Table 1: List of the reviewed studies and the salient research process.


Location of study and participants

Study design & sample size (n)

Exposure assessment (& method used)



Demers, et al. [3]

Quebec, Canada

Rural and Urban subjects

Case control study (cases = 315, controls = 526)

Concentration of PCG congeners measured in plasma lipids by high resolution gas chromatography

Lymph node invasion among cases increased with p,p’-DDE (OR: 2.54; 95% CI: 1.2-5.35)

Exposure to OC during adulthood is not associated with risk of breast cancer

Silva AMC, et al. [4]

Rondonopolis, Brazil

Urban subjects

Case control study (85 cases, 266 controls)

Assessment of environmental exposure to Pesticides through oral questionnaires

Living near cropland with pesticides and women aged > 50 yrs had high risk

Increasing trend of cancer due to diffusion of carcinogenic agents in the environment, including its effect during various stages of organ development

Ting-Ting He, et al. [6]

Qingdao, China

Rural and Urban subjects


Hospital based case control study (n = 102)

OC pesticide product accumulation in breast adipose tissue by gas chromatography

High levels of pp’DDE and PCB-52 was found in breast cancer patients

Concentration of pp’DDE and PCB-52 were not related to clinico pathologic parameters of breast cancer

Rodgers K.M [7]

Massachusetts, US

Systematic review of 158 articles

EDCs, PAHs, BPA, Phthalates, PFASs*

Higher risk for exposures during breast development to DDT, air pollution

Chemicals in current consumer use products with potential for cancer causation need to be studied.

Demers, et al. [8]

Quebec, Canada

Urban subjects

Case control (cases: 315, controls: 526)

Plasma lipid concentrations of chlorinated pesticides and PCB congeners

Risk for these congeners, OR: 2.02 (1.24-3.28),

Exposure to dioxin like mono-ortho PCB congeners increases risk of breast cancer

Mathur V, et al. [9]

Jaipur, India



Blood samples were collected to evaluate the body burden of OC

OC were significantly high in patients

Rural women had high levels of OC when compared to urban women

Kettles M.K, et al. [10]

Kentucky, US

Rural areas

4,859 wells were tested and 1979 survey of amount of pesticide used in each County was examined

Triazine herbicide exposure determined by water contamination data and corn crop production

County level exposure was significant for Medium (OR: 1.14) and High (OR: 1.2) categories

Acres of corn planted serves as a reasonable proxy of triazine use

Rich, et al. [11]

Kentucky, US

Rural subjects

Ecologic study, secondary data (1993-97) used to assess atrazine exposure

Public water samples, Acres of corn planted, Pounds of atrazine sold

Null association across all exposure indices

Individual level data are ideal to elucidate the relationship

Guttes, et al. [12]

Hasse, Germany

Rural and Urban subjects

Case control study (cases = 45, controls = 20)

Surgically removed breast tissue was examined by capillary gas chromatography

Significantly high pesticide concentration in breast cancer tissues

Surgical procedures did not influence the results

Aronson, et al. [13]

Ontario, Canada

Rural and Urban subjects

Case control (cases = 217, controls = 213)

Excision biopsy of breast adipose tissue

Breast cancer risk elevated for PCBs 105 & 118 (OR > 2 in highest category)

Breast tissue biopsy represents cumulative exposure at target site

Wolff, et al. [14]

NewYork city, US

Urban subjects

Hospital based Case control study (cases = 175, controls = 355)

OC exposure

OC levels not associated with risk of Breast cancer, nor did it differ with tumor stage or markers

High DDE levels in high BMI individuals, low HPCB among low BMI individuals

Romiew, et al. [15]

Mexico city, Mexico

Urban subjects

Subsample of a large breast cancer case control study (cases = 120, controls = 126)

Serum OC levels measured in the original study. Subjects were sampled from them.

Risk increase with high serum DDE levels (ORQ1-Q4 = 3.81, 95% CI: 1.14, 12.8), test of trend, p = 0.02

Longer period of lactation is associated with a slightly decreased risk of breast cancer

Hoyer, et al. [16]

Copenhagen, Denmark

Urban subjects


Cohort nested Case control study (cases = 161, controls = 322)

OC (Dieldrin) exposure

Exposure to large levels of OC increase the risk by 7 fold for ERN breast cancer

Adverse effect of OC on prognosis of hormone responsive breast cancer needs to be clarified

Tayour C, et al. [17]

California, US,

Rural subjects,

Case control study (cases: 155, controls: 150)

OC & OP (Chlorpyrifos) pesticides were assessed using historic pesticide exposure data and geocoded location histories,

High risk for women exposed to chlorpyrifos

Need to objectively assess exposure to specific pesticides occurring decades before breast cancer diagnosis

Krieger, et al. [18]

San Francisco Bay area, US

Urban subjects

Nested case control

Serum levels of DDE and PCBs

Data does not show an association between DDE & PCB exposure

Lack of association was regardless of length of follow-up, case patient’s menopausal and estrogen receptor status

Engel L.S, et al. [19]

Iowa and North Carolina, US,

Rural subjects

Prospective cohort study (n = 30,454)

Pesticide use assessed by oral questionnaire

Elevated risk for women whose homes were closest to areas of pesticide application

Non-differential exposure misclassification due to recall bias, while self-reporting for exposure assessment

Kaur N, et al. [20]

Delhi, India

Urban subjects

Hospital based case control study (42 cases, 42 controls)

Biopsy proven women with carcinoma breast aged ≤ 40 years,

Significant risk was found for heptachlor, DDE, Dieldrin and β-HCH

Exposure to OCPs could increase the incidence of breast cancer among young women in India

Shakeel, et al. [21]

Trivandrum, India

Systematic review of 41 articles


DDT is positively associated with breast cancer.

Level of Pesticide exposure is more in developing than developed countries.

*PFASs: Per and Polyfluoroalkyl Substances.