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Whether these compounds influence survival remains to be fully explored. We examined associations between organochlorine insecticides [<jats:italic>p<\/jats:italic>,<jats:italic>p<\/jats:italic>\u2032\u2010DDT (dichlorodiphenyltrichloroethane), its primary metabolite, <jats:italic>p<\/jats:italic>,<jats:italic>p<\/jats:italic>\u2032\u2010DDE, and chlordane] assessed shortly after diagnosis and survival among women with breast cancer. A population\u2010based sample of women diagnosed with a first primary invasive or <jats:italic>in situ<\/jats:italic> breast cancer in 1996\u20131997 and with available organochlorine blood measures (<jats:italic>n<\/jats:italic>\u2009=\u2009633) were followed for vital status through 2011. After follow\u2010up of 5 and 15 years, we identified 55 and 189 deaths, of which 36 and 74, respectively, were breast cancer\u2010related. Using Cox regression models, we estimated the multivariable\u2010adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for lipid\u2010adjusted organochlorine concentrations with all\u2010cause and breast cancer\u2010specific mortality. At 5 years after diagnosis, the highest tertile of DDT concentration was associated with all\u2010cause (HR\u2009=\u20092.19; 95% CI: 1.02, 4.67) and breast cancer\u2010specific (HR\u2009=\u20092.72; 95% CI: 1.04, 7.13) mortality. At 15 years, middle tertile concentrations of DDT (HR\u2009=\u20091.42; 95% CI 0.99, 2.06) and chlordane (HR\u2009=\u20091.42; 95% CI: 0.94, 2.12) were modestly associated with all\u2010cause and breast cancer\u2010specific mortality. Third tertile DDE concentrations were inversely associated with 15\u2010year all\u2010cause mortality (HR\u2009=\u20090.66; 95% CI: 0.44, 0.99). This is the first population\u2010based study in the United States to show that DDT may adversely impact survival following breast cancer diagnosis. Further studies are warranted given the high breast cancer burden and the ubiquity of these chemicals.<\/jats:p>","DOI":"10.1002\/ijc.29806","type":"journal-article","created":{"date-parts":[[2015,8,18]],"date-time":"2015-08-18T18:45:50Z","timestamp":1439923550000},"page":"565-575","source":"Crossref","is-referenced-by-count":49,"title":["Organochlorine insecticides DDT and chlordane in relation to survival following breast cancer"],"prefix":"10.1002","volume":"138","author":[{"suffix":"Jr.","given":"Humberto","family":"Parada","sequence":"first","affiliation":[{"name":"Department of Epidemiology University of North Carolina at Chapel Hill Chapel Hill NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary S.","family":"Wolff","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Mt. 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