https://www.sciencedirect.com/science/article/pii/S2352646721000855?via%3Dihub 

  Henley et al. Prepubertal gynecomastia linked to lavender and tea tree oils. N Engl J Med 2007; Feb 1;356(5):479-85. https://doi.org/10.1056/NEJMoa064725 

  Ramsey JT, Li Y, Arao Y, Naidu A, Coons LA, Diaz A, et al. Lavender Products Associated With Premature Thelarche and Prepubertal Gynecomastia: Case Reports and Endocrine-Disrupting Chemical Activities. J Clin Endocrinol Metab [Internet]. 2019 Nov 1 [cited 2023 Jul 21];104(11):5393–405. Available from: https://dx.doi.org/10.1210/jc.2018-01880 

  Q7. How can I tell if personal care products contain Endocrine Disrupting Chemicals (EDCs)? 

  See the links in question. 

  Q8. What sunscreens should I avoid? 

  Barr L, Alamer M, Darbre PD. Measurement of concentrations of four chemical ultraviolet filters in human breast tissue at serial locations across the breast. Journal of Applied Toxicology [Internet]. 2018 Aug 1 [cited 2023 Jul 21];38(8):1112–20. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/jat.3621 

  Majhi PD, Sharma A, Roberts AL, Daniele E, Majewski AR, Chuong LM, et al. Effects of Benzophenone-3 and Propylparaben on Estrogen Receptor–Dependent R-Loops and DNA Damage in Breast Epithelial Cells and Mice. Environ Health Perspect [Internet]. 2020 Jan 1 [cited 2023 Jul 21];128(1). Available from: https://ehp.niehs.nih.gov/doi/10.1289/EHP5221 

  EcoWatch. Your Sunscreen Is Toxic: How To Find One That’s Safe for You & the Planet [Internet]. 2022 [cited 2023 Jul 21]. Available from: https://www.ecowatch.com/sunscreen-guide.html 

  Q9. Does eating food stored in plastic containers or takeaway boxes increase breast cancer risk? 

  EFSA Panel on Food Contact Materials E and PA (CEP), Lambré C, Barat Baviera JM, Bolognesi C, Chesson A, Cocconcelli PS, et al. Re-evaluation of the risks to public health related to the presence of bisphenol A (BPA) in foodstuffs. EFSA Journal 2023;21:e06857. https://doi.org/10.2903/j.efsa.2023.6857. 

  European Commission. Commission Regulation (EU) 2024/3190 of 19 December 2024 on the use of bisphenol A (BPA) and other bisphenols and bisphenol derivatives with harmonised classification for specific hazardous properties in certain materials and articles intended to come into contact with food, amending Regulation (EU) No 10/2011 and repealing Regulation (EU) 2018/213. Official Journal of the European Union 2024. http://data.europa.eu/eli/reg/2024/3190/oj 

  Mercea P. Physicochemical processes involved in migration of bisphenol A from polycarbonate. J Appl Polym Sci [Internet]. 2009 Apr 15 [cited 2023 Jul 21];112(2):579–93. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/app.29421 

  Muncke J, Andersson AM, Backhaus T, Boucher JM, Carney Almroth B, Castillo Castillo A, et al. Impacts of food contact chemicals on human health: a consensus statement. Environmental Health [Internet]. 2020 Mar 3 [cited 2023 Jul 21];19(1):1–12. Available from: https://ehjournal.biomedcentral.com/articles/10.1186/s12940-020-0572-5 

  Stillwater BJ, Bull AC, Romagnolo DF, Neumayer LA, Donovan MG, Selmin OI. Bisphenols and Risk of Breast Cancer: A Narrative Review of the Impact of Diet and Bioactive Food Components. Front Nutr. 2020 Nov 19;7:581388. https://www.frontiersin.org/articles/10.3389/fnut.2020.581388/full 

  Q10. Can my child be exposed to EDCs in the womb? 

  Kay JE, Cardona B, Rudel RA, Vandenberg LN, Soto AM, Christiansen S, et al. Chemical Effects on Breast Development, Function, and Cancer Risk: Existing Knowledge and New Opportunities. Curr Environ Health Rep 2022;9:535–62. https://doi.org/10.1007/s40572-022-00376-2. 

  Vandenberg LN, Maffini M V., Schaeberle CM, Ucci AA, Sonnenschein C, Rubin BS, et al. Perinatal exposure to the xenoestrogen bisphenol-A induces mammary intraductal hyperplasias in adult CD-1 mice. Reproductive Toxicology. 2008 Nov 1;26(3–4):210–9. https://www.sciencedirect.com/science/article/abs/pii/S0890623808002451?via%3Dihub 

  Wormsbaecher C, Hindman AR, Avendano A, Cortes-Medina M, Jones CE, Bushman A, et al. In utero estrogenic endocrine disruption alters the stroma to increase extracellular matrix density and mammary gland stiffness. Breast Cancer Research [Internet]. 2020 May 5 [cited 2023 Jul 21];22(1):1–12. Available from: https://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-020-01275-w 

  Q11. Does exposure to parabens affect breast cancer risk? 

  Hager E, Chen J, Zhao L. Minireview: Parabens Exposure and Breast Cancer. Int J Environ Res Public Health 2022;19. https://doi.org/10.3390/ijerph19031873. 

  Mogus JP, Laplante CD, Bansal R, Matouskova K, Schneider BR, Daniele E, et al. Exposure to Propylparaben During Pregnancy and Lactation Induces Long-Term Alterations to the Mammary Gland in Mice. Endocrinology [Internet]. 2021 Jun 1 [cited 2023 Jul 21];162(6). Available from: https://pubmed.ncbi.nlm.nih.gov/33724348/ 

  Pugazhendhi D, Pope GS, Darbre PD. Oestrogenic activity of p-hydroxybenzoic acid (common metabolite of paraben esters) and methylparaben in human breast cancer cell lines. Journal of Applied Toxicology 2005;25:301–9. https://doi.org/10.1002/jat.1066 

  Shen X, Liang J, Zheng L, Wang H, Wang Z, Ji Q, et al. Ultrasound-assisted dispersive liquid-liquid microextraction followed by gas chromatography–mass spectrometry for determination of parabens in human breast tumor and peripheral adipose tissue. Journal of Chromatography B 2018;1096:48–55. https://doi.org/10.1016/j.jchromb.2018.08.004 

  Tong JH, Elmore S, Huang SS, Tachachartvanich P, Manz K, Pennell K, et al. Chronic Exposure to Low Levels of Parabens Increases Mammary Cancer Growth and Metastasis in Mice. Endocrinology 2023;164. https://doi.org/10.1210/endocr/bqad007 

  Q12. What are microplastics, and can they affect breast cancer risk? 

  Britannica. Microplastics [Internet]. 2022 [cited 2023 Jul 21]. Available from: https://www.britannica.com/technology/microplastic 

  Leslie HA, van Velzen MJM, Brandsma SH, Vethaak AD, Garcia-Vallejo JJ, Lamoree MH. Discovery and quantification of plastic particle pollution in human blood. Environ Int. 2022 May 1;163:107199. https://www.sciencedirect.com/science/article/pii/S0160412022001258 

  Munoz-Pineiro MA. MICROPLASTICS: Focus on Food and Health. Publications Office of the European Union [Internet]. 2018 [cited 2023 Jul 21];123–52. Available from: https://publications.jrc.ec.europa.eu/repository/handle/JRC110629 

  Ragusa A, Notarstefano V, Svelato A, Belloni A, Gioacchini G, Blondeel C, et al. Raman Microspectroscopy Detection and Characterisation of Microplastics in Human Breastmilk. Polymers (Basel) [Internet]. 2022 Jul 1 [cited 2023 Jul 21];14(13). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9269371/ 

  Q13. What are forever chemicals? 

  CHEMTrust. PFAS – the ’Forever Chemicals [Internet]. Vol. 126. Public Health Services, US Dept of Health and Human Services; 2018 [cited 2023 Jul 21]. Available from: https://chemtrust.org/pfas/ 

  Feng Y, Bai Y, Lu Y, Chen M, Fu M, Guan X, et al. Plasma perfluoroalkyl substance exposure and incidence risk of breast cancer: A case-cohort study in the Dongfeng-Tongji cohort. Environmental Pollution. 2022 Aug 1;306:119345. https://www.sciencedirect.com/science/article/abs/pii/S0269749122005590 

  Jiang H, Liu H, Liu G, Yu J, Liu N, Jin Y, et al. Associations between Polyfluoroalkyl Substances Exposure and Breast Cancer: A Meta-Analysis. Toxics 2022;10:318. https://doi.org/10.3390/toxics10060318. 

  Mancini FR, Cano-Sancho G, Gambaretti J, Marchand P, Boutron-Ruault MC, Severi G, et al. Perfluorinated alkylated substances serum concentration and breast cancer risk: Evidence from a nested case-control study in the French E3N cohort. Int J Cancer [Internet]. 2020 Feb 15 [cited 2023 Jul 21];146(4):917–28. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/ijc.32357 

  Q14. What is an ‘obesogen’? 

  Darbre PD. Endocrine Disruption and Disorders of Energy Metabolism. Endocrine Disruption and Human Health. 2015 Jan 1;273–85. https://www.sciencedirect.com/science/article/abs/pii/B9780128011393000156 

  Reproductive factors, natural and synthetic hormones 

  Q1. Is breast cancer during pregnancy common? 

  Allouch S, Gupta I, Malik S, Al Farsi HF, Vranic S, Al Moustafa AE. Breast Cancer During Pregnancy: A Marked Propensity to Triple-Negative Phenotype. Front Oncol. 2020 Dec 23;10:580345. https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.580345/full 

  Cancer Research UK. Breast cancer during pregnancy [Internet]. [cited 2023 Jul 24]. Available from: https://www.cancerresearchuk.org/about-cancer/breast-cancer/living-with/breast-cancer-during-pregnancy 

  Q2. How does age at the birth of a first child affect your breast cancer risk? 

  Borges VF, Lyons TR, Germain D, Schedin P. Postpartum involution and cancer: an opportunity for targeted breast cancer prevention and treatments? Cancer Res. 2020;80:1790–8. https://doi.org/10.1158/0008-5472.CAN-19-3448 

  Nichols HB, Schoemaker MJ, Cai J, Xu J, Wright LB, Brook MN, et al. Breast cancer risk after recent childbirth: A pooled analysis of 15 prospective studies. Ann Intern Med. 2019 Jan 1;170(1):22–30. https://pubmed.ncbi.nlm.nih.gov/30534999/ 

  Slepicka PF, Cyrill SL, dos Santos CO. Pregnancy and Breast Cancer: Pathways to Understand Risk and Prevention. Trends Mol Med [Internet]. 2019 Oct 1 [cited 2023 Jul 24];25(10):866–81. Available from: http://www.cell.com/article/S1471491419301650/fulltext 

  Q3. Does breastfeeding reduce the risk of breast cancer? 

  Fortner RT, Sisti J, Chai B, Collins LC, Rosner B, Hankinson SE, et al. Parity, breastfeeding, and breast cancer risk by hormone receptor status and molecular phenotype: Results from the Nurses’ Health Studies. Breast Cancer Research [Internet]. 2019 Mar 12 [cited 2023 Jul 24];21(1):1–9. Available from: https://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-019-1119-y 

  Stordal B. Breastfeeding reduces the risk of breast cancer: A call for action in high-income countries with low rates of breastfeeding. Cancer Med [Internet]. 2023 Feb 1 [cited 2023 Jul 24];12(4):4616–25. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/cam4.5288 

  World Cancer Research Fund. Lactation (breastfeeding) and the risk of cancer [Internet]. [cited 2023 Jul 24]. Available from: https://www.wcrf.org/dietandcancer/lactation-breastfeeding/ 

  Q4. Does HRT cause breast cancer?  

  Vinogradova Y, Coupland C, Hippisley-Cox J. Use of hormone replacement therapy and risk of breast cancer: nested case-control studies using the QResearch and CPRD databases. BMJ [Internet]. 2020 Oct 28 [cited 2023 Jul 27];371. Available from: https://www.bmj.com/content/371/bmj.m3873 

  Q5. Is it true that I’m more at risk if I don’t have children? 

  Britt K, Ashworth A, Smalley M. Pregnancy and the risk of breast cancer. Endocr Relat Cancer [Internet]. 2007 Dec [cited 2023 Jul 27];14(4):907–33. Available from: https://pubmed.ncbi.nlm.nih.gov/18045947/ 

  Li C, Fan Z, Lin X, Cao M, Song F, Song F. Parity and risk of developing breast cancer according to tumor subtype: A systematic review and meta-analysis. Cancer Epidemiol. 2021 Dec;75:102050. doi: 10.1016/j.canep.2021.102050. Epub 2021 Oct 24. PMID: 34706325. https://doi.org/10.1016/j.canep.2021.102050 

  Husby A, Wohlfahrt J, Øyen N, Melbye M. Pregnancy duration and breast cancer risk. Nat Commun [Internet]. 2018 Dec 1 [cited 2023 Jul 27];9(1). Available from: https://pubmed.ncbi.nlm.nih.gov/30353005/ 

  Q6. If I’m on a contraceptive pill or another type of hormonal contraception, am I at increased breast cancer risk? 

  Conz L, Mota BS, Bahamondes L, Teixeira Dória M, Françoise Mauricette Derchain S, Rieira R, et al. Levonorgestrel-releasing intrauterine system and breast cancer risk: A systematic review and meta-analysis. Acta Obstet Gynecol Scand [Internet]. 2020 Aug 1 [cited 2023 Jul 27];99(8):970–82. Available from: https://pubmed.ncbi.nlm.nih.gov/31990981/ 

  Fitzpatrick D, Pirie K, Reeves G, Green J, Beral V. Combined and progestagen-only hormonal contraceptives and breast cancer risk: A UK nested case–control study and meta-analysis. PLoS Med [Internet]. 2023 Mar 1 [cited 2023 Jul 27];20(3):e1004188. Available from: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004188 

  Karlsson T, Johansson T, Hoglund J, Ek WE, Johansson Å. Time-dependent effects of oral contraceptive use on breast, ovarian, and endometrial cancers. Cancer Res [Internet]. 2021 Feb 15 [cited 2023 Jul 27];81(4):1153–62. Available from: https://dx.doi.org/10.1158/0008-5472.CAN-20-2476 

  Samson M, Porter N, Orekoya O, Hebert JR, Adams SA, Bennett CL, et al. Progestin and breast cancer risk: a systematic review. Breast Cancer Res Treat [Internet]. 2016 Jan 1 [cited 2023 Jul 27];155(1):3–12. Available from: https://link.springer.com/article/10.1007/s10549-015-3663-1 

  Silva FR, Grande AJ, Lacerda Macedo AC, Colonetti T, Rocha MC, Rodrigues Uggioni ML, et al. Meta-Analysis of Breast Cancer Risk in Levonorgestrel-Releasing Intrauterine System Users. Clin Breast Cancer [Internet]. 2021 Dec 1 [cited 2023 Jul 27];21(6):497–508. Available from: https://pubmed.ncbi.nlm.nih.gov/34045174/ 

  Q7. Why are high levels of oestrogen potentially harmful? 

  Santen RJ, Yue W, Wang JP. Estrogen metabolites and breast cancer. Steroids [Internet]. 2015 May 26 [cited 2023 Jul 27];99(Pt A):61–6. Available from: https://pubmed.ncbi.nlm.nih.gov/25168343/ 

  Travis RC, Key TJ. Oestrogen exposure and breast cancer risk. Breast Cancer Res [Internet]. 2003 [cited 2023 Jul 27];5(5):239. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC314432/ 

  Q8. Do transgender women have an increased risk of breast cancer? 

  De Blok CJM, Wiepjes CM, Nota NM, Van Engelen K, Adank MA, Dreijerink KMA, et al. Breast cancer risk in transgender people receiving hormone treatment: nationwide cohort study in the Netherlands. BMJ [Internet]. 2019 [cited 2023 Jul 27];365. Available from: https://pubmed.ncbi.nlm.nih.gov/31088823/ 

  Iwamoto SJ, Defreyne J, Rothman MS, Van Schuylenbergh J, Van de Bruaene L, Motmans J, et al. Health considerations for transgender women and remaining unknowns: a narrative review. Ther Adv Endocrinol Metab [Internet]. 2019 [cited 2023 Jul 27];10. Available from: https://pubmed.ncbi.nlm.nih.gov/31516689/ 

  Q9. Do transgender men have an increased risk of breast cancer? 

  De Blok CJM, Wiepjes CM, Nota NM, Van Engelen K, Adank MA, Dreijerink KMA, et al. Breast cancer risk in transgender people receiving hormone treatment: nationwide cohort study in the Netherlands. BMJ [Internet]. 2019 [cited 2023 Jul 27];365. Available from: https://pubmed.ncbi.nlm.nih.gov/31088823/ 

  Fledderus AC, Gout HA, Ogilvie AC, Van Loenen DKG. Breast malignancy in female-to-male transsexuals: systematic review, case report, and recommendations for screening. The Breast [Internet]. 2020 [cited 2023 Jul 27];53:92–100. Available from: https://doi.org/10.1016/j.breast.2020.06.008 

  Genetics and family history 

  Q1. Are there any ethnic groups in the UK more at risk of breast cancer? 

  Gathani T, Ali R, Balkwill A, Green J, Reeves G, Beral V, et al. Ethnic differences in breast cancer incidence in England are due to differences in known risk factors for the disease: prospective study. Br J Cancer [Internet]. 2014 Jan 1 [cited 2023 Jul 27];110(1):224. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3887283/ 

  Gathani T, Reeves G, Broggio J, Barnes I. Ethnicity and the tumour characteristics of invasive breast cancer in over 116,500 women in England. British Journal of Cancer 2021 125:4 [Internet]. 2021 May 26 [cited 2023 Jul 27];125(4):611–7. Available from: https://www.nature.com/articles/s41416-021-01409-7 

  Haiman CA, Chen GK, Vachon CM, Canzian F, Dunning A, Millikan RC, et al. A common variant at the TERT-CLPTM1L locus is associated with estrogen receptor-negative breast cancer. Nat Genet [Internet]. 2011 Dec [cited 2023 Jul 27];43(12):1210–4. Available from: https://pubmed.ncbi.nlm.nih.gov/22037553/ 

  KB K, JL H, DR B, KA P, TM M, MJ RB, et al. Risks of Breast, Ovarian, and Contralateral Breast Cancer for BRCA1 and BRCA2 Mutation Carriers. JAMA [Internet]. 2017 Jun 20 [cited 2023 Jul 27];317(23):2402–16. Available from: https://pubmed.ncbi.nlm.nih.gov/28632866/ 

  Manchanda R, Loggenberg K, Sanderson S, Burnell M, Wardle J, Gessler S, et al. Population testing for cancer predisposing BRCA1/BRCA2 mutations in the Ashkenazi-Jewish community: a randomized controlled trial. J Natl Cancer Inst [Internet]. 2014 Jan 1 [cited 2023 Jul 27];107(1). Available from: https://pubmed.ncbi.nlm.nih.gov/25435541/ 

  Shirley MH, Barnes I, Sayeed S, Finlayson A, Ali R. Incidence of breast and gynaecological cancers by ethnic group in England, 2001-2007: A descriptive study. BMC Cancer [Internet]. 2014 Dec 18 [cited 2023 Jul 27];14(1):1–10. Available from: https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-14-979 

  Breast Cancer UK, Breast cancer risk and ethnicity explained. [Internet] October 2023. Available from: https://www.breastcanceruk.org.uk/breast-cancer-risk-and-ethnicity-explained/ 

  Q2. Does a family history of breast cancer put someone at a higher risk? 

  Economopoulou P, Dimitriadis G, Psyrri A. Beyond BRCA: New hereditary breast cancer susceptibility genes. Cancer Treat Rev [Internet]. 2015 Jan 1 [cited 2023 Jul 27];41(1):1–8. Available from: http://www.cancertreatmentreviews.com/article/S0305737214001741/fulltext 

  Breast Cancer UK, Are you susceptible to breast cancer. [Internet] November 2024 [cited 2025 March 19] Available from: https://www.breastcanceruk.org.uk/about-breast-cancer/are-you-susceptible-to-breast-cancer/ 

  Q3. What are BRCA1 and BRCA2 genes? 

  National Cancer Institute. BRCA Gene Mutations: Cancer Risk and Genetic Testing Fact Sheet [Internet]. 2020 [cited 2023 Jul 27]. Available from: https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet#what-are-brca1-and-brca2 

  The Royal Marsden NHS Foundation Trust. A beginner’s guide to BRCA1 and BRCA2. 2013. Available from: https://patientinfolibrary.royalmarsden.nhs.uk/brca1brac2 

  National Cancer Institute (2024) BRCA Gene Mutations: Cancer Risk and Genetic Testing. https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet 

  Q4. Is there a connection between breast cancer and ovarian cancer and are the causes the same? 

  Genomics Education Programme. Hereditary breast and ovarian cancer [Internet]. 2020 [cited 2023 Jul 27]. Available from: https://www.genomicseducation.hee.nhs.uk/documents/hereditary-breast-and-ovarian-cancer/ 

  Cancer.Net. Hereditary Breast and Ovarian Cancer [Internet]. 2020 [cited 2023 Jul 27]. Available from: https://www.cancer.net/cancer-types/hereditary-breast-and-ovarian-cancer 

  Q5. Why are taller women at a higher risk of getting breast cancer? 

  Zhang B, Shu XO, Delahanty RJ, Zeng C, Michailidou K, Bolla MK, et al. Height and Breast Cancer Risk: Evidence From Prospective Studies and Mendelian Randomization. J Natl Cancer Inst [Internet]. 2015 Nov 1 [cited 2023 Jul 27];107(11). Available from: https://pubmed.ncbi.nlm.nih.gov/26296642/ 

  Other frequently asked questions 

  Q1. Does having larger breasts increase the risk of breast cancer? 

  Hsieh C c, Trichopoulos D. Breast size, handedness and breast cancer risk. Eur J Cancer Clin Oncol. 1991 Jan 1;27(2):131–5. https://www.sciencedirect.com/science/article/abs/pii/027753799190469T?via%3Dihub 

  Ooi BNS, Loh H, Ho PJ, Milne RL, Giles G, Gao C, et al. The genetic interplay between body mass index, breast size and breast cancer risk: a Mendelian randomization analysis. Int J Epidemiol [Internet]. 2019 Jun 1 [cited 2023 Jul 27];48(3):781–94. Available from: https://academic.oup.com/ije/article/48/3/781/5523691 

  Sellahewa C, Nightingale P, Carmichael AR. Women with large breasts are at an increased risk of advanced breast cancer. International Seminars in Surgical Oncology [Internet]. 2008 Jun 30 [cited 2023 Jul 27];5(1):1–4. Available from: https://issoonline.biomedcentral.com/articles/10.1186/1477-7800-5-16 

  Q2. Am I more at risk of breast cancer if I have breast implants? 

  Brett EA, Aitzetmüller MM, Sauter MA, Huemer GM, Machens HG, Duscher D. Breast cancer recurrence after reconstruction: know thine enemy. Oncotarget [Internet]. 2018 Jun 12 [cited 2023 Jul 27];9(45):27895–906. Available from: https://pubmed.ncbi.nlm.nih.gov/29963246/ 

  Jones JL, Hanby AM, Wells C, Calaminici M, Johnson L, Turton P, et al. Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL): an overview of presentation and pathogenesis and guidelines for pathological diagnosis and management. Histopathology [Internet]. 2019 Dec 1 [cited 2023 Jul 27];75(6):787–96. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/his.13932 

  Noels EC, Lapid O, Lindeman JHN, Bastiaannet E. Breast implants and the risk of breast cancer: a meta-analysis of cohort studies. Aesthet Surg J [Internet]. 2015 Jan 1 [cited 2023 Jul 27];35(1):55–62. Available from: https://pubmed.ncbi.nlm.nih.gov/25568234/ 

  Q3. Is stress a risk factor for breast cancer? 

  Chiriac VF, Baban A, Dumitrascu DL. Psychological stress and breast cancer incidence: a systematic review. Clujul Med [Internet]. 2018 [cited 2023 Jul 27];91(1):18–26. Available from: https://pubmed.ncbi.nlm.nih.gov/29440947/ 

  Cancer Research UK. Can stress cause cancer? [Internet]. [cited 2023 Jul 27]. Available from: https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/cancer-myths/can-stress-cause-cancer 

  Mohan A, Huybrechts I, Michels N. Psychosocial stress and cancer risk: a narrative review. Eur J Cancer Prev [Internet]. 2022 Nov 1 [cited 2023 Jul 27];31(6):585–99. Available from: https://pubmed.ncbi.nlm.nih.gov/35352705/ 

  Pereira MA, Araújo A, Simões M, Costa C. Influence of Psychological Factors in Breast and Lung Cancer Risk – A Systematic Review. Front Psychol [Internet]. 2022 Jan 3 [cited 2023 Jul 27];12. Available from: https://pubmed.ncbi.nlm.nih.gov/35046872/ 

  Schoemaker MJ, Jones ME, Wright LB, Griffin J, McFadden E, Ashworth A, et al. Psychological stress, adverse life events and breast cancer incidence: a cohort investigation in 106,000 women in the United Kingdom. Breast Cancer Res [Internet]. 2016 Jul 15 [cited 2023 Jul 27];18(1). Available from: https://pubmed.ncbi.nlm.nih.gov/27418063/ 

  Q4. What does it mean to have dense breasts – is this a risk? 

  Sprague BL, Trentham-Dietz A, Hedman CJ, Wang J, Hemming JDC, Hampton JM, et al. Circulating serum xenoestrogens and mammographic breast density. Breast Cancer Research [Internet]. 2013 May 27 [cited 2023 Jul 27];15(3):1–8. Available from: https://breast-cancer-research.biomedcentral.com/articles/10.1186/bcr3432 

  Q5. Does fluoride in drinking water increase breast cancer risk? 

  National Cancer Institute. Fluoridated Water. https://www.cancer.gov/about-cancer/causes-prevention/risk/myths/fluoridated-water-fact-sheet (Accessed 7th May 2025) 

  Q6. Does chlorine in drinking water increase breast cancer risk? 

  IARC Working Group on the Evaluation of Carcinogenic Risks to Humans., International Agency for Research on Cancer. Some Chemicals that Cause Tumours of the Kidney or Urinary Bladder in Rodents and Some Other Substances. World Health Organization, International Agency for Research on Cancer; 1999. https://publications.iarc.fr/Book-And-Report-Series/Iarc-Monographs-On-The-Identification-Of-Carcinogenic-Hazards-To-Humans/Some-Chemicals-That-Cause-Tumours-Of-The-Kidney-Or-Urinary-Bladder-In-Rodents-And-Some-Other-Substances-1999 

  Q7. Can mammograms increase the risk of breast cancer? 

  GOV.UK. NHS breast screening: helping you decide [Internet]. 2021 [cited 2023 Jul 27]. Available from: https://www.gov.uk/government/publications/breast-screening-helping-women-decide/nhs-breast-screening-helping-you-decide 

  Q8. Does socioeconomic status affect your risk of breast cancer? 

  Li, S., He, Y., Liu, J. et al. An umbrella review of socioeconomic status and cancer. Nat Commun 15, 9993 (2024). https://doi.org/10.1038/s41467-024-54444-2 

  Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin [Internet]. 2021 May 1 [cited 2023 Jul 27];71(3):209–49. Available from: https://onlinelibrary.wiley.com/doi/full/10.3322/caac.21660 

  Q9. Does where you live affect your risk of breast cancer? 

  Sharp L, Donnelly D, Hegarty A, Carsin AE, Deady S, McCluskey N, et al. Risk of several cancers is higher in urban areas after adjusting for socioeconomic status. Results from a two-country population-based study of 18 common cancers. J Urban Health [Internet]. 2014 [cited 2023 Jul 27];91(3):510–25. Available from: https://pubmed.ncbi.nlm.nih.gov/24474611/ 

  National Cancer Registration and Analysis Service. The effect of rurality on cancer incidence and mortality [Internet]. [cited 2023 Jul 27]. Available from: http://www.ncin.org.uk/publications/data_briefings/rurality 

  Q10. Do underwire bras increase my risk of breast cancer? 

  Chen L, Malone KE, Li CI. Bra wearing not associated with breast cancer risk: A population-based case-control study. Cancer Epidemiology Biomarkers and Prevention [Internet]. 2014 Oct 1 [cited 2023 Jul 27];23(10):2181–5. Available from: https://dx.doi.org/10.1158/1055-9965.EPI-14-0414 

  Q11. Does night shift work increase breast cancer risk? 

  Gehlert S, Clanton M, Group on behalf of the SW and BCSA. Shift Work and Breast Cancer. Int J Environ Res Public Health [Internet]. 2020 Dec 2 [cited 2023 Jul 27];17(24):1–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7767214/ 

  Hill SM, Belancio VP, Dauchy RT, Xiang S, Brimer S, Mao L, et al. Melatonin: an inhibitor of breast cancer. Endocr Relat Cancer [Internet]. 2015 Jun 1 [cited 2023 Jul 27];22(3):R183–204. Available from: https://pubmed.ncbi.nlm.nih.gov/25876649/ 

  IARC Monographs Vol 124 group. Carcinogenicity of night shift work. Lancet Oncol [Internet]. 2019 Aug 1 [cited 2023 Jul 27];20(8):1058–9. Available from: https://pubmed.ncbi.nlm.nih.gov/31281097/ 

  Liu FC, Veierød MB, Kjærheim K, Robsahm TE, Ghiasvand R, Babigumira R, et al. Excess risk of male breast cancer in the Norwegian Offshore Petroleum Workers (NOPW) cohort: a possible link to extreme night shift work? Breast Cancer Res [Internet]. 2021 Dec 1 [cited 2023 Jul 27];23(1). Available from: https://pubmed.ncbi.nlm.nih.gov/34794511/ 

  Lopes J, Arnosti D, Trosko JE, Tai MH, Zuccari D. Melatonin decreases estrogen receptor binding to estrogen response elements sites on the oct4 gene in human breast cancer stem cells. Genes Cancer [Internet]. 2016 May 1 [cited 2023 Jul 27];7(5–6):209–17. Available from: https://www.genesandcancer.com/article/107/text/ 

  Manouchehri E, Taghipour A, Ghavami V, Ebadi A, Homaei F, Latifnejad Roudsari R. Night-shift work duration and breast cancer risk: an updated systematic review and meta-analysis. BMC Womens Health [Internet]. 2021 Dec 1 [cited 2023 Jul 27];21(1):1–16. Available from: https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-021-01233-4 

  Jones ME, Schoemaker MJ, McFadden EC, Wright LB, Johns LE, Swerdlow AJ. Night shift work and risk of breast cancer in women: the Generations Study cohort. British Journal of Cancer. 2019 Jul [cited 2024 May 22];121(2):172-179. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6738051/ 

  Q12. Does mobile phone use increase breast cancer risk? 

  Röösli M, Lagorio S, Schoemaker MJ, Schüz J, Feychting M. Brain and Salivary Gland Tumors and Mobile Phone Use: Evaluating the Evidence from Various Epidemiological Study Designs. Annu Rev Public Health [Internet]. 2019 Apr 1 [cited 2023 Jul 27];40:221–38. Available from: https://pubmed.ncbi.nlm.nih.gov/30633716/ 

  Schüz J, Jacobsen R, Olsen JH, Boice JD, McLaughlin JK, Johansen C. Cellular telephone use and cancer risk: update of a nationwide Danish cohort. J Natl Cancer Inst [Internet]. 2006 Dec 6 [cited 2023 Jul 27];98(23):1707–13. Available from: https://pubmed.ncbi.nlm.nih.gov/17148772/ 

  West JG, Kapoor NS, Liao SY, Chen JW, Bailey L, Nagourney RA. Multifocal Breast Cancer in Young Women with Prolonged Contact between Their Breasts and Their Cellular Phones. Case Rep Med [Internet]. 2013 [cited 2023 Jul 27];2013. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789302/ 

  Q13. Does having type 2 diabetes increase breast cancer risk? 

  Diabetes.co.uk. Breast Cancer and Diabetes [Internet]. 2019 [cited 2023 Jul 27]. Available from: https://www.diabetes.co.uk/diabetes-complications/breast-cancer.html 

  Hardefeldt PJ, Edirimanne S, Eslick GD. Diabetes increases the risk of breast cancer: a meta-analysis. Endocr Relat Cancer [Internet]. 2012 Dec 1 [cited 2023 Jul 27];19(6):793–803. Available from: https://erc.bioscientifica.com/view/journals/erc/19/6/793.xml 

  Lu Y, Hajjar A, Cryns VL, Trentham-Dietz A, Gangnon RE, Heckman-Stoddard BM, et al. Breast cancer risk for women with diabetes and the impact of metformin: A meta-analysis. Cancer Med [Internet]. 2023 May 1 [cited 2023 Jul 27];12(10):11703–18. Available from: https://pubmed.ncbi.nlm.nih.gov/36533539/ 

   

• References - Fibre

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  5. Deschasaux, M. et al. 2013. Prospective association between dietary fiber intake and breast cancer risk. PloS one 8:e79718. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3828192/
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• References - Menopause

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  Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.

  Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.

  Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.

  Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.

  Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.

  Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum.