potential carcinogens at home, in the workplace, and in our communities,16 as well as new approaches to monitoring lifestyle factors,17 are creating unprecedented opportunities to advance breast cancer prevention research. At the same time, basic laboratory research is rapidly uncovering underlying biological mechanisms of cancer causation,18 presenting the opportunity to examine how the reduction or elimination of exposures will help prevent breast cancer. Transdisciplinary research will accelerate progress towards understanding breast cancer and the environment, which ultimately will affect public health. Now is the time to accelerate progress toward understanding the role of the environment in breast cancer prevention. The Committee’s ultimate goal is to recommend research that will provide the evidence to inform, enable, and promote breast cancer intervention programs across the cancer control continuum—from prevention through detection, diagnosis, treatment, and survivorship—to reduce the burden of breast cancer. a Breast Cancer and Environmental Research Act of 2008, P. L. No. participation in decisions about breast cancer research, to increase the involvement of patient advocacy and community organizations that represent a broad geographical area. » The optimal mode of dissemination of information on breast cancer research progress. » Strategies to expand partnerships between public entities and federal agencies and private entities to enhance collaborative, cross-cutting research. Under P.L. 110-354, IBCERCC comprised: • Federal members, including representatives from the Centers for Disease Control and Prevention (CDC), the National Institute of Environmental Health Sciences (NIEHS), the National Cancer Institute (NCI), the NCI Board of Scientific Advisors (BSA), other HHS agencies as the Secretary deems appropriate, and other federal agencies that conduct or support cancer research, including the DoD. • Nonfederal members from (a) the scientific or medical communities who represent multiple disciplines and different geographical regions of the country; and (b) practice settings, academia, or other research settings. These members included individuals experienced in the scientific peerreview process. • Nonfederal members who represent individuals with breast cancer. • As many nonvoting members as the Secretary deemed appropriate. Congress asked the Committee to: • Identify advances related to breast cancer and the environment and key scientific questions to answer. • Propose ways to improve the research process and engage the public in this process and the dissemination of findings. • to improve existing research programs that are related to breast cancer. • Develop a comprehensive strategy and advise the NIH and other federal agencies on the solicitation of proposals for collaborative, transdisciplinary research, including proposals to evaluate environmental and genomic factors that may be related to the etiology (or causes and origins) of breast cancer that would: » Result in innovative approaches to studying emerging scientific opportunities or eliminating knowledge gaps and thereby improve the research portfolio. » Outline key research questions, methodologies, and knowledge gaps. » Expand the number of research proposals involving collaboration between two or more national research institutes or national centers (including proposals for the NIH Common Fund) and; » Increase the number of collaborative, transdisciplinary, and multi-institutional research grants. • Develop a summary of advances in breast cancer research supported or conducted by federal agencies relevant to the diagnosis, prevention, and treatment of cancer and other diseases and disorders. • Make recommendations to the Secretary of HHS about: » Changes to research activities, including recommendations to improve the research portfolio of the NIH and ensure that scientifically based strategic planning is implemented in support of priorities that affect breast cancer research activities. » Enhanced cooperation across the activities of the NIH and other federal agencies, including the U.S. Department of Defense (DoD), thereby reducing duplication of effort. 2-4 Breast Cancer and the Environment: Prioritizing Prevention 2 living organisms. The types of environmental factors discussed in this report are: • Lifestyle and behavioral factors such as alcohol intake, physical activity, weight gain in adulthood, and night shift work. • Chemical substances to which people are exposed through pesticides, industrial pollutants, consumer products, and medications. • Physical factors such as radiation from medical and other sources, light at night, and other nonchemical exposures. • Social and cultural influences, such as family, community, psychosocial/social, and societal factors that determine exposure to; the extent of exposure to; or ability to ameliorate the impact of chemical, physical, lifestyle, and behavioral factors that influence breast cancer risk. People may be exposed to mixtures or combinations of these factors, which may interact with each other and/or with genetic or other breast cancer susceptibility factors to increase or decrease breast cancer risk. Risk factors can be modified at the individual level (e.g., by changing personal behaviors) and/or the population level (e.g., by