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

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

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.

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Abbreviations

MD:

Mammographic density

FFQ:

Food frequency questionnaire

BMI:

Body mass index

HRT:

Hormone replacement therapy

E2:

Estradiol

IGF-1:

Insulin-like growth factor 1

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Acknowledgments

We should like to thank the participants in the DDM-Spain study for their contribution to breast cancer research. This study was supported by: Research Grant FIS PI060386 from Spain’s Health Research Fund (Fondo de Investigación Sanitaria); the EPY 1306/06 Collaboration Agreement between Astra-Zeneca and the Carlos III Institute of Health (Instituto de Salud Carlos III); and a grant from the Spanish Federation of Breast Cancer (FECMA).

Author information

Authors and Affiliations

  1. National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain

    Anna Cabanes, Roberto Pastor-Barriuso & Marina Pollan

  2. Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP) http://ciberesp.es/web/

    Anna Cabanes, Roberto Pastor-Barriuso, Milagros García-López, Nieves Ascunce & Marina Pollan

  3. Navarra Breast Cancer Screening Programme, Public Health Institute, Pamplona, Spain

    Milagros García-López & Nieves Ascunce

  4. Castilla-Leon Breast Cancer Screening Programme, D.G. Salud Pública ID e I, Castilla y León, Spain

    Carmen Pedraz-Pingarrón

  5. Balearic Islands Breast Cancer Screening Programme, Health Promotion for women and childhood. General Directorate Public Health and Participation, Regional Authority of Health and Consumer Affairs, Balearic Islands, Spain

    Carmen Sánchez-Contador & Francisca Collado-García

  6. Galicia Breast Cancer Screening Programme, Regional Authority of Health, Galicia Regional Government, A Coruña, Spain

    Jose Antonio Vázquez Carrete & María Carmen Santamariña

  7. Aragon Breast Cancer Screening Programme, Health Service of Aragon, Zaragoza, Spain

    María Pilar Moreno & Pilar Moreo

  8. Cancer Prevention and Control Unit, Catalan Institute of Oncology (ICO), Barcelona, Spain

    Carmen Vidal & Mercé Peris

  9. Valencia Breast Cancer Screening Programme, General Directorate Public Health, Valencia, Spain

    Dolores Salas & Josefa Miranda-García

  10. Centro Superior de Investigación en Salud Pública (CSISP), Valencia, Spain

    Dolores Salas & Josefa Miranda-García

  11. Castilla-Leon Breast Cancer Screening Programme, Health and Social Welfare Department, Castilla y León, Spain

    Isabel Gonzalez-Román

  12. Área de Epidemiología Ambiental y Cáncer, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Monforte de Lemos 5, 28029, Madrid, Spain

    Marina Pollan

Authors
  1. Anna Cabanes
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  2. Roberto Pastor-Barriuso
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  3. Milagros García-López
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  4. Carmen Pedraz-Pingarrón
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  5. Carmen Sánchez-Contador
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  6. Jose Antonio Vázquez Carrete
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  7. María Pilar Moreno
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  8. Carmen Vidal
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  9. Dolores Salas
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  10. Josefa Miranda-García
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  11. Mercé Peris
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  14. Francisca Collado-García
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  15. Isabel Gonzalez-Román
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  16. Nieves Ascunce
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  17. Marina Pollan
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Consortia

DDM-Spain

Corresponding author

Correspondence to Marina Pollan.

Additional information

The other members of DDM-Spain along with their affiliations details are listed under Appendix.

Appendix: Other Members of DDM-Spain

Appendix: Other Members of DDM-Spain

Virginia Lope, Beatriz Pérez-Gómez, Nuria Aragonés, and Gonzalo López-Abente are with National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; Virginia Lope, Beatriz Pérez-Gómez, Nuria Aragonés, Gonzalo López-Abente, María Ederra, Juana Vidán, and Jesus Vioque are with Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Spain; María Ederra and Juana Vidán are with Navarra Breast Cancer Screening Programme, Public Health Institute, Pamplona, Spain; Francisco Casanova is with Castilla-Leon Breast Cancer Screening Programme, D.G. Salud Pública ID e I. SACYL, Castilla y León, Spain; Montserrat Corujo and Ana Belén Fernández are with Galicia Breast Cancer Screening Programme, Regional Authority of Health, Galicia Regional Government, Galicia, Spain; Soledad Abad is with Aragon Breast Cancer Screening Programme, Health Service of Aragon, Zaragoza, Spain; Francisco Ruiz-Perales, Maria Soledad Laso, and Manuela Alcaraz are with Valencia Breast Cancer Screening Programme, General Directorate Public Health, Valencia, Spain and Centro Superior de Investigación en Salud Pública(CSISP), Valencia, Spain; and Jesus Vioque is also with Universidad Miguel Hernandez, Alicante, Spain.

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Cabanes, A., Pastor-Barriuso, R., García-López, M. et al. Alcohol, tobacco, and mammographic density: a population-based study. Breast Cancer Res Treat 129, 135–147 (2011). https://doi.org/10.1007/s10549-011-1414-5

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