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Is breast cancer risk associated with alcohol intake before first full-term pregnancy?

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Abstract

Purpose

It is plausible that breast tissue is particularly susceptible to carcinogens, including ethanol, between menarche and the first full-term pregnancy (“first pregnancy”). There is some epidemiological evidence that intake before the first pregnancy is more closely associated with risk of breast cancer than is intake thereafter. We examined this association using lifetime alcohol consumption data from a prospective cohort study.

Methods

We calculated usual alcohol intake for age periods 15–19 years and for 10-year period from age 20 to current age (in grams per day) using recalled frequency and quantity of beverage-specific consumption for 13,630 parous women who had their first pregnancy at age 20 years or later, had no cancer history and were aged 40–69 years at enrollment. Cox regression was performed to estimate hazard ratios (HRs) and their 95 % confidence intervals (CIs).

Results

A total of 651 incident invasive adenocarcinomas of the breast were diagnosed during a mean follow-up of 16.1 years. Alcohol consumption was low overall with only a few drinking ≥40 g/day. Intake before the first pregnancy was markedly lower (mean intake: 2.5 g/day; abstention: 58.8 %) than intake thereafter (mean intake: 6.0 g/day; abstention: 33.6 %). Any alcohol intake before the first pregnancy was associated with an increased risk of breast cancer (HR 1.35, 95 % CI 1.10–1.66 for drinking compared with abstention), whereas any intake after the first pregnancy was not (HR 0.89, 95 % CI 0.72–1.09).

Conclusions

Limiting alcohol intake before the first pregnancy might reduce women’s risk of breast cancer.

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Fig. 1

Abbreviations

CI:

Confidence interval

EPIC:

European Prospective Investigation into Cancer and Nutrition

HR:

Hazard ratio

MCCS:

Melbourne Collaborative Cohort Study

NHSII:

Nurses’ Health Study II

VCR:

Victorian Cancer Registry

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Acknowledgments

We thank the original investigators and the diligent team, who recruited the participants and who continue working on follow-up, for their contribution. We also express our gratitude to the many thousands of Melbourne residents who continue to participate in the study.

Grant support

MCCS cohort recruitment was funded by VicHealth and Cancer Council Victoria. The MCCS was further supported by Australian National Health and Medical Research Council Grants 209057, 251553, and 504711 and by infrastructure provided by Cancer Council Victoria. JLH is a National Health and Medical Research Council Senior Principal Research Fellow. RR’s position was funded by the Victorian Department of Health and the Foundation for Alcohol Research and Education. The funding sources played no role in the study design, in the collection, analysis, and interpretation of data, in the writing of the report, and in the decision to submit the article for publication.

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Correspondence to Harindra Jayasekara.

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Jayasekara, H., MacInnis, R.J., Hodge, A.M. et al. Is breast cancer risk associated with alcohol intake before first full-term pregnancy?. Cancer Causes Control 27, 1167–1174 (2016). https://doi.org/10.1007/s10552-016-0789-3

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