Abstract
Background: Since breast cancer is increasing worldwide and previous risk factors cannot justify such an increasing trend, investigating new environmental factors is necessary for each population. Mammographic breast density (MBD) is a strong risk factor for breast cancer as well as a biomarker for the effect of chemicals on breast tissue.
Objective: Given limited data about the association between breast density and cosmetic products containing endocrine-disrupting chemicals (EDCs), the purpose of this study was to evaluate the effects of cosmetic products on MBD in Iranian women.
Methods: In this cross-sectional study, women who attended two university hospitals for breast screening mammography and who had been living in the capital city of Iran for the last 3 years or more were recruited. We asked women to fill out a questionnaire containing two parts; the first part was about the women's characteristics and medical history and the second part consisted of cosmetic use. The frequency of cosmetic use was measured using the Likert scale in four scales. One expert radiologist in each center reported the MBD on a four-category scale.
Results: The mean age of 813 participants was 50.16 ± 7.65. Three hundred-seven (37.8%) women had low breast density and 506 (62.2%) had high breast density. Based on our results, heavy use of moisturizers, sunscreen, nail polish, eye products, makeup products, and lipstick was associated with increased breast density. In multivariable analysis after adjusting for menopause, excessive use of nail polish, sunscreen, and moisturizing cream was associated with increased MBD.
Conclusion: Our study shows a probability of an increased MBD with the excessive use of cosmetic products. Since a small increase in the risk of breast cancer may lead to a considerable public health impact, thus further studies are needed to find new prevention strategies.
Graphical Abstract
[1]
Valipour, A.A.; Mohammadian, M.; Ghafari, M.; Mohammadian-Hafshejani, A. Predict the future incidence and mortality of breast cancer in Iran from 2012-2035. Iran. J. Public Health, 2017, 46(4), 579-580.
[PMID: 28540280]
[PMID: 28540280]
[2]
Wan, M.L.Y.; Co, V.A.; El-Nezami, H. Endocrine disrupting chemicals and breast cancer: a systematic review of epidemiological studies. Crit. Rev. Food Sci. Nutr., 2021, 62(24), 6549-6576.
[PMID: 33819127]
[PMID: 33819127]
[3]
Darbre, P.D. Metalloestrogens: an emerging class of inorganic xenoestrogens with potential to add to the oestrogenic burden of the human breast. J. Appl. Toxicol., 2006, 26(3), 191-197.
[http://dx.doi.org/10.1002/jat.1135] [PMID: 16489580]
[http://dx.doi.org/10.1002/jat.1135] [PMID: 16489580]
[4]
Darbre, P.D. Environmental oestrogens, cosmetics and breast cancer. Best Pract. Res. Clin. Endocrinol. Metab., 2006, 20(1), 121-143.
[http://dx.doi.org/10.1016/j.beem.2005.09.007] [PMID: 16522524]
[http://dx.doi.org/10.1016/j.beem.2005.09.007] [PMID: 16522524]
[5]
Konduracka, E.; Krzemieniecki, K.; Gajos, G. Relationship between everyday use cosmetics and female breast cancer. Polish Arch. Inter. Med., 2014, 124(5), 264-269.
[http://dx.doi.org/10.20452/pamw.2257] [PMID: 24694726]
[http://dx.doi.org/10.20452/pamw.2257] [PMID: 24694726]
[6]
Mousavi, S.M.; Montazeri, A.; Mohagheghi, M.A.; Jarrahi, A.M.; Harirchi, I.; Najafi, M.; Ebrahimi, M. Breast cancer in Iran: an epidemiological review. Breast J., 2007, 13(4), 383-391.
[http://dx.doi.org/10.1111/j.1524-4741.2007.00446.x] [PMID: 17593043]
[http://dx.doi.org/10.1111/j.1524-4741.2007.00446.x] [PMID: 17593043]
[7]
Hosseini, S.N.; Mari, A.; Jouybari, T.A.; Salehi, I.; Vahidinia, A.A.; Emdadi, S. Cosmetic products use intention among iranian female college students. Int. Sci. Index., 2014, 7, 669-672.
[8]
Nourmoradi, H.; Foroghi, M.; Farhadkhani, M.; Vahid Dastjerdi, M. Assessment of lead and cadmium levels in frequently used cosmetic products in Iran. J. Environ. Public Health, 2013, 2013, 1-5.
[http://dx.doi.org/10.1155/2013/962727] [PMID: 24174937]
[http://dx.doi.org/10.1155/2013/962727] [PMID: 24174937]
[9]
Parizi, M.G.; Sedaghat, Z.; Mazloomi, M.; Fararouei, M. Serum level of lead and cadmium is linked to facial cosmetics use among Iranian young women. Environ. Sci. Pollut. Res. Int., 2021, 28(11), 13913-13918.
[http://dx.doi.org/10.1007/s11356-020-11618-x] [PMID: 33201504]
[http://dx.doi.org/10.1007/s11356-020-11618-x] [PMID: 33201504]
[10]
Ghaderpoori, M.; Kamarehie, B.; Jafari, A.; Alinejad, A.A.; Hashempour, Y.; Saghi, M.H.; Yousefi, M.; Oliveri Conti, G.; Mohammadi, A.A.; Ghaderpoury, A.; Ferrante, M.; Mohammadi, A.A.; Ghaderpoury, A.; Ferrante, M. Health risk assessment of heavy metals in cosmetic products sold in Iran: the Monte Carlo simulation. Environ. Sci. Pollut. Res. Int., 2020, 27(7), 7588-7595.
[http://dx.doi.org/10.1007/s11356-019-07423-w] [PMID: 31885066]
[http://dx.doi.org/10.1007/s11356-019-07423-w] [PMID: 31885066]
[11]
Khalili, F.; Mahvi, A.H.; Nasseri, S.; Yunesian, M.; Yaseri, M.; Djahed, B. Health risk assessment of dermal exposure to heavy metals content of chemical hair dyes. Iran. J. Public Health, 2019, 48(5), 902-911.
[http://dx.doi.org/10.18502/ijph.v48i5.1807] [PMID: 31523647]
[http://dx.doi.org/10.18502/ijph.v48i5.1807] [PMID: 31523647]
[12]
Fillon, M. Examining the link between hair chemicals and cancer. J. Natl. Cancer Inst., 2017, 109(9), 2-5.
[http://dx.doi.org/10.1093/jnci/djx202] [PMID: 28954289]
[http://dx.doi.org/10.1093/jnci/djx202] [PMID: 28954289]
[13]
Gore, A.C.; Cohn, B. Endocrine-disrupting chemicals in cosmetics. JAMA Dermatol., 2020, 156(5), 603-604.
[http://dx.doi.org/10.1001/jamadermatol.2020.0301] [PMID: 32186657]
[http://dx.doi.org/10.1001/jamadermatol.2020.0301] [PMID: 32186657]
[14]
Gera, R.; Mokbel, R.; Igor, I.; Mokbel, K. Does the use of hair dyes increase the risk of developing breast cancer? A meta-analysis and review of the literature. Anticancer Res., 2018, 38(2), 707-716.
[PMID: 29374694]
[PMID: 29374694]
[15]
Eberle, C.E.; Sandler, D.P.; Taylor, K.W.; White, A.J. Hair dye and chemical straightener use and breast cancer risk in a large US population of black and white women. Int. J. Cancer, 2020, 147(2), 383-391.
[http://dx.doi.org/10.1002/ijc.32738] [PMID: 31797377]
[http://dx.doi.org/10.1002/ijc.32738] [PMID: 31797377]
[16]
Llanos, A.A.M.; Rabkin, A.; Bandera, E.V.; Zirpoli, G.; Gonzalez, B.D.; Xing, C.Y.; Qin, B.; Lin, Y.; Hong, C.C.; Demissie, K.; Ambrosone, C.B. Hair product use and breast cancer risk among African American and White women. Carcinogenesis, 2017, 38(9), 883-892.
[http://dx.doi.org/10.1093/carcin/bgx060] [PMID: 28605409]
[http://dx.doi.org/10.1093/carcin/bgx060] [PMID: 28605409]
[17]
Linhart, C.; Talasz, H.; Morandi, E.M.; Exley, C.; Lindner, H.H.; Taucher, S.; Egle, D.; Hubalek, M.; Concin, N.; Ulmer, H. Use of underarm cosmetic products in relation to risk of breast cancer: a case-control study. EBioMedicine, 2017, 21, 79-85.
[http://dx.doi.org/10.1016/j.ebiom.2017.06.005] [PMID: 28629908]
[http://dx.doi.org/10.1016/j.ebiom.2017.06.005] [PMID: 28629908]
[18]
Dianatinasab, M.; Fararouei, M.; Mohammadianpanah, M.; Zare-bandamiri, M.; Rezaianzadeh, A. Hair coloring, stress, and smoking increase the risk of breast cancer: a case-control study. Clin. Breast Cancer, 2017, 17(8), 650-659.
[http://dx.doi.org/10.1016/j.clbc.2017.04.012] [PMID: 28549689]
[http://dx.doi.org/10.1016/j.clbc.2017.04.012] [PMID: 28549689]
[19]
White, A.J.; Gregoire, A.M.; Taylor, K.W.; Eberle, C.; Gaston, S.; O’Brien, K.M.; Jackson, C.L.; Sandler, D.P. Adolescent use of hair dyes, straighteners and perms in relation to breast cancer risk. Int. J. Cancer, 2021, 148(9), 2255-2263.
[http://dx.doi.org/10.1002/ijc.33413] [PMID: 33252833]
[http://dx.doi.org/10.1002/ijc.33413] [PMID: 33252833]
[20]
Taylor, K.W.; Troester, M.A.; Herring, A.H.; Engel, L.S.; Nichols, H.B.; Sandler, D.P.; Baird, D.D. Associations between personal care product use patterns and breast Cancer risk among white and black women in the sister study. Environ. Health Perspect., 2018, 126(2), 027011.
[http://dx.doi.org/10.1289/EHP1480] [PMID: 29467107]
[http://dx.doi.org/10.1289/EHP1480] [PMID: 29467107]
[21]
Heikkinen, S.; Pitkäniemi, J.; Sarkeala, T.; Malila, N.; Koskenvuo, M. Does hair dye use increase the risk of breast cancer? A population-based case-control study of Finnish women. PLoS One, 2015, 10(8), e0135190.
[http://dx.doi.org/10.1371/journal.pone.0135190] [PMID: 26263013]
[http://dx.doi.org/10.1371/journal.pone.0135190] [PMID: 26263013]
[22]
Boyd, N.F.; Martin, L.J.; Bronskill, M.; Yaffe, M.J.; Duric, N.; Minkin, S. Breast tissue composition and susceptibility to breast cancer. J. Natl. Cancer Inst., 2010, 102(16), 1224-1237.
[http://dx.doi.org/10.1093/jnci/djq239] [PMID: 20616353]
[http://dx.doi.org/10.1093/jnci/djq239] [PMID: 20616353]
[23]
Sprague, B.L.; Trentham-Dietz, A.; Hedman, C.J.; Wang, J.; Hemming, J.D.C.; Hampton, J.M.; Buist, D.S.M.; Aiello Bowles, E.J.; Sisney, G.S.; Burnside, E.S. Circulating serum xenoestrogens and mammographic breast density. Breast Cancer Res., 2013, 15(3), R45.
[http://dx.doi.org/10.1186/bcr3432] [PMID: 23710608]
[http://dx.doi.org/10.1186/bcr3432] [PMID: 23710608]
[24]
McDonald, J.A.; Tehranifar, P.; Flom, J.D.; Terry, M.B.; James-Todd, T. Hair product use, age at menarche and mammographic breast density in multiethnic urban women. Environ. Health, 2018, 17(1), 1-8.
[http://dx.doi.org/10.1186/s12940-017-0345-y] [PMID: 29301538]
[http://dx.doi.org/10.1186/s12940-017-0345-y] [PMID: 29301538]
[25]
Binder, A.M.; Corvalan, C.; Pereira, A.; Calafat, A.M.; Ye, X.; Shepherd, J.; Michels, K.B. Prepubertal and pubertal endocrine-disrupting chemical exposure and breast density among Chilean adolescents. Cancer Epidemiol. Biomarkers Prev., 2018, 27(12), 1491-1499.
[http://dx.doi.org/10.1158/1055-9965.EPI-17-0813] [PMID: 30158279]
[http://dx.doi.org/10.1158/1055-9965.EPI-17-0813] [PMID: 30158279]
[26]
Jacob, S.L.; Cornell, E.; Kwa, M.; Funk, W.E.; Xu, S. Cosmetics and cancer: Adverse event reports submitted to the Food and Drug Administration. JNCI Cancer Spectr., 2018, 2(2), pky012.
[http://dx.doi.org/10.1093/jncics/pky012] [PMID: 31360845]
[http://dx.doi.org/10.1093/jncics/pky012] [PMID: 31360845]
[27]
Sickles, E.; d’Orsi, C.; Bassett, L.; Appleton, C.; Berg, W.; Burnside, E. ACR BI-RADS Mammography. In: ACR BI-RADS Atlas, Breast Imaging Reporting and Data System, 5th Edition, American College of Radiology, Reston, VA, pp. 134-136.
[28]
Kim, K.H.; Kabir, E.; Jahan, S.A. The use of personal hair dye and its implications for human health. Environ. Int., 2016, 89-90, 222-227.
[http://dx.doi.org/10.1016/j.envint.2016.01.018] [PMID: 26895479]
[http://dx.doi.org/10.1016/j.envint.2016.01.018] [PMID: 26895479]
[29]
Dehghan, M.; Baniasadi, H.; Moghadam, R.F.; Salehi, M. Cosmetic products don’t increase the risk of breast cancer: A retrospective case-control study in Southern Iran. World. J. Cancer. Res. WCRJ., 2020, 7, e1572.
[30]
Darbre, P.D. Underarm cosmetics and breast cancer. J. Appl. Toxicol., 2003, 23(2), 89-95.
[http://dx.doi.org/10.1002/jat.899] [PMID: 12666152]
[http://dx.doi.org/10.1002/jat.899] [PMID: 12666152]
[31]
Fakri, S.; Al-Azzawi, A.; Al-Tawil, N. Antiperspirant use as a risk factor for breast cancer in Iraq. East. Mediterr. Health J., 2006, 12(3-4), 478-482.
[PMID: 17037719]
[PMID: 17037719]
[32]
Mirick, D.K.; Davis, S.; Thomas, D.B. Antiperspirant use and the risk of breast cancer. J. Natl. Cancer Inst., 2002, 94(20), 1578-1580.
[http://dx.doi.org/10.1093/jnci/94.20.1578] [PMID: 12381712]
[http://dx.doi.org/10.1093/jnci/94.20.1578] [PMID: 12381712]
[33]
Allam, M.F. Breast cancer and deodorants/antiperspirants: a systematic review. Cent. Eur. J. Public Health, 2016, 24(3), 245-247.
[http://dx.doi.org/10.21101/cejph.a4475] [PMID: 27755864]
[http://dx.doi.org/10.21101/cejph.a4475] [PMID: 27755864]
[34]
McGrath, K.G. An earlier age of breast cancer diagnosis related to more frequent use of antiperspirants/deodorants and underarm shaving. Eur. J. Cancer Prev., 2003, 12(6), 479-485.
[http://dx.doi.org/10.1097/00008469-200312000-00006] [PMID: 14639125]
[http://dx.doi.org/10.1097/00008469-200312000-00006] [PMID: 14639125]
[35]
Darbre, P.D. Underarm antiperspirants/deodorants and breast cancer. Breast Cancer Res., 2009, 11(S3), S5.
[http://dx.doi.org/10.1186/bcr2424] [PMID: 20030880]
[http://dx.doi.org/10.1186/bcr2424] [PMID: 20030880]
[36]
Charles, A.K.; Darbre, P.D. Combinations of parabens at concentrations measured in human breast tissue can increase proliferation of MCF-7 human breast cancer cells. J. Appl. Toxicol., 2013, 33(5), 390-398.
[http://dx.doi.org/10.1002/jat.2850] [PMID: 23364952]
[http://dx.doi.org/10.1002/jat.2850] [PMID: 23364952]
[37]
López-Carrillo, L.; Hernández-Ramírez, R.U.; Calafat, A.M.; Torres-Sánchez, L.; Galván-Portillo, M.; Needham, L.L.; Ruiz-Ramos, R.; Cebrián, M.E. Exposure to phthalates and breast cancer risk in Northern Mexico. Environ. Health Perspect., 2010, 118(4), 539-544.
[http://dx.doi.org/10.1289/ehp.0901091] [PMID: 20368132]
[http://dx.doi.org/10.1289/ehp.0901091] [PMID: 20368132]
[38]
Parada, H., Jr; Gammon, M.D.; Ettore, H.L.; Chen, J.; Calafat, A.M.; Neugut, A.I.; Santella, R.M.; Wolff, M.S.; Teitelbaum, S.L. Urinary concentrations of environmental phenols and their associations with breast cancer incidence and mortality following breast cancer. Environ. Int., 2019, 130, 104890.
[http://dx.doi.org/10.1016/j.envint.2019.05.084] [PMID: 31228785]
[http://dx.doi.org/10.1016/j.envint.2019.05.084] [PMID: 31228785]
[39]
Rylander, C.; Veierød, M.B.; Weiderpass, E.; Lund, E.; Sandanger, T.M. Use of skincare products and risk of cancer of the breast and endometrium: a prospective cohort study. Environ. Health, 2019, 18(1), 105.
[http://dx.doi.org/10.1186/s12940-019-0547-6] [PMID: 31796030]
[http://dx.doi.org/10.1186/s12940-019-0547-6] [PMID: 31796030]
[40]
Kiani Feizabadi, G.; Hajizadeh, Y.; Feizi, A.; Ebrahimpour, K. Urinary concentrations of parabens in a population of Iranian adolescent and their association with sociodemographic indicators. Arch. Environ. Contam. Toxicol., 2020, 79(2), 195-207.
[http://dx.doi.org/10.1007/s00244-020-00746-7] [PMID: 32572517]
[http://dx.doi.org/10.1007/s00244-020-00746-7] [PMID: 32572517]
[41]
Burnett, M.E.; Wang, S.Q. Current sunscreen controversies: a critical review. Photodermatol. Photoimmunol. Photomed., 2011, 27(2), 58-67.
[http://dx.doi.org/10.1111/j.1600-0781.2011.00557.x] [PMID: 21392107]
[http://dx.doi.org/10.1111/j.1600-0781.2011.00557.x] [PMID: 21392107]
