California Breast Cancer Prevention Initiatives: Setting a research agenda for prevention

•The environment is an underutilized pathway to breast cancer prevention.•Current research approaches and funding are unequal to the task at hand.•We set a research agenda to explore the environment, disparities and prevention.•We propose modifying the world around us to promote a less carcinogenic environment.•Redirecting research to prevention could reduce breast cancer among future generations. The environment is an underutilized pathway to breast cancer prevention. Current research approaches and funding streams related to breast cancer and the environment are unequal to the task at hand. We undertook the California Breast Cancer Prevention Initiatives, a four-year comprehensive effort to set a research agenda related to breast cancer, the environment, disparities and prevention. We identified 20 topics for Concept Proposals reflecting a life-course approach and the complex etiology of breast cancer; considering the environment as chemical, physical and socially constructed exposures that are experienced concurrently: at home, in the community and at work; and addressing how we should be modifying the world around us to promote a less carcinogenic environment. Redirecting breast cancer research toward prevention-oriented discovery could significantly reduce the incidence and associated disparities of the disease among future generations.