From Medscape Medical News

Family History, Alcohol Affect Risk for Benign Breast Disease

Rod Franklin

November 14, 2011 — A young girl's chances of developing benign breast disease (BBD), a known risk factor for breast cancer (BC), appears to double if the patient has a family history of BBD or BC and also consumes alcohol, according to study data published online November 14 in Cancer.

However, alcohol consumption was not associated with an increased risk of BBD for young girls who did not have a family history of BBD or BC. For these participants, smaller increases in BBD risk were associated with control variables such as height, body mass index, and waist circumference.

The results come from the Growing Up Today Study (GUTS), coordinated at the Washington University School of Medicine in St. Louis, Missouri, and focusing on daughters of participants in the Nurses' Health Study II. The new information adds to existing epidemiological evidence that links alcohol use to heightened risk of breast disease, but is the first study to examine alcohol's effect in adolescent girls.

The authors, led by Catherine S. Berkey, ScD, from the Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, studied data from 9037 girls from all 50 states.

When initially enrolled in GUTS in 1996, study participants ranged in age from 9 to 15 years. They completed annual questionnaires from 1996 to 2001, and then again in 2003, 2005, and 2007. The 2005 and 2007 surveys revealed that 67 participants had biopsy-confirmed BBD, and 6741 of the respondents to those surveys reported no BBD.

The researchers initially looked at the effect of family history on risk of BBD, independent of alcohol consumption. Using logistic regression models, they report that the risk for BBD was doubled if a girl's mother and/or a maternal aunt had previously been diagnosed with BC (odds ratio [OR], 2.34; P = .01, univariate analysis). The daughters of mothers previously diagnosed with BBD faced a less dramatic risk hike for BBD (OR, 1.59; P = .095, univariate analysis).

Within this cohort, alcohol use (7 drinks per week) exacerbated BBD risk in the girls with a family history. Study participants who drank and had any family history of BC (originating with a mother, aunt, or grandmother) had a greater than 2-fold risk of acquiring BBD (OR, 2.28; P = .01). Those who consumed alcohol and whose mothers previously reported BBD only also reflected a heightened risk for BBD (OR, 1.96; P = .02). In contrast, alcohol was not associated with a statistically significant increase in risk for those who had no family history (OR, 1.22; P = .57).

Risk assessments were aligned with age and with level of alcohol consumption. Study authors reported that "girls with any family history of disease (BC or maternal BBD) and who are in the highest quartile of alcohol consumption for their age (≥1 drink/wk for age 16 years, 2 drinks/wk for 18 years, 3 drinks/wk for 19 years) have significantly greater BBD risk (OR, 2.27; P = .03) relative to girls with no family history who do not drink any alcohol."

The limitations of the study include the small number of BBD cases within certain family history subgroups (particularly mothers with BC and aunts with BC), as well as the potential for a BBD detection bias, owing to the higher likelihood of BBD diagnoses being conducted on girls with a family history of breast health issues compared with those without a family history of complication.

The researchers concluded that reduction of alcohol use during adolescence can affect BBD risk exposure in girls with a family history of breast-related issues. Moreover, the study supports earlier research related to the effect of alcohol on BC risk elevation in women.

The authors have disclosed no relevant financial relationships.
Cancer. Published online November 14, 2011. Abstract