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Home | Pregnancy Timeline | News Alerts |News Archive Aug 29, 2013

 



Increased risk for breast cancer is linked to drinking between adolescence and first pregnancy.






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School-age drinking increases breast cancer risk

Here's a sobering fact for millions of young women heading back to school: The more alcohol they drink before motherhood, the greater their risk of future breast cancer.

That's according to new research from Washington University School of Medicine in St. Louis that, for the first time, links increased breast cancer risk to drinking between early adolescence and first full-term pregnancy. Previous studies have looked at breast cancer risk and alcohol consumption later in life or at the effect of adolescent drinking on noncancerous breast disease.

“More and more heavy drinking is occurring on college campuses and during adolescence, and not enough people are considering future risk. But, according to our research, the lesson is clear: If a female averages a drink per day between her first period and her first full-term pregnancy, she increases her risk of breast cancer by 13 percent,” said co-author Graham Colditz, MD, DrPH, associate director for cancer prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine.

The study is published online Aug. 28 in the Journal of the National Cancer Institute.

Colditz also is the Niess-Gain Professor of Surgery at Washington University School of Medicine. He worked on the study with first author Ying Liu, MD, PhD, a School of Medicine instructor in the Division of Public Health Sciences, and colleagues from Brigham and Women's Hospital, Harvard Medical School, Beth Israel Deaconess Medical Center and Harvard School of Public Health.


Researchers found that for every bottle of beer, glass of wine or shot of liquor consumed daily, a young woman increases her risk of proliferative benign breast disease by 15 percent. Although such lesions are noncancerous, their presence increases breast cancer risk by as much as 500 percent, Liu said.


"Parents should educate their daughters about the link between drinking and risk of breast cancer and breast disease," she said. "That's very important because this time period is very critical."

The findings are based on a review of the health histories of 91,005 mothers enrolled in the Nurses' Health Study II from 1989 to 2009. Colditz was key to the development and administration of that and similar studies that track disease risk in female nurses.

Colditz and Liu didn't consider the effects of adolescent and early adulthood drinking on women who didn't have a full-term pregnancy because not enough were represented among those studied, Liu said.


Breast tissue cells are particularly susceptible to cancer-causing substances as they undergo rapid proliferation during adolescence and later.

Adding to the risk is the lengthening time frame between the average age of a girl's first menstrual cycle and the average age of a woman's first full-term pregnancy. Colditz doesn't foresee any shortening of that, which is why young women should drink less, he said – to lower average daily consumption and, therefore, risk.

"Reducing drinking to less than one drink per day, especially during this time period, is a key strategy to reducing lifetime risk of breast cancer," he added.


Colditz said the findings call for more research into what young women can do to counteract alcohol's adverse effects if they choose to drink. Past studies that didn't consider alcohol use suggest that eating more fiber and exercising more lowers cancer risk for everyone.

Abstract
Background Adult alcohol consumption during the previous year is related to breast cancer risk. Breast tissue is particularly susceptible to carcinogens between menarche and first full-term pregnancy. No study has characterized the contribution of alcohol consumption during this interval to risks of proliferative benign breast disease (BBD) and breast cancer.

Methods We used data from 91005 parous women in the Nurses’ Health Study II who had no cancer history, completed questions on early alcohol consumption in 1989, and were followed through June 30, 2009, to analyze breast cancer risk. A subset of 60093 women who had no history of BBD or cancer in 1991 and were followed through June 30, 2001, were included in the analysis of proliferative BBD. Relative risks (RRs) were estimated using Cox proportional hazard regression.

Results We identified 1609 breast cancer cases and 970 proliferative BBD cases confirmed by central histology review. Alcohol consumption between menarche and first pregnancy, adjusted for drinking after first pregnancy, was associated with risks of breast cancer (RR = 1.11 per 10g/day intake; 95% confidence interval [CI] = 1.00 to 1.23) and proliferative BBD (RR = 1.16 per 10g/day intake; 95% CI = 1.02 to 1.32). Drinking after first pregnancy had a similar risk for breast cancer (RR = 1.09 per 10g/day intake; 95% CI = 0.96 to 1.23) but not for BBD. The association between drinking before first pregnancy and breast neoplasia appeared to be stronger with longer menarche to first pregnancy intervals.

Conclusions Alcohol consumption before first pregnancy was consistently associated with increased risks of proliferative BBD and breast cancer.

To learn more about breast cancer risk based on age and lifestyle factors, visit http://www.yourdiseaserisk.wustl.edu. A related free iPad app, called Zuum, is available on iTunes at https://itunes.apple.com/us/app/id521273376.

This work was supported by the National Cancer Institute, National Institutes of Health (NIH) (R01 CA050385, R01 CA046475). Colditz's work also is supported by an American Cancer Society Clinical Research Professorship and the Breast Cancer Research Foundation. Liu's research is supported by The Foundation for Barnes-Jewish Hospital.

Liu Y, Colditz GA, Rosner B, Berkey CS, Collins LC, Schnitt SJ, Connolly JL, Chen WY, Willett WC, Tamimi RM. Alcohol intake between menarche and first pregnancy: A prospective study of breast cancer risk. Journal of the National Cancer Institute. Online Aug. 28, 2013.

Washington University School of Medicine's 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked sixth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.

The Siteman Cancer Center?, the only National Cancer Institute-designated Comprehensive Cancer Center in Missouri, is ranked among the top cancer facilities in the nation by U.S. News & World Report. Comprising the cancer research, prevention and treatment programs of Barnes-Jewish Hospital and Washington University School of Medicine, Siteman is also Missouri's only member of the National Comprehensive Cancer Network.

Original press release: http://www.eurekalert.org/pub_releases/2013-08/wuso-sdi082813.php