Skip to main content

Advertisement

SpringerLink
Log in

Women’s Understanding of Windows of Susceptibility and the Role of the Environment in Breast Cancer Risk

  • Published:
Journal of Cancer Education Aims and scope Submit manuscript

Abstract

Emerging evidence suggests women who are exposed to harmful environmental exposures, especially during certain critical periods across the lifespan, may increase their breast cancer risk. Such windows of susceptibility (WoS) occur throughout a woman’s lifetime, during which she is especially vulnerable to the effects of harmful environmental exposures. This interaction makes the reduction of harmful environmental toxicants during those time periods a priority for community health promotion. Communicating about environmental exposures and their impact on women’s health requires an assessment of sense-making around, and understanding of, the link between breast cancer and the environment. To that end, focus groups were conducted to assess the themes that emerge when women make sense of (a) their own breast cancer risk, (b) the environment-cancer connection, and (c) WoS. Results provide insight into how women understand these issues which can inform messaging strategies focused on reducing harmful environmental exposures. Implications are discussed within the context of communication efforts tailored to educate women, particularly mothers with daughters in the prepubertal and pubertal WoS who are particularly vulnerable to harmful environmental exposures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. American Cancer Society (2019) How common is breast cancer. Retrieved from https://www.cancer.org/cancer/breastcancer/about/how-common-is-breast-cancer.html. Accessed  2-9-2020

  2. President’s Cancer Panel (2010) Reducing environmental risk: what we can do now – 2008–2009 annual report of the President’s Cancer Panel. Retrieved from http://pcp.cancer.gov. Accessed 2-9-2020

  3. Biro FM, Deardorff Julianna (2013) Identifying opportunities for cancer prevention during preadolescence and adolescence: puberty as a window of susceptibility. J Adolesc Health. https://doi.org/10.1016/j.jadohealth.2012.09.019

    Article  Google Scholar 

  4. Terry MB, Michels KB, Brody JG, Byrne C, Chen S, Jerry DJ, Malecki KMC, Martin MB, Miller RL, Neuhausen SL, Silk KJ, Trentham-Dietz A (2019) Environmental exposures during windows of susceptibility for breast cancer: a framework for prevention research. Breast Cancer Res. https://doi.org/10.1186/s13058-019-1168-2

    Article  Google Scholar 

  5. Parrott Roxanne L (1996) A women-centered “sense-making” approach to communicating about women’s reproductive health. In: Parrott Roxanne L, Condit Celeste M (eds) Evaluating women’s health messages. SAGE, Thousand Oaks, pp 414–425

    Google Scholar 

  6. American Cancer Society (2020) Cancer facts & figures 2020. American Cancer Society, Atlanta

    Google Scholar 

  7. Kaplowitz PB (2008) Link between body fat and the timing of puberty. Pediatrics. https://doi.org/10.1542/peds.2007-1813F

    Article  Google Scholar 

  8. Biro FM, Galvez MP, Greenspan LC, Succop PA, Vangeepuram N, Pinney SM, Tietelbaum S, Windham GC, Kushi LH, Wolff MS (2010) Pubertal assessment methods and baseline characteristics in a mixed longitudinal study of girls. Pediatrics. https://doi.org/10.1542/peds.2009-3079

    Article  Google Scholar 

  9. Diamanti-Kandarakis E, Bourguignon JP, Giudice LC, Hauser R, Prins GS, Soto AM, Zoeller RT, Gore AC (2009) Endocrine-disrupting chemicals: an Endocrine Society Scientific Statement. Endocr Rev. https://doi.org/10.1210/er.2009-0002

    Article  Google Scholar 

  10. Gore Andrea C (2010) The basic biology of endocrine disruption. In: Gore Andrea C (ed) Endocrine-disrupting chemicals: from basic research to clinical practice. Humana Press, Totowa

    Google Scholar 

  11. Atkin CK, Smith SW (2010) Improving communication practices to reduce breast cancer environmental risks. Health Commun. https://doi.org/10.1080/10410236.2010.496836

    Article  Google Scholar 

  12. Hiatt RA, Haslam SZ, Osuch J (2009) The breast cancer and the environment research centers: transdisciplinary research on the role of the environment in breast cancer etiology. Environ Health Perspect. https://doi.org/10.1289/ehp.0800120

    Article  Google Scholar 

  13. Silk KJ, Bigsby E, Volkman J, Kingsley C, Atkin CK, Ferrara M, Goins L-A (2006) Formative research on adolescent and adult risk perceptions for breast cancer. Soc Sci Med. https://doi.org/10.1016/j.socscimed.2006.08.010

    Article  Google Scholar 

  14. Smith SW, Atkin CK, Skubisz CM, Nazione S, Stohl C (2009) The impact of personal and/or close relationship experience on memorable messages about breast cancer and the perceived speech acts of the sender. J Cancer Educ. https://doi.org/10.1080/08858190902854681

    Article  Google Scholar 

  15. Smith SW, Nazione S, LaPlante C, Kotowski MR, Atkin CK, Skubisz C, Stohl C (2009) Topics and sources of memorable breast cancer messages: their impact on prevention and detection behaviors. J Health Commun. https://doi.org/10.1080/10810730902805903

    Article  Google Scholar 

  16. Atkin CK, Smith SW, McFeters C, Ferguson V (2008) A comprehensive analysis of breast cancer news coverage in leading media outlets. J Health Commun. https://doi.org/10.1080/10810730701806912

    Article  Google Scholar 

  17. Silk KJ, Perrault EK, Neuberger L, Rogers A, Atkin CK, Barlow J, Duncan DM (2014) Translating and testing breast cancer risk reduction messages for mothers of adolescent girls. J Health Commun. https://doi.org/10.1080/10810730.2013.811322

    Article  Google Scholar 

  18. Powe BD (1995) Fatalism among elderly African Americans: effects on colorectal cancer screening. Cancer Nurs. https://doi.org/10.1097/00002820-199510000-00008

    Article  Google Scholar 

  19. Silk Kami J, Totzkay Daniel (2018) The Breast Cancer and the Environment Research Program. In: Parrott Roxanne L (ed) The Oxford research encyclopedia of health and risk message design and processing. Oxford University Press, Oxford

    Google Scholar 

  20. Reyna VF (2008) A theory of medical decision making and health: fuzzy trace theory. Med Decis Making. https://doi.org/10.1177/0272989X08327066

    Article  Google Scholar 

  21. Seltenrich N (2016) Institutes in the lead: identifying environmental factors in breast cancer. Environ Health Perspect. https://doi.org/10.1289/ehp.124-A199

    Article  Google Scholar 

  22. Hiatt RA, Brody JG (2018) Environmental determinants of breast cancer. Annu Rev Public Health. https://doi.org/10.1146/annurev-publhealth-040617-014101

    Article  Google Scholar 

  23. Deardorff J, Ekwaru JP, Kushi LH, Ellis BJ, Greenspan LC, Mirabedi A, Landaverde EG, Hiatt RA (2011) Father absence, body mass index, and pubertal timing in girls: differential effects by family income and ethnicity. J Adolesc Health. https://doi.org/10.1016/j.jadohealth.2010.07.032

    Article  Google Scholar 

  24. Zota AR, Aschengrau A, Rudel RA, Brody JG (2010) Self-reported chemicals exposure, beliefs about disease causation, and risk of breast cancer in the Cape Cod Breast Cancer and Environment Study: a case-control study. Environ Health. https://doi.org/10.1186/1476-069x-9-40

    Article  Google Scholar 

  25. Silk KJ, Walling BM, Totzkay D, Mulroy M, Smith SW, Quaderer T, Boumis J, Thomas B (2019) Continuing medical education as a translational science opportunity for health communication researchers: the BCERP model. Health Commun. https://doi.org/10.1080/10410236.2019.1625003

    Article  Google Scholar 

Download references

Funding

This work was supported by the Breast Cancer and the Environment Research Program under Grant Number 5U01ES026127-02.

Author information

Authors and Affiliations

  1. West Virginia University, Morgantown, WV, USA

    D. Totzkay

  2. University of Delaware, Newark, DE, USA

    K. J. Silk

  3. Michigan State University, East Lansing, MI, USA

    B. Thomas, B. M. Walling & S. W. Smith

Authors
  1. D. Totzkay
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. J. Silk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Thomas
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. B. M. Walling
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S. W. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. W. Smith.

Ethics declarations

Ethics Approval

This project was approved by the Michigan State University Institutional Review Board in 2016 (#X15-112e).

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendix. Focus Group Moderator Guide

Appendix. Focus Group Moderator Guide

Today, we are going be discussing breast cancer and the environment. Again, there are no right or wrong answers—we are looking for your thoughts, insights, and opinions. So, let us get started.

  1. I.

    There are lots of things to worry about in our lives in general and related to our health. How does breast cancer rank for you in terms of your overall level of worry? Please explain.

  2. II.

    When you think about breast cancer, what are the major risk factors that might contribute to someone getting breast cancer?

    1. a

      Are there any other factors that you think might increase someone’s risk of breast cancer?

    2. b

      We are also going to be talking about environmental exposures—so my next question for everyone is when you think of environmental exposures, what comes to mind?

      1. i.

        If you had to define it for someone, what would you say?

  3. III.

    For our purposes today, we are going to define environmental exposures as “contact with substances, such as chemicals or small particles, through the air we breathe, the food we eat, the water we drink, and things we touch and put on our skin.”

    1. a

      Now that you know how we are defining environmental exposures, what types of specific concerns do you have about environmental exposures and breast cancer?

    2. b

      Do you think that chemical exposures can increase the risk of breast cancer? What kind of chemicals are you concerned about—please name them if you can?

      1. i.

        How concerned are you about chemicals in food and everyday products?

      2. ii.

        Which chemicals or products in your home concern you?

      3. iii.

        Are there certain health effects that concern you?

    3. c

      Throughout one’s lifespan, when are individuals vulnerable to chemical exposures?

      1. i.

        Are there times when one might be more vulnerable to chemical exposures? When might these times be?

      2. ii.

        What would you call this time frame of high risk?

      3. iii.

        Have you ever heard/seen the term Window of Susceptibility as it relates to breast cancer? What does it mean to you?

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Totzkay, D., Silk, K.J., Thomas, B. et al. Women’s Understanding of Windows of Susceptibility and the Role of the Environment in Breast Cancer Risk. J Canc Educ 38, 115–126 (2023). https://doi.org/10.1007/s13187-021-02086-z

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13187-021-02086-z

Keywords

Search

Navigation