Spatial Patterns of Breast Cancer Risk Associated with Industrial and Environmental Pollutants: A Scoping Review.

This scoping review examined published evidence linking environmental and industrial exposures to breast cancer, synthesizing studies conducted between 2015 and 2025. Using the Arksey and O'Malley framework, 51 peer-reviewed studies were identified and analyzed across five domains: study design, evidence quality, pollutant associations, geographic emphasis, and research gaps. Most studies used retrospective designs, primarily case-control, ecological, cross-sectional, and cohort approaches, which identified associations but could not establish causation. Evidence of quality varied due to heterogeneous environmental modeling methods, exposure to misclassification concerns, and unmeasured confounding, even though 86 percent of studies had sample sizes larger than 1000 cases. Pesticides, polycyclic aromatic hydrocarbons (PAHs), and polychlorinated biphenyls (PCBs) were consistently associated with breast cancer, and nitrogen oxides (NOx), particulate matter (PM), and endocrine-disrupting chemicals (EDCs) also showed frequent significant associations. Research was geographically concentrated in North America and Europe, and few studies examined industrial hotspots or low-income regions. Gaps included the need for stronger epidemiological designs, multipollutant models, standardized exposure metrics, and clearer integration of significant environmental findings into public health protections. Overall, while evidence of pollution-related breast cancer risk continued to accumulate, the precautionary principle remained largely unimplemented. Advancing environmental policy, improving exposure transparency, and incorporating hotspot-based approaches are critical for reducing pollutant burdens and strengthening cancer prevention.