Associations between dietary exposure to profiles of metalloestrogens and estrogen-receptor positive breast cancer risk in the French E3N cohort

Abstract Metalloestrogens are ionic metals and metalloids that can activate estrogen receptor, and are suspected to play a role in breast cancer occurrence. This study explored the relationship between dietary exposure profiles to metalloestrogens and estrogen-receptor positive breast cancer (ERP-BC...

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Main Authors: Florian Saint-Martin, Chloé Marques, Xuan Ren, Emeline Lequy, Francesca Romana Mancini, Pauline Frénoy
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Environmental Health
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Online Access:https://doi.org/10.1186/s12940-025-01167-6
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author Florian Saint-Martin
Chloé Marques
Xuan Ren
Emeline Lequy
Francesca Romana Mancini
Pauline Frénoy
author_facet Florian Saint-Martin
Chloé Marques
Xuan Ren
Emeline Lequy
Francesca Romana Mancini
Pauline Frénoy
author_sort Florian Saint-Martin
collection DOAJ
description Abstract Metalloestrogens are ionic metals and metalloids that can activate estrogen receptor, and are suspected to play a role in breast cancer occurrence. This study explored the relationship between dietary exposure profiles to metalloestrogens and estrogen-receptor positive breast cancer (ERP-BC) risk among women in the French E3N cohort. A prospective study was conducted involving 66 722 women who completed a food frequency questionnaire in 1993. Food consumption data were combined with food contamination data obtained from the Second French Total Diet Study, to estimate the dietary intake of 14 metalloestrogens. A principal component analysis was performed to identify the main dietary exposure profiles to metalloestrogens. The retained principal components were included in Cox regression models, used to estimate Hazard Ratios (HR) and their 95% confidence intervals (95% CI) for the associations between the adherence to the identified profiles and ERP-BC risk identified until 2014, adjusted for confounding factors selected using a directed acyclic graph. After an average follow-up of 17.7 years, 3 739 incident cases of ERP-BC were identified. Four principal components were retained, explaining 80.5% of the variance. A statistically significant positive association between the third principal component, mainly characterized by dietary intake of inorganic arsenic and vanadium, and ERP-BC risk was estimated (HR: 1.04, 95% CI: 1.00–1.07, p-value: 0.03). No statistically significant association was found when evaluating the effect of each metalloestrogen individually. The results suggests that even relatively low levels of exposure to inorganic arsenic and vanadium, when combined, could increase the risk of ERP-BC.
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spelling doaj-art-5eddf5a1c7a24e63976ab107cb0eda162025-08-20T02:24:30ZengBMCEnvironmental Health1476-069X2025-04-0124111210.1186/s12940-025-01167-6Associations between dietary exposure to profiles of metalloestrogens and estrogen-receptor positive breast cancer risk in the French E3N cohortFlorian Saint-Martin0Chloé Marques1Xuan Ren2Emeline Lequy3Francesca Romana Mancini4Pauline Frénoy5Université Paris-Saclay, UVSQ, Gustave Roussy, CESPUniversité Paris-Saclay, UVSQ, Gustave Roussy, CESPUniversité Paris-Saclay, UVSQ, Gustave Roussy, CESPUniversité Paris-Saclay, UVSQ, Gustave Roussy, CESPUniversité Paris-Saclay, UVSQ, Gustave Roussy, CESPUniversité Paris-Saclay, UVSQ, Gustave Roussy, CESPAbstract Metalloestrogens are ionic metals and metalloids that can activate estrogen receptor, and are suspected to play a role in breast cancer occurrence. This study explored the relationship between dietary exposure profiles to metalloestrogens and estrogen-receptor positive breast cancer (ERP-BC) risk among women in the French E3N cohort. A prospective study was conducted involving 66 722 women who completed a food frequency questionnaire in 1993. Food consumption data were combined with food contamination data obtained from the Second French Total Diet Study, to estimate the dietary intake of 14 metalloestrogens. A principal component analysis was performed to identify the main dietary exposure profiles to metalloestrogens. The retained principal components were included in Cox regression models, used to estimate Hazard Ratios (HR) and their 95% confidence intervals (95% CI) for the associations between the adherence to the identified profiles and ERP-BC risk identified until 2014, adjusted for confounding factors selected using a directed acyclic graph. After an average follow-up of 17.7 years, 3 739 incident cases of ERP-BC were identified. Four principal components were retained, explaining 80.5% of the variance. A statistically significant positive association between the third principal component, mainly characterized by dietary intake of inorganic arsenic and vanadium, and ERP-BC risk was estimated (HR: 1.04, 95% CI: 1.00–1.07, p-value: 0.03). No statistically significant association was found when evaluating the effect of each metalloestrogen individually. The results suggests that even relatively low levels of exposure to inorganic arsenic and vanadium, when combined, could increase the risk of ERP-BC.https://doi.org/10.1186/s12940-025-01167-6MetalloestrogensBreast cancerPrincipal component analysisDietary exposure to contaminantsFood frequency questionnaireProspective cohort
spellingShingle Florian Saint-Martin
Chloé Marques
Xuan Ren
Emeline Lequy
Francesca Romana Mancini
Pauline Frénoy
Associations between dietary exposure to profiles of metalloestrogens and estrogen-receptor positive breast cancer risk in the French E3N cohort
Environmental Health
Metalloestrogens
Breast cancer
Principal component analysis
Dietary exposure to contaminants
Food frequency questionnaire
Prospective cohort
title Associations between dietary exposure to profiles of metalloestrogens and estrogen-receptor positive breast cancer risk in the French E3N cohort
title_full Associations between dietary exposure to profiles of metalloestrogens and estrogen-receptor positive breast cancer risk in the French E3N cohort
title_fullStr Associations between dietary exposure to profiles of metalloestrogens and estrogen-receptor positive breast cancer risk in the French E3N cohort
title_full_unstemmed Associations between dietary exposure to profiles of metalloestrogens and estrogen-receptor positive breast cancer risk in the French E3N cohort
title_short Associations between dietary exposure to profiles of metalloestrogens and estrogen-receptor positive breast cancer risk in the French E3N cohort
title_sort associations between dietary exposure to profiles of metalloestrogens and estrogen receptor positive breast cancer risk in the french e3n cohort
topic Metalloestrogens
Breast cancer
Principal component analysis
Dietary exposure to contaminants
Food frequency questionnaire
Prospective cohort
url https://doi.org/10.1186/s12940-025-01167-6
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