Abstract
Purpose
The role of alcohol in young-onset breast cancer (YOBC) is unclear. We examined associations between lifetime alcohol consumption and YOBC in the Young Women’s Health History Study, a population-based case–control study of breast cancer among Non-Hispanic Black and White women < 50 years of age.
Methods
Breast cancer cases (n = 1,812) were diagnosed in the Metropolitan Detroit and Los Angeles County SEER registry areas, 2010–2015. Controls (n = 1,381) were identified through area-based sampling and were frequency-matched to cases by age, site, and race. Alcohol consumption and covariates were collected from in-person interviews. Weighted multivariable logistic regression was conducted to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for associations between alcohol consumption and YOBC overall and by subtype (Luminal A, Luminal B, HER2, or triple negative).
Results
Lifetime alcohol consumption was not associated with YOBC overall or with subtypes (all ptrend ≥ 0.13). Similarly, alcohol consumption in adolescence, young and middle adulthood was not associated with YOBC (all ptrend ≥ 0.09). An inverse association with triple-negative YOBC, however, was observed for younger age at alcohol use initiation (< 18 years vs. no consumption), aOR (95% CI) = 0.62 (0.42, 0.93). No evidence of statistical interaction by race or household poverty was observed.
Conclusions
Our findings suggest alcohol consumption has a different association with YOBC than postmenopausal breast cancer—lifetime consumption was not linked to increased risk and younger age at alcohol use initiation was associated with a decreased risk of triple-negative YOBC. Future studies on alcohol consumption in YOBC subtypes are warranted.
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Data availability
All authors contributed to the study conception and design. Data analyses were performed by Darek Lucas. The first draft of the manuscript was written by Kelly A. Hirko and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript and assume full responsibility for analyses and interpretation of these data. The datasets analyzed for this study are not publicly available because main study findings are in the process of being analyzed, but can be made available on reasonable request.
Abbreviations
- YWHHS:
-
Young women’s health history study
- YOBC:
-
Young-onset breast cancer
- ER:
-
Estrogen receptor
- PR:
-
Progesterone receptor
- HER2:
-
Human epidermal growth factor 2
- TNBC:
-
Triple-negative breast cancer
- aOR:
-
Adjusted odds ratios
- CI:
-
Confidence intervals
- BMI:
-
Body mass index
- NHB:
-
Non-hispanic black
- NHW:
-
Non-hispanic white
- SEER:
-
Surveillance epidemiology and end results
- HHP:
-
Household percent poverty
- SEP:
-
Socioeconomic position
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Acknowledgments
We would like to thank the participants and staff of the Young Women’s Health History Study for their valuable contributions as well as the Detroit and Los Angeles SEER registries for their assistance. The authors assume full responsibility for analyses and interpretation of these data.
Funding
The Young Women’s Health History Study was funded by the National Institutes of Health, National Cancer Institute R01CA136861 (E.M. Velie, Principal Investigator).
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KH drafted the manuscript text. DL and LM conducted data analyses. DP, AH, NC, RH, KS, LM, and EV contributed to data collection and study methodology. EV and KH were involved with study conceptualization. All authors reviewed and edited the manuscript.
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This study protocol was approved by the Institutional Review Boards (IRB) at the University of Wisconsin—Milwaukee (UWM), Milwaukee, WI (and the Medical College of Wisconsin deferred to UWM); Michigan State University (MSU), East Lansing, MI; Wayne State University (WSU), Detroit, MI; the Karmanos Cancer Center, Detroit MI; the Michigan Department of Community Health, MI; the University of Southern California (USC) Health Sciences, Los Angeles, CA; the California Committee for the Protection of Human Subjects, CA; and the California Cancer Registry. All study participants provided informed consent.
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The collection of cancer incidence data used in this study was supported by the Metropolitan Detroit SEER registry and Epidemiology Research Core at Wayne State University/Karmanos Cancer Institute and by the California Department of Public Health pursuant to California Health and Safety Code Section 103885; Centers for Disease Control and Prevention’s (CDC) National Program of Cancer Registries, under cooperative agreement 5NU58DP006344; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HHSN261201800032I awarded to the University of California, San Francisco, contract HHSN261201800015I awarded to the University of Southern California, and contract HHSN261201800009I awarded to the Public Health Institute. The ideas and opinions expressed herein are those of the authors and do not necessarily reflect the opinions of the funders.
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This study protocol was approved by the Institutional Review Boards at the University of Wisconsin—Milwaukee (UWM), Milwaukee, WI (and the Medical College of Wisconsin deferred to UWM); Michigan State University (MSU), East Lansing, MI; Wayne State University (WSU), Detroit, MI; the Karmanos Cancer Center, Detroit MI; the Michigan Department of Community Health, MI; the University of Southern California (USC) Health Sciences, Los Angeles, CA; the California Committee for the Protection of Human Subjects, CA; and the California Cancer Registry. All study participants provided informed consent.
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Hirko, K.A., Lucas, D.R., Pathak, D.R. et al. Lifetime alcohol consumption patterns and young-onset breast cancer by subtype among Non-Hispanic Black and White women in the Young Women’s Health History Study. Cancer Causes Control 35, 377–391 (2024). https://doi.org/10.1007/s10552-023-01801-z
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DOI: https://doi.org/10.1007/s10552-023-01801-z