Breast Cancer Research and Treatment

, Volume 117, Issue 3, pp 643–651

Alcohol intake over the life course and mammographic density

  • Julie D. Flom
  • Jennifer S. Ferris
  • Parisa Tehranifar
  • Mary Beth Terry


Alcohol intake is one of the few modifiable risk factors for breast cancer. Current alcohol intake has been associated with mammographic density, a strong intermediate marker of breast cancer risk, though few studies have examined the effect of both current and average lifetime alcohol intake. We interviewed 262 participants from a New York birth cohort (born 1959–1963) and obtained mammograms from 163 (71.5% of participants with a mammogram). We collected information on alcohol intake by beverage type separately for each decade of life. We used multivariable linear models to assess the associations between current and average lifetime alcohol intake and mammographic density using a quantitative measure of density from digitized images. Overall, current alcohol intake was more strongly associated with mammographic density than average lifetime alcohol intake; compared with nondrinkers, those with current intake of seven or more servings per week had on average 12.3% (95% CI: 4.3, 20.4) higher density, adjusted for average lifetime alcohol intake, age, and body mass index. We observed a consistent inverse association for red wine intake and mammographic density, suggesting that the positive association between mammographic density and overall alcohol intake was driven by other types of alcoholic beverages. Our findings support an association between current alcohol intake and increased mammographic density independent of the effect of average lifetime alcohol intake. If replicated, our study suggests that reducing current alcohol consumption, particularly beer and white wine intake, may be a means of reducing mammographic density regardless of intake earlier in life.


Alcohol Mammographic density Breast cancer Risk factors Life course 


  1. 1.
    World Cancer Research Fund/American Institute for Cancer Research (2007) Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. AICR, Washington DCGoogle Scholar
  2. 2.
    Singletary KW, Gapstur SM (2001) Alcohol and breast cancer: review of epidemiologic and experimental evidence and potential mechanisms. JAMA 286(17):2143–2151. doi:10.1001/jama.286.17.2143 PubMedCrossRefGoogle Scholar
  3. 3.
    Hamajima N et al (2002) Alcohol, tobacco and breast cancer-collaborative reanalysis of individual data from 53 epidemiological studies, including 58, 515 women with breast cancer and 95, 067 women without the disease. Br J Cancer 87(11):1234–1245. doi:10.1038/sj.bjc.6600596 PubMedCrossRefGoogle Scholar
  4. 4.
    Hiatt RA (1990) Alcohol consumption and breast cancer. Med Oncol Tumor Pharmacother 7(2–3):143–151PubMedGoogle Scholar
  5. 5.
    Terry MB et al (2006) Lifetime alcohol intake and breast cancer risk. Ann Epidemiol 16(3):230–240. doi:10.1016/j.annepidem.2005.06.048 PubMedCrossRefGoogle Scholar
  6. 6.
    Longnecker MP et al (1995) Risk of breast cancer in relation to lifetime alcohol consumption. J Natl Cancer Inst 87(12):923–929. doi:10.1093/jnci/87.12.923 PubMedCrossRefGoogle Scholar
  7. 7.
    Martin LJ, Boyd NF (2008) Mammographic density. Potential mechanisms of breast cancer risk associated with mammographic density: hypotheses based on epidemiological evidence. Breast Cancer Res 10(1):201. doi:10.1186/bcr1831 PubMedCrossRefGoogle Scholar
  8. 8.
    Byng JW et al (1994) The quantitative analysis of mammographic densities. Phys Med Biol 39(10):1629–1638. doi:10.1088/0031-9155/39/10/008 PubMedCrossRefGoogle Scholar
  9. 9.
    Boyd NF et al (1998) Mammographic densities and breast cancer risk. Cancer Epidemiol Biomarkers Prev 7(12):1133–1144PubMedGoogle Scholar
  10. 10.
    McCormack VA, s Silva I (2006) Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev 15(6):1159–1169. doi:10.1158/1055-9965.EPI-06-0034 PubMedCrossRefGoogle Scholar
  11. 11.
    Boyd NF et al (2005) Mammographic breast density as an intermediate phenotype for breast cancer. Lancet Oncol 6(10):798–808. doi:10.1016/S1470-2045(05)70390-9 PubMedCrossRefGoogle Scholar
  12. 12.
    Boyd NF et al (1995) Plasma lipids, lipoproteins, and mammographic densities. Cancer Epidemiol Biomarkers Prev 4(7):727–733PubMedGoogle Scholar
  13. 13.
    Masala G et al (2006) Dietary and lifestyle determinants of mammographic breast density. A longitudinal study in a Mediterranean population. Int J Cancer 118(7):1782–1789. doi:10.1002/ijc.21558 PubMedCrossRefGoogle Scholar
  14. 14.
    Vachon CM et al (2000) Association of mammographically defined percent breast density with epidemiologic risk factors for breast cancer (United States). Cancer Causes Control 11(7):653–662. doi:10.1023/A:1008926607428 PubMedCrossRefGoogle Scholar
  15. 15.
    Herrinton LJ et al (1993) Do alcohol intake and mammographic densities interact in regard to the risk of breast cancer? Cancer 71(10):3029–3035. doi:10.1002/1097-0142(19930515)71:10<3029::AID-CNCR2820711024>3.0.CO;2-K PubMedCrossRefGoogle Scholar
  16. 16.
    Maskarinec G et al (2006) Alcohol consumption and mammographic density in a multiethnic population. Int J Cancer 118(10):2579–2583. doi:10.1002/ijc.21705 PubMedCrossRefGoogle Scholar
  17. 17.
    Vachon CM et al (2000) Association of diet and mammographic breast density in the Minnesota breast cancer family cohort. Cancer Epidemiol Biomarkers Prev 9(2):151–160PubMedGoogle Scholar
  18. 18.
    Vachon CM et al (2005) Alcohol intake in adolescence and mammographic density. Int J Cancer 117(5):837–841. doi:10.1002/ijc.21227 PubMedCrossRefGoogle Scholar
  19. 19.
    Gapstur SM et al (2003) Associations of breast cancer risk factors with breast density in Hispanic women. Cancer Epidemiol Biomarkers Prev 12(10):1074–1080PubMedGoogle Scholar
  20. 20.
    Maskarinec G et al (2007) Ethnic and geographic differences in mammographic density and their association with breast cancer incidence. Breast Cancer Res Treat 104(1):47–56. doi:10.1007/s10549-006-9387-5 PubMedCrossRefGoogle Scholar
  21. 21.
    Sala E et al (1999) High-risk mammographic parenchymal patterns and anthropometric measures: a case-control study. Br J Cancer 81(7):1257–1261. doi:10.1038/sj.bjc.6690838 PubMedCrossRefGoogle Scholar
  22. 22.
    Brisson J et al (1989) Diet, mammographic features of breast tissue, and breast cancer risk. Am J Epidemiol 130(1):14–24PubMedGoogle Scholar
  23. 23.
    Broman SH (1984) The collaborative perinatal project: an overview. In: Mednick SA, Harway M, Finello KM (eds) Hanbook of longitudinal research. Praeger, New York, pp 166–179Google Scholar
  24. 24.
    Terry MB, Wei Y, Esserman D (2007) Maternal, birth, and early life influences on adult body size in women. Am J Epidemiol 166(1):5–13. doi:10.1093/aje/kwm094 PubMedCrossRefGoogle Scholar
  25. 25.
    Harvey EB et al (1987) Alcohol consumption and breast cancer. J Natl Cancer Inst 78(4):657–661PubMedGoogle Scholar
  26. 26.
    Byng JW et al (1996) Symmetry of projection in the quantitative analysis of mammographic images. Eur J Cancer Prev 5(5):319–327. doi:10.1097/00008469-199610000-00003 PubMedCrossRefGoogle Scholar
  27. 27.
    Jang M et al (1997) Cancer chemopreventive activity of resveratrol, a natural product derived from grapes. Science 275(5297):218–220. doi:10.1126/science.275.5297.218 PubMedCrossRefGoogle Scholar
  28. 28.
    Longnecker MP (1995) Alcohol consumption and risk of cancer in humans: an overview. Alcohol 12(2):87–96. doi:10.1016/0741-8329(94)00088-3 PubMedCrossRefGoogle Scholar
  29. 29.
    Blot WJ (1992) Alcohol and cancer. Cancer Res 52(7 (Suppl)):2119s–2123sPubMedGoogle Scholar
  30. 30.
    Yu H, Berkel J (1999) Do insulin-like growth factors mediate the effect of alcohol on breast cancer risk? Med Hypotheses 52(6):491–496. doi:10.1054/mehy.1998.0828 PubMedCrossRefGoogle Scholar
  31. 31.
    Byrne C et al (2000) Plasma insulin-like growth factor (IGF) I, IGF-binding protein 3 and Mammographic density. Cancer Res 60:3744–3748PubMedGoogle Scholar
  32. 32.
    Baglietto L et al (2005) Does dietary folate intake modify effect of alcohol consumption on breast cancer risk? Prospective cohort study. BMJ 331(7520):807. doi:10.1136/bmj.38551.446470.06 PubMedCrossRefGoogle Scholar
  33. 33.
    Negri E, La Vecchia C, Franceschi S (2000) Re: dietary folate consumption and breast cancer risk. J Natl Cancer Inst 92(15):1270–1271. doi:10.1093/jnci/92.15.1270-a PubMedCrossRefGoogle Scholar
  34. 34.
    Rohan TE et al (2000) Dietary folate consumption and breast cancer risk. J Natl Cancer Inst 92(3):266–269. doi:10.1093/jnci/92.3.266 PubMedCrossRefGoogle Scholar
  35. 35.
    Terry MB et al (2006) ADH3 genotype, alcohol intake and breast cancer risk. Carcinogenesis 27(4):840–847. doi:10.1093/carcin/bgi285 PubMedCrossRefGoogle Scholar
  36. 36.
    National Center for Health Statistics Health, United States (2007) With Chartbook on Trends in the Health of Americans. Hyattsville, MDGoogle Scholar
  37. 37.
    US Department of Health and Human Services and US Department of Agriculture (2005) Dietary guidelines for Americans, 6th edn. US Government Printing Office, Washington DCGoogle Scholar
  38. 38.
    Kerlikowske K et al (2007) Longitudinal measurement of clinical mammographic breast density to improve estimation of breast cancer risk. J Natl Cancer Inst 99(5):386–395. doi:10.1093/jnci/djk066 PubMedCrossRefGoogle Scholar
  39. 39.
    Cuzick J et al (2004) Tamoxifen and breast density in women at increased risk of breast cancer. J Natl Cancer Inst 96(8):621–628PubMedCrossRefGoogle Scholar
  40. 40.
    Rutter CM et al (2001) Changes in breast density associated with initiation, discontinuation, and continuing use of hormone replacement therapy. JAMA 285:171–176. doi:10.1001/jama.285.2.171 PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC. 2009

Authors and Affiliations

  • Julie D. Flom
    • 1
  • Jennifer S. Ferris
    • 1
  • Parisa Tehranifar
    • 1
  • Mary Beth Terry
    • 1
  1. 1.Department of Epidemiology, Columbia UniversityMailman School of Public HealthNew YorkUSA

Personalised recommendations