Epidemiology

Breast Cancer Research and Treatment

, Volume 129, Issue 1, pp 135-147

Alcohol, tobacco, and mammographic density: a population-based study

  • Anna CabanesAffiliated withNational Center for Epidemiology, Instituto de Salud Carlos IIIConsortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP)
  • , Roberto Pastor-BarriusoAffiliated withNational Center for Epidemiology, Instituto de Salud Carlos IIIConsortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP)
  • , Milagros García-LópezAffiliated withConsortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP)Navarra Breast Cancer Screening Programme, Public Health Institute
  • , Carmen Pedraz-PingarrónAffiliated withCastilla-Leon Breast Cancer Screening Programme, D.G. Salud Pública ID e I
  • , Carmen Sánchez-ContadorAffiliated withBalearic Islands Breast Cancer Screening Programme, Health Promotion for women and childhood. General Directorate Public Health and Participation, Regional Authority of Health and Consumer Affairs
  • , Jose Antonio Vázquez CarreteAffiliated withGalicia Breast Cancer Screening Programme, Regional Authority of Health, Galicia Regional Government
  • , María Pilar MorenoAffiliated withAragon Breast Cancer Screening Programme, Health Service of Aragon
  • , Carmen VidalAffiliated withCancer Prevention and Control Unit, Catalan Institute of Oncology (ICO)
  • , Dolores SalasAffiliated withNational Center for Epidemiology, Instituto de Salud Carlos IIIValencia Breast Cancer Screening Programme, General Directorate Public HealthCentro Superior de Investigación en Salud Pública (CSISP)
    • , Josefa Miranda-GarcíaAffiliated withNational Center for Epidemiology, Instituto de Salud Carlos IIIValencia Breast Cancer Screening Programme, General Directorate Public HealthCentro Superior de Investigación en Salud Pública (CSISP)
    • , Mercé PerisAffiliated withCancer Prevention and Control Unit, Catalan Institute of Oncology (ICO)
    • , Pilar MoreoAffiliated withAragon Breast Cancer Screening Programme, Health Service of Aragon
    • , María Carmen SantamariñaAffiliated withGalicia Breast Cancer Screening Programme, Regional Authority of Health, Galicia Regional Government
    • , Francisca Collado-GarcíaAffiliated withBalearic Islands Breast Cancer Screening Programme, Health Promotion for women and childhood. General Directorate Public Health and Participation, Regional Authority of Health and Consumer Affairs
    • , Isabel Gonzalez-Román Affiliated withNational Center for Epidemiology, Instituto de Salud Carlos IIICastilla-Leon Breast Cancer Screening Programme, Health and Social Welfare Department
    • , Nieves AscunceAffiliated withConsortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP)Navarra Breast Cancer Screening Programme, Public Health Institute
    • , Marina PollanAffiliated withNational Center for Epidemiology, Instituto de Salud Carlos IIIConsortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP)Área de Epidemiología Ambiental y Cáncer, Centro Nacional de Epidemiología, Instituto de Salud Carlos III Email author 
    • , DDM-Spain

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Abstract

Mammographic density (MD), or the proportion of the breast with respect to its overall area that is composed of dense tissue, is a strong risk factor for breast cancer. Studies support a positive association of mammographic density and alcohol drinking. This was a cross-sectional multicenter study based on 3584 women, aged 45–68 years, recruited from seven screening centers within the Spanish breast cancer screening program network. The association between MD, alcohol consumption and tobacco use was evaluated by using ordinal logistic models with random center-specific intercepts. We found a weak positive association between current alcohol intake and higher MD, with current alcohol consumption increasing the odds of high MD by 13% (OR = 1.13; 95% CI 0.99–1.28) and high daily grams of alcohol being positively associated with increased MD (P for trend = 0.045). There were no statistically significant differences in MD between smokers and non-smokers. Nevertheless, increased number of daily cigarettes and increased number of accumulated lifetime cigarettes were negatively associated with high MD (P for trend 0.017 and 0.021). The effect of alcohol on MD was modified by menopausal status and tobacco smoking: whereas, alcohol consumption and daily grams of alcohol were positively associated with higher MD in postmenopausal women and in women who were not currently smoking, alcohol consumption had no effect on MD in premenopausal women and current smokers. Our results support an association between recent alcohol consumption and high MD, characterized by a modest increase in risk at low levels of current consumption and a decrease in risk among heavier drinkers. Our study also shows how the effects of alcohol in the breast can be modified by other factors, such as smoking.

Keywords

Mammographic density Alcohol Smoking Breast cancer Ordinal logistic models