“Pinktober” – Breast Cancer Awareness Month

Pink ribbons. Pink pens. Pink socks. Pink jewelry. Pink banners. Even pink window nets at NASCAR. October is designated Breast Cancer Awareness Month. The purpose is to increase awareness of the disease and raise funds for research into its cause, prevention, diagnosis, treatment and cure.

Because the disease is so widespread, chances are each of us knows someone who has been touched by breast cancer. Many who have been through it will tell you:

“The waiting is the worst. Finding out you have a questionable result on your mammogram and then waiting days or weeks for confirmation one way or the other can drive you to distraction.”

“Unless it’s caught extremely early, the journey back to health is a long one. It usually includes surgery (sometimes, but not always, removing the entire breast and lymph nodes. Then chemotherapy. Then radiation. Each part of the treatment destroys a piece of your body in a different way.”

“Cancer treatment is the gift that keeps on giving. Sometimes long after it’s over, the effects of the treatment are a daily reminder that you are a cancer survivor.”

How big is the problem?

One in eight women in the United States will get breast cancer. And that number keeps rising.

One in 39 will die from breast cancer. Breast cancer is the second most deadly cancer for women, directly behind lung cancer.¹

Among the population that gets breast cancer, the risk of serious disease is not equal. Younger women and Black women are at greater risk of dying from breast cancer than others.

When breast cancer occurs in women aged 20 to 49 years old, they tend to get more aggressive forms of the disease. In fact, breast cancer deaths for young women surpass lung cancer as the cause of death.²

Black women have the highest rate of breast cancer among young women. Additionally, Black women are twice as likely as white women to have “triple negative” cancer – a subset of breast cancer that is more aggressive than other types. Black women have the lowest survival rate regardless of the stage (how advanced) the cancer is. According to the American Cancer Society, this is likely due to more limited access to quality care, in addition to the higher rates of triple negative cancer.³

Men can also get breast cancer, but at much lower rates. Men account for less than 1 percent of all breast cancer cases. One in approximately 1,000 men will get breast cancer. It is notable that Black men have the highest male breast cancer rate and highest death rate.⁴

The Good News

Despite these statistics, there is some good news. Early detection and innovations in treatment have made breast cancer less deadly than it previously was.

  • Ninety-one (91) percent of women are living more than five years since they were diagnosed.
  • Eighty-six (86) percent of women are living more than 10 years since they were diagnosed.
  • Eighty-one (81) percent of women are living more than 15 years since they were diagnosed.⁵

Who is at risk?

Approximately 30 percent of breast cancers are thought to be due to factors that can be modified with behavior changes (weight, inactivity, alcohol consumption, etc.). That means that the vast majority cannot be prevented with individual behavior.⁶

Personal risk factors include:

  • Age
  • Family history
  • Genetics
  • Breast density
  • Height
  • Age at puberty; age at menopause
  • Type 2 diabetes
  • Body weight
  • Physical inactivity
  • Diet
  • Alcohol and tobacco
  • Diethylstilbestrol (DES) exposure (from mother’s use 1940-1971)

Environmental and occupational risk factors.

Breast cancer is a workplace issue. Exposures on the job are known to be risk factors.

The following workplace conditions are known risk factors for breast cancer:

  • Radiation
  • Environmental chemicals and pollutants
  • Night shift work⁷

The Silent Spring Institute is a project on women’s health and the environment. In 2007 they published a list of 216 chemicals known to cause mammary (breast) tumors in animals. At least 25 of these chemicals are found in workplaces with a large number of women workers. The following chemicals are found in many manufacturing facilities.⁸

ChemicalUse for Product

1,2 Dichloroethane

Production of polyvinyl chloride (PVC)

1,2 Propylene Oxide

Polyurethane plastics; fumigant

3,3 Dimethylbenzidine

Dyes and pigments

Acrylonitrile

Plastics, rubbers, acrylic fibers, coatings and adhesives

Benzene

Found in crude oil and gasosline. Production of plastics, resins and synthetic fibers. Lubricants, rubbers, dyes, detergents, drugs and pesticides.

C.I. Direct Black 38

Benzidine-based dyes

Carbon tetrachloride

Degreaser, dry cleaning, solvent for oils, fats, lacquers, varnishes, rubber waxes and resins

Ethylene Oxide

Antifreeze, textiles, plastics, detergents and adhesives. It is also used to sterilize devices that can’t be sterilized using steam or radiation, such as some medical and dental equipment.

Methylene Chloride

Solvent used in a variety of industries and applications, such as adhesives, paint and coating products, pharmaceuticals, metal cleaning, chemical processing, and aerosols.

Nitromethane

Degreaser, dry cleaning and for cleaning semiconductors and lenses. It is also used to stabilize the halogenated propellants for aerosols and to inhibit corrosion on the interiors of tin-plated steel cans containing water-based aerosol formulations

Ortho-toluidine hydrochloride

Used in the manufacture of more than 90 dyes and pigments (e.g., acid-fast dyestuffs, azo pigment dyes, triarylmethane dyes, sulfur dyes and indigo compounds), and as an intermediate

Styrene

Used in plastics, latex paints and coatings, synthetic rubbers, polyesters and styrene-alkyd coatings

Urethane

Construction materials, automobile parts, textiles, medical equipment

Risk reduction v. early detection

Early detection is key in ensuring women do not die from breast cancer. The goal, however, should be preventing the disease. As was noted above, only 30 percent of cancers can be prevented through lifestyle changes. While there is not a precise number of cancers caused by workplace or environmental exposures, this area is an important place for unions to step in.

Preventing workplace injuries and illnesses using the Hierarchy of Controls or the United Steelworkers (USW) Systems of Safety works for other hazards. They can work in cancer risk reduction also.

What can unions do?

Unions have a long history of advocating for risk reduction in the workplace. One early example of a union defending its members, both men and women, from exposures that can cause breast cancer is from the 1970s.

While men are far less likely to get breast cancer than women, there have been known occupational exposures that put them at greater risk. In 1977 the National Institute for Occupational Safety and Health (NIOSH) conducted a health hazard evaluation (HHE) at the request of Oil, Chemical and Atomic Workers Local Union 7-765. Workers there were exposed to diethylstilbestrol (DES), a synthetic form of estrogen that was previously used to prevent miscarriage. The evaluation was requested on behalf of men in the facility who developed enlarged breasts and suffered impotence.

NIOSH concluded that a health hazard existed based on workers’ exposure to DES. While no incidents of breast cancer were reported at the time of the HHE, no known follow-up to this group has been published. Cancers take a number of years to develop and it is possible that the exposed workers may have developed the disease later.⁹

What can be done?

Recommendations (Personal)

  • Regular screening for early detection
  • Mammogram
  • Magnetic resonance imaging (MRI)
  • Ultrasound
  • Healthy habits
  • Physical activity
  • Maintain healthy weight
  • Do not use tobacco
  • Alcohol use in moderation if at all

Recommendations (Societal, Environmental, Occupational)¹⁰

Education

  • Provide community education on key aspects of breast cancer risks, prevention and treatment
  • Include educational programs in K-12 schools about nutrition and physical activity

Diet and Nutrition

  • Provide support for community gardens and access to nutritious, locally grown foods
  • Create programs that eliminate “food deserts” in poorer neighborhoods
  • Provide free, healthy breakfast and lunch programs at school

Occupational/Unions

USW members are trained to identify workplace hazards and advocate for solutions that protect workers from on the job exposures. Applying the same principles to conditions that can cause breast cancer will spare many women from having to go through surgery, chemotherapy and radiation treatments to save their lives.

Work with workers and their unions to establish practices (industry-wide) that reduce or eliminate workplace exposures to cancer-causing substances on the job.

Work with governmental agencies to ensure implementation and enforcement of standards that reduce or eliminate workplace exposures to cancer-causing substances on the job.

The exposures above include chemical and radiation hazards.

Identify and implement best practices for shift workers who must work at night.

Advocate for additional research on the affects of workplace exposures on breast cancer.

Negotiate for workplace policies that support patients going through cancer treatment.

Chemicals in consumer products

Advocate for regulation of the use of harmful chemicals in consumer products

Educate the public about harmful chemicals found in consumer products

Race and health inequities

Require anti-racism training for those engaged in the provision of medical care and health care systems.

Require the state cancer registry to collect information on race, occupation, and household income and other social factors that affect cancer rates.

Support community education on the disproportionate impact rate has on breast cancer.

Attention must be paid to the underlying causes of breast cancer throughout the year – not just in October. If companies and organizations want to benefit from the favorable publicity they get by acknowledging Breast Cancer Awareness Month, they must also be held accountable for any ways in which their company, product or organizational continues to either contribute directly to causing breast cancer or contribute to the stigma women and men often feel when they have the disease.

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