الفهرس 
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Abstract
Background
Hormones and growth factors act upon stromal and epithelial cells to regulate mammary gland development, maturation and differentiation.
Breast disease in women encompasses a spectrum of benign and malignant disorders. 34 percent of cancer cases among Egyptian women suffer from breast cancer. The rate of recovery from breast cancer may reach up to 98 percent if the disease is detected in its early stages.
There are several breast imaging modalities available such as Ultrasound, CT, Digital Mammography, MRI and scintimammography. Mammography remains the cornerstone of breast imaging. When mammography is correctly performed and interpreted it offers the necessary reliability to diagnose the curable forms of breast cancers.
A potential risk factor for breast cancer is exposure to environmental estrogens. Environmental estrogens are any of a group of synthetic substances found in the environment that, when absorbed into a person’s system, function in a similar way to estrogen. Estrogen stimulates breast cell growth, and exposure to estrogen over long periods of time, without any breaks, can increase the risk of breast cancer.
Aim of the work
The aim of this study is to detect significant effect of exposure to some environmental factors with more concern to those related to environmental estrogens on different breast pathologies especially malignant breast diseases, aiming to reduce risk of breast cancer as much as possible.
Subjects and methods
The present study is a cross sectional study held on one hundred female patients (50 cases and 50 control) subjected to the following:
• History taking (Complete personal and family history).
• Anthropometric measures (Height in meters, weight in kilograms and body mass index)
• Clinical examination including inspection and palpation.
• Questionnaire: All cases filled a questionnaire about how often they deal with each item (Never, Occasionally or Daily). Items included in the questionnaire are (Alcohol intake, Caffeine intake, Active Cigarette Smoking, exposure to passive smoking, Use of some material that are commonly used in daily life and known to have estrogenic effect including (food and soda cans, plastic containers, use of plastic containers for heating in microwave, insecticides, detergents and cleaning agent, deodorants, cosmetics and ordinary cultured plants – non organic origin- .
• Digital mammographic examination
• Laboratory examination: Blood samples for testing 17b Estradiol hormone at the follicular phase of the menstrual cycle.
• Statistical analysis.
Results:
The percentage of cases that categorized as BIRADS II (breast lesions with benign criteria) in mammography was 50%; and cases categorized as BIRADS III in mammography (breast lesions with borderline criteria) was 14%; cases categorized as BIRADS IV in mammography (breast lesions with probably malignant criteria) was 18% and cases categorized as BIRADS V in mammography (breast lesions with malignant criteria) was 18%.
Occurrence of benign and malignant lesions was significantly associated with environmental estrogens containing items namely, use of diet and soda cans, food containing xenoestrogen, use of insecticides, use of plastic containers, heating plastic containers in microwave, use of detergents and cleaning agents, use of deodorants and use of cosmetics. Other environmental factors showing high association with benign and malignant lesions are age of the patient, BMI of the patient, passive smoking, previous mammographic examinations and occupational radiological exposure. Occurrence of benign and malignant lesions was not affected by smoking, caffeine intake and alcohol intake.
Conclusion:
Occurrence of benign and malignant breast diseases is significantly associated with many environmental factors as passive smoking, previous mammographic examinations and occupational radiological exposure, age and BMI of the patient & environmental estrogens containing items namely, use of diet and soda cans, food containing xenoestrogen, use of insecticides, use of plastic containers, heating plastic containers in microwave, use of detergents and cleaning agents, use of deodorants and use of cosmetics.