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Arsenic and breast cancer: a systematic review of epidemiologic studies

  • Narges Khanjani , Abu-Bakr Jafarnejad and Leila Tavakkoli EMAIL logo



Arsenic is one of the heavy metals known to be a cause of cancer and many other serious human health problems. The International Agency for Research on Cancer (IARC), has classified arsenic as a Group 1 carcinogen. Studies were performed in different populations to investigate the association between arsenic and breast cancer and the present paper attempts to review these studies.

Methods and materials:

Accessible electronic resources including, PubMed, Web of Knowledge, Science Direct and Scopus and Google Scholar were searched, with relevant phrases up to October 30, 2016. All articles were reviewed by two people separately and among them, original epidemiologic studies that investigated the association between breast cancer and exposure to arsenic were included.


Eventually seven articles were selected from 126 retrieved articles. Although three studies (one case-control and two ecological) were not able to show a significant affect, others provide some evidence of a relation between arsenic and breast cancer in specific subgroups.


Exposure to arsenic may increase the risk of breast cancer. The strength of this relation can vary due to regional and individual differences.

Author Statement

  1. Research funding: Authors state no funding involved. Conflict of interest: Authors state no conflict of interest. Informed consent: Informed consent is not applicable. Ethical approval: The conducted research is not related to either human or animals use.


Appendix 1:

Quality assessment for case-control studies based on the Newcastle-Ottawa scale.a

1Is the case definition adequate?
AYes, with independent validationa
BYes, e.g. record linkage or based on self reports
CNo description
2Representativeness of the cases
AConsecutive or obviously representative series of casesa
BPotential for selection biases or not stated
3Selection of controls
ACommunity controlsa
BHospital controls
CNo description
4Definition of controls
ANo history of disease (endpoint)a
BNo description of source
1Comparability of cases and controls on the basis of the design or analysis
AStudy controls for _______________ (Select the most important factor.)a
BStudy controls for any additional factora (This criteria could be modified to indicate specific control for a second important factor.)
1Ascertainment of exposure
ASecure record (e.g. surgical records)a
BStructured interview where blind to case/control statusa
CInterview not blinded to case/control status
DWritten self report or medical record only
ENo description
2Same method of ascertainment for cases and controls
3Non-response rate
ASame rate for both groupsa
BNon respondents described
CRate different and no designation
  1. aA study can be awarded a maximum of one star for each numbered item within the Selection and Exposure categories. A maximum of two stars can be given for Comparability.

Appendix 2:

Quality assessment of the case-control studies included in this paper according to the Newcastle Ottawa Assessment scale for case-control studies.

Author, publication yearSelectionComparabilityExposure
Garland et al. (13)*-******-
Muszyńska et al. (11) (conference abstract)*---*-**-
López-Carrillo et al. (10)*****-***
Pineda-Belmontes et al. (12)*-***--*-
  1. *For selection, comparability and exposure, 4, 2 and 3 questions are asked, respectively. Each study has been awarded stars according to the listed items.


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Received: 2016-12-13
Accepted: 2017-1-29
Published Online: 2017-3-11
Published in Print: 2017-9-26

©2017 Walter de Gruyter GmbH, Berlin/Boston

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