The authors start right off with "What you don't know CAN hurt you." Breast cancer rates continue to climb, with this disease striking more women every year, and yet information about known risks and prevention strategies is not reaching you. The cancer establishment has a vested interest in keeping you focused on early detection, treatment, and basic genetic research rather than on reducing the risks for developing the disease in the first place."

Documenting every strategy they present, the writers call attention to what they call "The Dirty Dozen," twelve unpublicized risks for breast cancer.

1. Oral contraceptives
2. Estrogen replacement treatment
3. Premenopausal mammography
4. Drugs used to 'prevent' breast cancer, such as tamoxifen and GnRH, in healthy women
5. Silicone gel breast implant
6. Alcohol abuse
7. Tobacco abuse
8. A diet high in animal fat (for example, the authors cite high levels of estrogen and other hormones in beef).
9. A sedentary lifestyle
10. Exposure to household chemicals and neighborhood pollution from chemical plants and hazardous waste sites.
11. Workplace exposures to a wide range of carcinogens. (Some studies have shown that cancer-causing chemicals carried home on the clothes of men working in certain industries may pose significant risks to their wives, mothers, sister, and daughters).
12. Dark hair dyes

Once these risks have been described, the authors tell us what we can do about them. They have had lengthy experience: Dr. Epstein, professor of occupational and environmental medicine at the University of Illinois School of Public Health, is a leading international expert and author of The Politics of Cancer, Safe Shoppers' Bible, and Hazardous Waste in America. Investigative journalist David Steinman has written Diet for a Poisoned Planet, and science writer Suzanne LeVert has written several books on health, including The Woman Doctor's Guide to Menopause.

The Breast Cancer Prevention Program is an important contribution to our understanding of breast cancer and a welcome alternative to the mainstream cancer establishment's point of view.

Pat Cody is founder and program director of DES Action. DES Action's web site is at http://www.desaction.org.

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