Skip to main content

Advertisement

SpringerLink
Log in

Interactions of alcohol and postmenopausal hormone use in regards to mammographic breast density

  • Original paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Purpose

We investigated the association of alcohol intake with mammographic breast density in postmenopausal women by their hormone therapy (HT) status.

Methods

This study included 2,100 cancer-free postmenopausal women within the Nurses’ Health Study and Nurses’ Health Study II cohorts. Percent breast density (PD), absolute dense (DA), and non-dense areas (NDA) were measured from digitized film mammograms using a computer-assisted thresholding technique; all measures were square root transformed. Alcohol consumption was assessed with a food frequency questionnaire (0, < 5, and ≥ 5 g/day). Information regarding breast cancer risk factors was obtained from baseline or biennial questionnaires closest to the mammogram date. We used generalized linear regression to examine associations between alcohol and breast density measures in women with no HT history, current, and past HT users.

Results

In multivariable analyses, we found no associations of alcohol consumption with PD (p trend = 0.32) and DA (p trend = 0.53) and an inverse association with NDA (β = − 0.41, 95% CI − 0.73, − 0.09 for ≥ 5 g/day, p trend < 0.01). In the stratified analysis by HT status, alcohol was not associated with PD in any of the strata. We found a significant inverse association of alcohol with NDA among past HT users (β = − 0.79, 95% CI − 1.51, − 0.07 for ≥ 5 g/day, p trend = 0.02). There were no significant interactions between alcohol and HT in relation to PD, DA, and NDA (p interaction = 0.19, 0.42, and 0.43, respectively).

Conclusions

Our findings suggest that associations of alcohol with breast density do not vary by HT status.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Boyd NF, Rommens JM, Vogt K, Lee V, Hopper JL, Yaffe MJ, Paterson AD (2005) Mammographic breast density as an intermediate phenotype for breast cancer. Lancet Oncol 6:798–808

    Article  PubMed  Google Scholar 

  2. Ginsburg OM, Martin LJ, Boyd NF (2008) Mammographic density, lobular involution, and risk of breast cancer. Br J Cancer 99:1369–1374

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  3. Tamimi RM, Byrne C, Colditz GA, Hankinson SE (2007) Endogenous hormone levels, mammographic density, and subsequent risk of breast cancer in postmenopausal women. J Natl Cancer Inst 99:1178–1187

    Article  PubMed  CAS  Google Scholar 

  4. Harvey JA, Bovbjerg VE (2004) Quantitative assessment of mammographic breast density: relationship with breast cancer risk. Radiology 230:29–41

    Article  PubMed  Google Scholar 

  5. Boyd NF, Byng JW, Jong RA, Fishell EK, Little LE, Miller AB, Lockwood GA, Tritchler DL, Yaffe MJ (1995) Quantitative classification of mammographic densities and breast cancer risk: results from the Canadian National Breast Screening Study. J Natl Cancer Inst 87:670–675

    Article  PubMed  CAS  Google Scholar 

  6. Byrne C, Schairer C, Wolfe J, Parekh N, Salane M, Brinton LA, Hoover R, Haile R (1995) Mammographic features and breast cancer risk: effects with time, age, and menopause status. J Natl Cancer Inst 87:1622–1629

    Article  PubMed  CAS  Google Scholar 

  7. Pettersson A, Hankinson S, Willett W, Lagiou P, Trichopoulos D, Tamimi R (2011) Nondense mammographic area and risk of breast cancer. Breast Cancer Research 13:R100

    Article  PubMed  Google Scholar 

  8. Aitken Z, McCormack VA, Highnam RP, Martin L, Gunasekara A, Melnichouk O, Mawdsley G, Peressotti C, Yaffe M, Boyd NF, dos Santos Silva I (2010) Screen-film mammographic density and breast cancer risk: a comparison of the volumetric standard mammogram form and the interactive threshold measurement methods. Cancer Epidemiol Biomark Prev 19:418–428

    Article  Google Scholar 

  9. Stone J, Ding J, Warren RM, Duffy SW, Hopper JL (2010) Using mammographic density to predict breast cancer risk: dense area or percentage dense area. Breast Cancer Res 12:R97

    Article  PubMed  PubMed Central  Google Scholar 

  10. Ursin G, Ma H, Wu AH, Bernstein L, Salane M, Parisky YR, Astrahan M, Siozon CC, Pike MC (2003) Mammographic density and breast cancer in three ethnic groups. Cancer Epidemiol Biomark Prev 12:332–338

    Google Scholar 

  11. Maskarinec G, Pagano I, Lurie G, Wilkens LR, Kolonel LN (2005) Mammographic density and breast cancer risk. Am J Epidemiol 162:743–752

    Article  PubMed  Google Scholar 

  12. Boyd N, Martin L, Gunasekara A, Melnichouk O, Maudsley G, Peressotti C, Yaffe M, Minkin S (2009) Mammographic density and breast cancer risk: evaluation of a novel method of measuring breast tissue volumes. Cancer Epidemiol Biomark Prev 18:1754–1762

    Article  Google Scholar 

  13. Vachon CM, Brandt KR, Ghosh K, Scott CG, Maloney SD, Carston MJ, Pankratz VS, Sellers TA (2007) Mammographic breast density as a general marker of breast cancer risk. Cancer Epidemiol Biomark Prev 16:43–49

    Article  Google Scholar 

  14. Lokate M, Peeters PH, Peelen LM, Haars G, Veldhuis WB, van Gils CH (2011) Mammographic density and breast cancer risk: the role of the fat surrounding the fibroglandular tissue. Breast Cancer Res 13:R103

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  15. Pettersson A, Graff RE, Ursin G, Santos Silva ID, McCormack V, Baglietto L, Vachon C, Bakker MF, Giles GG, Chia KS, Czene K, Eriksson L, Hall P, Hartman M, Warren RM, Hislop G, Chiarelli AM, Hopper JL, Krishnan K, Li J, Li Q, Pagano I, Rosner BA, Wong CS, Scott C, Stone J, Maskarinec G, Boyd NF, van Gils CH, Tamimi RM (2014) Mammographic density phenotypes and risk of breast cancer: a meta-analysis. J Natl Cancer Inst. https://doi.org/10.1093/jnci/dju078

    Article  PubMed  PubMed Central  Google Scholar 

  16. Scoccianti C, Lauby-Secretan B, Bello PY, Chajes V, Romieu I (2014) Female breast cancer and alcohol consumption: a review of the literature. Am J Prev Med 46:S16–S25

    Article  PubMed  Google Scholar 

  17. Boyle P, Boffetta P (2009) Alcohol consumption and breast cancer risk. Breast Cancer Res 11(Suppl 3):S3

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  18. McDonald JA, Goyal A, Terry MB (2013) Alcohol intake and breast cancer risk: weighing the overall evidence. Curr Breast Cancer Rep. https://doi.org/10.1007/s12609-013-0114-z

    Article  PubMed  PubMed Central  Google Scholar 

  19. Ziembicki S, Zhu J, Tse E, Martin LJ, Minkin S, Boyd NF (2017) The association between alcohol consumption and breast density: a systematic review and meta-analysis. Cancer Epidemiol Biomark Prev 26:170–178

    Article  CAS  Google Scholar 

  20. Conner P, Svane G, Azavedo E, Soderqvist G, Carlstrom K, Graser T, Walter F, von Schoultz B (2004) Mammographic breast density, hormones, and growth factors during continuous combined hormone therapy. Fertil Steril 81:1617–1623

    Article  PubMed  Google Scholar 

  21. Greendale GA, Palla SL, Ursin G, Laughlin GA, Crandall C, Pike MC, Reboussin BA (2005) The association of endogenous sex steroids and sex steroid binding proteins with mammographic density: results from the Postmenopausal Estrogen/Progestin Interventions Mammographic Density Study. Am J Epidemiol 162:826–834

    Article  PubMed  Google Scholar 

  22. Pettersen PC, Raundahl J, Loog M, Nielsen M, Tanko LB, Christiansen C (2008) Parallel assessment of the impact of different hormone replacement therapies on breast density by radiologist- and computer-based analyses of mammograms. Climacteric 11:135–143

    Article  PubMed  CAS  Google Scholar 

  23. Vachon CM, Sellers TA, Vierkant RA, Wu FF, Brandt KR (2002) Case-control study of increased mammographic breast density response to hormone replacement therapy. Cancer Epidemiol Biomarkers Prev 11:1382–1388

    PubMed  CAS  Google Scholar 

  24. Shah NR, Borenstein J, Dubois RW (2005) Postmenopausal hormone therapy and breast cancer: a systematic review and meta-analysis. Menopause 12:668–678

    Article  PubMed  PubMed Central  Google Scholar 

  25. Nielsen NR, Grønbæk M (2008) Interactions between intakes of alcohol and postmenopausal hormones on risk of breast cancer. Int J Cancer 122:1109–1113

    Article  PubMed  CAS  Google Scholar 

  26. Onland-Moret NC, Peeters PH, van der Schouw YT, Grobbee DE, van Gils CH (2005) Alcohol and endogenous sex steroid levels in postmenopausal women: a cross-sectional study. J Clin Endocrinol Metab 90:1414–1419

    Article  PubMed  CAS  Google Scholar 

  27. Zhu BT, Conney AH (1998) Functional role of estrogen metabolism in target cells: review and perspectives. Carcinogenesis 19:1–27

    Article  PubMed  Google Scholar 

  28. Rahmioglu N, Heaton J, Clement G, Gill R, Surdulescu G, Zlobecka K, Hodgkiss D, Ma Y, Hider RC, Smith NW, Ahmadi KR (2011) Genetic epidemiology of induced CYP3A4 activity. Pharmacogenet Genomics 21:642–651

    Article  PubMed  CAS  Google Scholar 

  29. Weathermon R, Crabb DW (1999) Alcohol and medication interactions. Alcohol Res Health 23:40–54

    PubMed  CAS  Google Scholar 

  30. Tanaka E (1998) Clinically important pharmacokinetic drug-drug interactions: role of cytochrome P450 enzymes. J Clin Pharm Ther 23:403–416

    Article  PubMed  CAS  Google Scholar 

  31. Hong C-C, Tang B-K, Hammond GL, Tritchler D, Yaffe M, Boyd NF (2004) Cytochrome P450 1A2 (CYP1A2) activity and risk factors for breast cancer: a cross-sectional study. Breast Cancer Res 6:R352–R365

    Article  PubMed  PubMed Central  Google Scholar 

  32. Colditz GA, Hankinson SE (2005) The Nurses’ Health Study: lifestyle and health among women. Nat Rev Cancer 5:388–396

    Article  PubMed  CAS  Google Scholar 

  33. Tworoger SS, Sluss P, Hankinson SE (2006) Association between plasma prolactin concentrations and risk of breast cancer among predominately premenopausal women. Cancer Res 66:2476–2482

    Article  PubMed  CAS  Google Scholar 

  34. Bertrand KA, Rosner B, Eliassen AH, Hankinson SE, Rexrode KM, Willett W, Tamimi RM (2015) Premenopausal plasma 25-hydroxyvitamin D, mammographic density, and risk of breast cancer. Breast Cancer Res Treat 149:479–487

    Article  PubMed  CAS  Google Scholar 

  35. Farvid MS, Cho E, Chen WY, Eliassen AH, Willett WC (2014) Dietary protein sources in early adulthood and breast cancer incidence: prospective cohort study. Br Med J 348:g3437

    Article  CAS  Google Scholar 

  36. Chen WY, Rosner B, Hankinson SE, Colditz GA, Willett WC (2011) Moderate alcohol consumption during adult life, drinking patterns, and breast cancer risk. J Am Med Assoc 306:1884–1890

    Article  CAS  Google Scholar 

  37. Tamimi RM, Byrne C, Baer HJ, Rosner B, Schnitt SJ, Connolly JL, Colditz GA (2005) Benign breast disease, recent alcohol consumption, and risk of breast cancer: a nested case–control study. Breast Cancer Res 7:R555

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  38. Glovannucci E, Colditz G, Stampfer MJ, Rimm EB, Litin L, Sampson L, Willett WC (1991) The assessment of alcohol consumption by a simple self-administered questionnaire. Am J Epidemiol 133:810–817

    Article  Google Scholar 

  39. Byng JW, Boyd NF, Little L, Lockwood G, Fishell E, Jong RA, Yaffe MJ (1996) Symmetry of projection in the quantitative analysis of mammographic images. Eur J Cancer Prev 5:319–327

    Article  PubMed  CAS  Google Scholar 

  40. Bertrand K, Eliassen AH, Hankinson S, Gierach G, Xu X, Rosner B, Ziegler R, Tamimi R (2012) Urinary estrogens and estrogen metabolites and mammographic density in premenopausal women. Breast Cancer Res Treat 136:277–287

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  41. Rice MS, Rosner BA, Tamimi RM (2017) Percent mammographic density prediction: development of a model in the nurses’ health studies. Cancer Causes Control 28:677–684

    Article  PubMed  PubMed Central  Google Scholar 

  42. Willett W, Stampfer MJ, Bain C, Lipnick R, Speizer FE, Rosner B, Cramer D, Hennekens CH (1983) Cigarette smoking, relative weight, and menopause. Am J Epidemiol 117:651–658

    Article  PubMed  CAS  Google Scholar 

  43. Stampfer MJ, Willett WC, Colditz GA, Rosner B, Speizer FE, Hennekens CH (1985) A prospective study of postmenopausal estrogen therapy and coronary heart disease. N Engl J Med 313:1044–1049

    Article  PubMed  CAS  Google Scholar 

  44. Ginsburg ES, Mello NK, Mendelson JH et al (1996) EFfects of alcohol ingestion on estrogens in postmenopausal women. J Am Med Assoc 276:1747–1751

    Article  CAS  Google Scholar 

  45. Chen WY, Colditz GA, Rosner B et al (2002) USe of postmenopausal hormones, alcohol, and risk for invasive breast cancer. Ann Intern Med 137:798–804

    Article  PubMed  Google Scholar 

  46. Zhang SM, Lee I-M, Manson JE, Cook NR, Willett WC, Buring JE (2007) Alcohol consumption and breast cancer risk in the Women’s Health Study. Am J Epidemiol 165:667–676

    Article  PubMed  Google Scholar 

  47. Vrieling A, Voskuil DW, de Mesquita HBB, Kaaks R, van Noord PAH, Keinan-Boker L, van Gils CH, Peeters PHM (2004) Dietary determinants of circulating insulin-like growth factor (IGF)-I and IGF binding proteins 1, -2 and -3 in women in the Netherlands. Cancer Causes Control 15:787–796

    Article  PubMed  Google Scholar 

  48. Christopoulos PF, Msaouel P, Koutsilieris M (2015) The role of the insulin-like growth factor-1 system in breast cancer. Mol Cancer 14:43

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  49. Quandt Z, Flom JD, Tehranifar P, Reynolds D, Terry MB, McDonald JA (2015) The association of alcohol consumption with mammographic density in a multiethnic urban population. BMC Cancer 15:124

    Article  PubMed Central  CAS  Google Scholar 

  50. Lindgren J, Dorgan J, Savage-Williams J, Coffman D, Hartman T (2013) Diet across the lifespan and the association with breast density in adulthood. Int J Breast Cancer 2013:808317

    Article  PubMed  PubMed Central  Google Scholar 

  51. Singletary KW, Gapstur SM (2001) Alcohol and breast cancer: review of epidemiologic and experimental evidence and potential mechanisms. J Am Med Assoc 286:2143–2151

    Article  CAS  Google Scholar 

  52. Yaghjyan L, Mahoney MC, Succop P, Wones R, Buckholz J, Pinney SM (2012) Relationship between breast cancer risk factors and mammographic breast density in the Fernald Community Cohort. Br J Cancer 106:996

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  53. Brand JS, Czene K, Eriksson L, Trinh T, Bhoo-Pathy N, Hall P, Celebioglu F (2013) Influence of lifestyle factors on mammographic density in postmenopausal women. PLoS ONE 8:e81876

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  54. Lands WE, Zakhari S (1991) The case of the missing calories. Am J Clin Nutr 54:47–48

    Article  PubMed  CAS  Google Scholar 

  55. Westerterp KR (2004) Diet induced thermogenesis. Nutr Metab 1:5

    Article  CAS  Google Scholar 

  56. Yaghjyan L, Colditz GA, Rosner B, Tamimi RM (2013) Mammographic breast density and subsequent risk of breast cancer in postmenopausal women according to the time since the mammogram. Cancer Epidemiol Biomarkers Prev 22:1110–1117

    Article  PubMed  PubMed Central  Google Scholar 

  57. Hu FB, Rimm E, Smith-Warner SA, Feskanich D, Stampfer MJ, Ascherio A, Sampson L, Willett WC (1999) Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire. Am J Clin Nutr 69:243–249

    Article  PubMed  CAS  Google Scholar 

  58. Willett WC, Sampson L, Stampfer MJ, Rosner B, Bain C, Witschi J, Hennekens CH, Speizer FE (1985) Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 122:51–65

    Article  PubMed  CAS  Google Scholar 

  59. Del Boca FK, Darkes J (2003) The validity of self-reports of alcohol consumption: state of the science and challenges for research. Addiction 98:1–12

    Article  PubMed  Google Scholar 

  60. Feunekes GI, van’t Veer P, van Staveren WA, Kok FJ (1999) Alcohol intake assessment: the sober facts. Am J Epidemiol 150:105–112

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This work was supported by the National Cancer Institute at the National Institutes of Health [CA131332, CA087969, CA175080 to R.M.T., UM1 CA186107 to M.S., UM1 CA176726 to W.W], Avon Foundation for Women, Susan G. Komen for the Cure®, and Breast Cancer Research Foundation.

Author information

Authors and Affiliations

  1. Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, 2004 Mowry Rd., Gainesville, FL, 32610, USA

    Lusine Yaghjyan & Aleksandra Gasparova

  2. Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA

    Graham Colditz

  3. Institute for Public Health, Washington University in St. Louis, St. Louis, MO, USA

    Graham Colditz

  4. Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Heather Eliassen, Bernard Rosner & Rulla M. Tamimi

Authors
  1. Lusine Yaghjyan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Graham Colditz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Heather Eliassen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bernard Rosner
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Aleksandra Gasparova
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rulla M. Tamimi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lusine Yaghjyan.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

This study was approved by the Institutional Review Board at the Brigham and Women’s Hospital. Consent was obtained or implied by return of questionnaires.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 19 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yaghjyan, L., Colditz, G., Eliassen, H. et al. Interactions of alcohol and postmenopausal hormone use in regards to mammographic breast density. Cancer Causes Control 29, 751–758 (2018). https://doi.org/10.1007/s10552-018-1053-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-018-1053-9

Keywords

Search

Navigation