It’s a real sobering fact for millions of young women heading back to school or college. Researcher have found a link confirming that alcoholconsumptionbefore motherhood increases their risk of future breast cancer.

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

The International Agency for Research on Cancer(IARC)considers alcohol to be causally related to invasive breast cancer. For each 10 gram of alcohol consumed daily they estimate an increase of risk of 7% to 10%. However, the risk attributable to school-age alcohol drinking and early adulthood remained, so far, inconclusive.

…Reducing alcohol consumption to less than one drink per day… is a key strategy to reducing lifetime risk of breast cancer…

?More and more heavy drinking – including binge 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%,? noted co-author Graham Colditz, MD, DrPH, associate director for cancer prevention and control atSiteman Cancer CenteratBarnes-Jewish Hospitaland Washington University School of Medicine.

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The study is published online in the August 28, 2013 edition of theJournal of the National Cancer Institute.

Colditz is also 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.

Benign Breast Disease
The researchers also 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 (BBD) by 15%. Although such lesions are noncancerous, their presence increases breast cancer risk by as much as 500%, 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.”

Nurses’ Health Study
The findings in this study are based on a review of the health histories of 91,005 mothers enrolled in the Nurses’ Health Study II (NHSII) from 1989 to 2009.The Nurses? Health Studies are among the largest and longest running investigations of factors that influence women?s health. The original study started in 1976 and was expanded in 1989. The collected information provided by the 238,000 dedicated nurse-participants has led to many new insights on health and disease.Colditz was key to the development and administration of that and similar studies that track disease risk in female nurses.

For this study alcohol consumption in four age periods were obtained by asking participants about the total number of alcoholic drinks consumed at different ages (ages 15-17, 18-22, 23-30, and 31-40). After excluding women who did not meet the predetermined study criteria, a total of 91,005 women with a history of full-term pregnancy were included in the final analysis. Among these women, 1,609 cases of breast cancer and 970 cases of BBD occurred during the study period. These cases were confirmed by physicians who reviewed information from each patient’s medical records.

Based on the data, the authors of the study also observed that longer intervals between first menstrual period and first pregnancy showed stronger associations compared with shorter intervals. They further reported that drinking after the first pregnancy was associated with breast cancer risk but not BBD.

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 Cancer
One mechanism involved in the link between early alcohol consumption and breast cancer may be alcohol-induced increases in circulating estrogens and subsequently epithelial cell proliferation. Breast tissue cells are particularly susceptible to cancer-causing substances as they undergo rapid proliferation during adolescence. 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 said.

The authors of the article said that these 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.

Measuring lifestyle risk
To measure individual breast cancer risk and lifestyle factors medical experts at the Washington University School of Medicine havedevelopedYour Disease Risk, the source on prevention, an app designed to find out an individual’s own risk of developing five of the most important diseases in the United States. The app offers personalized tips for preventing these diseases. Developed over the past ten years by world-renowned experts, Your Disease Risk collects the latest scientific evidence on disease risk factors into one easy-to-use tool. A related free iPad app, called Zuum, is available on iTunes.

For more information:
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.JNCI J Natl Cancer Inst(2013)doi:10.1093/jnci/djt213Online Aug. 28, 2013 [Article]

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