Alcohol is a well-documented
cause of breast cancer. Risk increases by approximately 7% for each 10 g of
alcohol consumed daily by adult women.1-3 That is for each drink of beer wine or liquor,
risk increases about 7% more compared to a never drinker. About one third of
the population of US women never drinks. We have previously written on the
mechanism for this increase in risk among adult women (see related posts).
Today we turn to the
role of alcohol in early adult life and how it can increase risk of breast
cancer by driving normal breast cell along the pathway to begin changes that
are precursors or intermediate steps on the way to breast cancer. This evidence is behind our post on how parents can help lower risk for their daughters (see post Early Life and Later Breast Cancer Risk: "Hey, Mom & Dad")
First, we know that
early menarche or first menstrual period, and late age at first birth, are each
related to increased risk of breast cancer. In fact, during the interval
between menarche and first birth the breast cells accumulate risk (or DNA
damage) of progressing to cancer at a faster rate than any other time in the
life of a woman. After first pregnancy, the rate of risk accumulation slows and
after each subsequent birth it slows more. Finally at menopause, the rate of
increase slows even more and is largely driven by circulating estrogen levels
after menopause.
We have studied
alcohol intake and risk of premalignant breast lesions in a number of settings
and note that we see a strong increase in risk when we follow women from late
adolescence into their early adult years. Alcohol intake reported in late adolescence
and early adulthood increases subsequent risk of the most aggressive
premalignant lesions that carry increased risk of developing invasive breast cancer.4,5
For example, our data from the follow-up of over
6000 late adolescent and young adult women and their subsequent risk of biopsy
confirmed benign breast disease shows that those who have a family history of
breast cancer or if their mother has a history of breast cancer – then drinking
alcohol increases the risk of breast cancer precursor lesions.
Women with a family history of breast cancer who
drank an average of one drink per day in late adolescence and early adult years
have a doubling in their risk of biopsy confirmed benign breast disease
compared to those who never drink alcohol. Given much concern among women as to
what they can do to lower breast cancer risk or prevent breast cancer in their
children (grandchildren, nieces, etc.) these data document that limiting
alcohol intake will help avoid the increase in risk that goes with drinking 6.
During the time from
menarche to first birth we might also expect lifestyle factors to lower risk –
slowing the accumulation of damage to DNA in breast cells and reducing the
long-term accumulation of risk of breast cancer. We, and others, have studied physical
activity, or exercise, as one possible strategy to reduce risk. A number of
studies now show that higher levels of activity from menarche through the
premenopausal years is related to substantially lower risk of invasive breast canner.
Bernstein showed as
early as 1994 that women who were active in physical exercise for 3.8 hours or
more per week had half the risk for beast cancer of women who were not active
at all 7. Subsequent studies confirm this protection – both
in retrospective recall of activity and in prospective studies such as the
Nurses’ Health Study II where women reported their activity through high school
and were then followed over time to see who went on to develop breast cancer
and who did not 8.
While much interest
and research continues to explore how diet may modify the benefits of activity
or prevent the adverse effects of alcohol in adolescence on breast cancer risk,
to date the studies are few and not yet consistent enough to conclude that we
can prevent breast cancer through diet in these years. There is, however, promising evidence
that higher fiber intake may reduce risk – and this is safe and recommended
approach to a health diet in general 9. Likewise rowing evidence points to soy intake
through childhood and adolescent years as the most protective time for this dietary
factor to lower risk for beast cancer 10 11.
Related CNiC posts
Further evidence that alcohol causes breast cancer
Literature
Cited