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The association of alcohol consumption with mammographic density in a multiethnic urban population.

Quandt Z, Flom JD, Tehranifar P, Reynolds D, Terry MB, McDonald JA - BMC Cancer (2015)

Bottom Line: We considered confounding by age, body mass index (BMI), hormone contraceptive use, family history of breast cancer, menopausal status, smoking status, nativity, race/ethnicity, age at first birth, and parity.We did not observe race/ethnicity modification of the association between alcohol intake and percent density.In women with a BMI of <25 kg/m(2), drinkers consuming >7 servings/week of alcohol had a = 17% increase in percent density compared to nondrinkers (95% CI 5.4, 29.0) and there was no association in women with a BMI ≥ 25 kg/m(2) (BMI ≥ 25-30 kg/m(2) > 7 β = 5.1, 95% CI -8.5, 18.7 and BMI > 30 kg/m(2) > 7 β = 0.5, 95% CI -6.5, 7.5) after adjusting for age and BMI (continuous).

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology, Columbia University Medical Center, Mailman School of Public Health, New York, NY, USA, zquandt@stanford.edu.

ABSTRACT

Background: Alcohol consumption is associated with higher breast cancer risk. While studies suggest a modest association between alcohol intake and mammographic density, few studies have examined the association in racial/ethnic minority populations.

Methods: We assessed dense breast area and total breast area from digitized film mammograms in an urban cohort of African American (42%), African Caribbean (22%), white (22%), and Hispanic Caribbean (9%) women (n = 189, ages 40-61). We examined the association between alcohol intake and mammographic density (percent density and dense area). We used linear regression to examine mean differences in mammographic density across alcohol intake categories. We considered confounding by age, body mass index (BMI), hormone contraceptive use, family history of breast cancer, menopausal status, smoking status, nativity, race/ethnicity, age at first birth, and parity.

Results: Fifty percent currently consumed alcohol. Women who consumed >7 servings/week of alcohol, but not those consuming ≤7 servings/week, had higher percent density compared to nondrinkers after full adjustments (servings/week >7 β = 8.2, 95% Confidence Interval (CI) 1.8, 14.6; ≤7 β = -0.5, 95% CI -3.7, 2.8). There was a positive association between high alcohol intake and dense area after full adjustments (servings/week >7 β = 5.8, 95% CI -2.7, 14.2; ≤7 β = -0.1, 95% CI -4.4, 4.2). We did not observe race/ethnicity modification of the association between alcohol intake and percent density. In women with a BMI of <25 kg/m(2), drinkers consuming >7 servings/week of alcohol had a = 17% increase in percent density compared to nondrinkers (95% CI 5.4, 29.0) and there was no association in women with a BMI ≥ 25 kg/m(2) (BMI ≥ 25-30 kg/m(2) > 7 β = 5.1, 95% CI -8.5, 18.7 and BMI > 30 kg/m(2) > 7 β = 0.5, 95% CI -6.5, 7.5) after adjusting for age and BMI (continuous).

Conclusion: In a racially/ethnically diverse cohort, women who consumed >7 servings/week of alcohol, especially those with a BMI < 25 kg/m(2), had higher percent density.

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Multiple linear regression coefficients for the association between percent density and current alcohol intake (servings/week) by BMI, New York City Multiethnic Breast Cancer Project (n=176); 2007-2008. Models are adjusted for age at interview (years) and BMI (kg/m2, continuous).
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Fig2: Multiple linear regression coefficients for the association between percent density and current alcohol intake (servings/week) by BMI, New York City Multiethnic Breast Cancer Project (n=176); 2007-2008. Models are adjusted for age at interview (years) and BMI (kg/m2, continuous).

Mentions: In BMI-stratified analyses adjusted for age and continuous BMI, percent density specific confounders, in women with a BMI of <25 kg/m2, those who consumed >7 servings/week of alcohol had a 17% increase in percent density (95% CI 5.4, 29.0) (Figure 2). There was no association between percent density and alcohol consumption in women with a BMI = 25- < 30 kg/m2 (servings/week ≤7 β = 1.8, 95% CI -4.3, 7.9; >7 β = 5.1, 95% CI -8.5, 18.7) or BMI ≥ 30 kg/m2 (servings/week ≤7 β = -2.0, 95% CI -5.6, 1.7; >7 β = 0.5, 95% CI -6.5, 7.5). Results for BMI-stratified analyses were essentially the same after fully adjusting for all confounders (data not shown). Further, results were confirmed in fully adjusted models where we also observed a positive linear relationship between alcohol intake modeled as a continuous variable (g/week) and percent density in women with a BMI of <25 kg/m2 (β = 0.07, 95% CI 0.002, 0.1) and associations in women with a BMI ≥ 25 kg/m2 (BMI = 25- < 30 kg/m2 β = -0.1, 95% CI -0.1, 0.08 and BMI ≥ 30 kg/m2 β = 0.02, 95% CI -0.01, 0.05). We observed statistical interaction between alcohol intake and BMI on an additive scale when we modeled for percent density (P <0.01). In contrast, we observed no interaction with BMI when we examined dense area or non-dense area. However, similar to percent density after adjusting for age and BMI, when we modeled for dense area we observed stronger associations in women with a BMI of <25 kg/m2. Women consuming >7 servings/week of alcohol had greater dense area, but the association did not reach significance (P = 0.07).Figure 2


The association of alcohol consumption with mammographic density in a multiethnic urban population.

Quandt Z, Flom JD, Tehranifar P, Reynolds D, Terry MB, McDonald JA - BMC Cancer (2015)

Multiple linear regression coefficients for the association between percent density and current alcohol intake (servings/week) by BMI, New York City Multiethnic Breast Cancer Project (n=176); 2007-2008. Models are adjusted for age at interview (years) and BMI (kg/m2, continuous).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4374505&req=5

Fig2: Multiple linear regression coefficients for the association between percent density and current alcohol intake (servings/week) by BMI, New York City Multiethnic Breast Cancer Project (n=176); 2007-2008. Models are adjusted for age at interview (years) and BMI (kg/m2, continuous).
Mentions: In BMI-stratified analyses adjusted for age and continuous BMI, percent density specific confounders, in women with a BMI of <25 kg/m2, those who consumed >7 servings/week of alcohol had a 17% increase in percent density (95% CI 5.4, 29.0) (Figure 2). There was no association between percent density and alcohol consumption in women with a BMI = 25- < 30 kg/m2 (servings/week ≤7 β = 1.8, 95% CI -4.3, 7.9; >7 β = 5.1, 95% CI -8.5, 18.7) or BMI ≥ 30 kg/m2 (servings/week ≤7 β = -2.0, 95% CI -5.6, 1.7; >7 β = 0.5, 95% CI -6.5, 7.5). Results for BMI-stratified analyses were essentially the same after fully adjusting for all confounders (data not shown). Further, results were confirmed in fully adjusted models where we also observed a positive linear relationship between alcohol intake modeled as a continuous variable (g/week) and percent density in women with a BMI of <25 kg/m2 (β = 0.07, 95% CI 0.002, 0.1) and associations in women with a BMI ≥ 25 kg/m2 (BMI = 25- < 30 kg/m2 β = -0.1, 95% CI -0.1, 0.08 and BMI ≥ 30 kg/m2 β = 0.02, 95% CI -0.01, 0.05). We observed statistical interaction between alcohol intake and BMI on an additive scale when we modeled for percent density (P <0.01). In contrast, we observed no interaction with BMI when we examined dense area or non-dense area. However, similar to percent density after adjusting for age and BMI, when we modeled for dense area we observed stronger associations in women with a BMI of <25 kg/m2. Women consuming >7 servings/week of alcohol had greater dense area, but the association did not reach significance (P = 0.07).Figure 2

Bottom Line: We considered confounding by age, body mass index (BMI), hormone contraceptive use, family history of breast cancer, menopausal status, smoking status, nativity, race/ethnicity, age at first birth, and parity.We did not observe race/ethnicity modification of the association between alcohol intake and percent density.In women with a BMI of <25 kg/m(2), drinkers consuming >7 servings/week of alcohol had a = 17% increase in percent density compared to nondrinkers (95% CI 5.4, 29.0) and there was no association in women with a BMI ≥ 25 kg/m(2) (BMI ≥ 25-30 kg/m(2) > 7 β = 5.1, 95% CI -8.5, 18.7 and BMI > 30 kg/m(2) > 7 β = 0.5, 95% CI -6.5, 7.5) after adjusting for age and BMI (continuous).

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology, Columbia University Medical Center, Mailman School of Public Health, New York, NY, USA, zquandt@stanford.edu.

ABSTRACT

Background: Alcohol consumption is associated with higher breast cancer risk. While studies suggest a modest association between alcohol intake and mammographic density, few studies have examined the association in racial/ethnic minority populations.

Methods: We assessed dense breast area and total breast area from digitized film mammograms in an urban cohort of African American (42%), African Caribbean (22%), white (22%), and Hispanic Caribbean (9%) women (n = 189, ages 40-61). We examined the association between alcohol intake and mammographic density (percent density and dense area). We used linear regression to examine mean differences in mammographic density across alcohol intake categories. We considered confounding by age, body mass index (BMI), hormone contraceptive use, family history of breast cancer, menopausal status, smoking status, nativity, race/ethnicity, age at first birth, and parity.

Results: Fifty percent currently consumed alcohol. Women who consumed >7 servings/week of alcohol, but not those consuming ≤7 servings/week, had higher percent density compared to nondrinkers after full adjustments (servings/week >7 β = 8.2, 95% Confidence Interval (CI) 1.8, 14.6; ≤7 β = -0.5, 95% CI -3.7, 2.8). There was a positive association between high alcohol intake and dense area after full adjustments (servings/week >7 β = 5.8, 95% CI -2.7, 14.2; ≤7 β = -0.1, 95% CI -4.4, 4.2). We did not observe race/ethnicity modification of the association between alcohol intake and percent density. In women with a BMI of <25 kg/m(2), drinkers consuming >7 servings/week of alcohol had a = 17% increase in percent density compared to nondrinkers (95% CI 5.4, 29.0) and there was no association in women with a BMI ≥ 25 kg/m(2) (BMI ≥ 25-30 kg/m(2) > 7 β = 5.1, 95% CI -8.5, 18.7 and BMI > 30 kg/m(2) > 7 β = 0.5, 95% CI -6.5, 7.5) after adjusting for age and BMI (continuous).

Conclusion: In a racially/ethnically diverse cohort, women who consumed >7 servings/week of alcohol, especially those with a BMI < 25 kg/m(2), had higher percent density.

Show MeSH
Related in: MedlinePlus