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Exposure to ambient air pollution during pregnancy and risk of early-onset breast cancer

Edlund, Jessica ; Wu, Wendy Yi Ying ; Gustafsson, Malin ; Lindén, Jenny ; Oudin, Anna LU orcid and Harlid, Sophia (2025) In Breast Cancer Research 27(1).
Abstract

Background: Air pollution has been linked to breast cancer risk, but previous studies have seldom considered specific exposure windows, like pregnancy. During pregnancy the breast undergoes substantial changes and exposures may have a stronger impact than if they occurred during other time periods. This study aims to identify associations between ambient air pollution exposure during pregnancy and risk of early-onset breast cancer. Methods: Using nationwide data from Swedish registers, we constructed a cohort consisting of all cancer-free women in Sweden giving birth to their first child between 1991 and 2015. Residential exposure to nitrogen dioxide (NO2), particulate matter < 10 μm (PM10) and < 2.5 μm... (More)

Background: Air pollution has been linked to breast cancer risk, but previous studies have seldom considered specific exposure windows, like pregnancy. During pregnancy the breast undergoes substantial changes and exposures may have a stronger impact than if they occurred during other time periods. This study aims to identify associations between ambient air pollution exposure during pregnancy and risk of early-onset breast cancer. Methods: Using nationwide data from Swedish registers, we constructed a cohort consisting of all cancer-free women in Sweden giving birth to their first child between 1991 and 2015. Residential exposure to nitrogen dioxide (NO2), particulate matter < 10 μm (PM10) and < 2.5 μm (PM2.5) were modelled based on air pollution concentrations from 2019. Particulate matter between 2.5 and 10 μm (PMcoarse) was calculated separately. Detailed data on residential addresses (including exact moving dates) were available for the entire study period, allowing for spatial variation in the exposure dataset. Mean air pollution levels were assessed at first pregnancy, last pregnancy, 35 years of age, and 2 years after the last delivery. Associations were evaluated using Cox proportional hazards regression to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Among 1,019,076 women, 12,085 (1.2%) were diagnosed with breast cancer and 65.2% moved at least once between their first pregnancy and two years after their last delivery. All exposures during pregnancy periods were positively associated with breast cancer, with the highest HR observed for exposure to PMcoarse during the last pregnancy (HRPMcoarse = 1.12 (95% CI = 1.04, 1.20) per 5 μg/m3 increase). The lowest HR were for NO2 levels estimated at 35 years of age, regardless of pregnancy status (HRNO2 = 1.03 (95% CI = 0.99, 1.06) per 10 μg/m3 increase). In analyses differentiating between invasive breast cancer and ductal carcinoma in situ, only invasive breast cancer was associated with air pollution exposure. Conclusions: In this cohort study, air pollution exposure was consistently associated with increased risk of early-onset breast cancer.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Air pollution, Breast cancer, Pregnancy, Risk factors
in
Breast Cancer Research
volume
27
issue
1
article number
203
publisher
BioMed Central (BMC)
external identifiers
  • pmid:41233900
  • scopus:105021544259
ISSN
1465-5411
DOI
10.1186/s13058-025-02165-9
language
English
LU publication?
yes
id
095c9370-f707-4e3e-a4b7-f97911097777
date added to LUP
2026-01-12 14:05:09
date last changed
2026-01-13 03:00:12
@article{095c9370-f707-4e3e-a4b7-f97911097777,
  abstract     = {{<p>Background: Air pollution has been linked to breast cancer risk, but previous studies have seldom considered specific exposure windows, like pregnancy. During pregnancy the breast undergoes substantial changes and exposures may have a stronger impact than if they occurred during other time periods. This study aims to identify associations between ambient air pollution exposure during pregnancy and risk of early-onset breast cancer. Methods: Using nationwide data from Swedish registers, we constructed a cohort consisting of all cancer-free women in Sweden giving birth to their first child between 1991 and 2015. Residential exposure to nitrogen dioxide (NO<sub>2</sub>), particulate matter &lt; 10 μm (PM<sub>10</sub>) and &lt; 2.5 μm (PM<sub>2.5</sub>) were modelled based on air pollution concentrations from 2019. Particulate matter between 2.5 and 10 μm (PM<sub>coarse</sub>) was calculated separately. Detailed data on residential addresses (including exact moving dates) were available for the entire study period, allowing for spatial variation in the exposure dataset. Mean air pollution levels were assessed at first pregnancy, last pregnancy, 35 years of age, and 2 years after the last delivery. Associations were evaluated using Cox proportional hazards regression to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Among 1,019,076 women, 12,085 (1.2%) were diagnosed with breast cancer and 65.2% moved at least once between their first pregnancy and two years after their last delivery. All exposures during pregnancy periods were positively associated with breast cancer, with the highest HR observed for exposure to PM<sub>coarse</sub> during the last pregnancy (HR<sub>PMcoarse</sub> = 1.12 (95% CI = 1.04, 1.20) per 5 μg/m<sup>3</sup> increase). The lowest HR were for NO<sub>2</sub> levels estimated at 35 years of age, regardless of pregnancy status (HR<sub>NO2</sub> = 1.03 (95% CI = 0.99, 1.06) per 10 μg/m<sup>3</sup> increase). In analyses differentiating between invasive breast cancer and ductal carcinoma in situ, only invasive breast cancer was associated with air pollution exposure. Conclusions: In this cohort study, air pollution exposure was consistently associated with increased risk of early-onset breast cancer.</p>}},
  author       = {{Edlund, Jessica and Wu, Wendy Yi Ying and Gustafsson, Malin and Lindén, Jenny and Oudin, Anna and Harlid, Sophia}},
  issn         = {{1465-5411}},
  keywords     = {{Air pollution; Breast cancer; Pregnancy; Risk factors}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Breast Cancer Research}},
  title        = {{Exposure to ambient air pollution during pregnancy and risk of early-onset breast cancer}},
  url          = {{http://dx.doi.org/10.1186/s13058-025-02165-9}},
  doi          = {{10.1186/s13058-025-02165-9}},
  volume       = {{27}},
  year         = {{2025}},
}