Cui Yan, Page David L, Chlebowski Rowan T, Beresford Shirley A, Hendrix Susan L, Lane Dorothy S, Rohan Thomas E
Office of Health Assessment and Epidemiology, Los Angeles County Department of Public Health, Los Angeles, CA, USA.
Int J Cancer. 2007 Sep 15;121(6):1346-51. doi: 10.1002/ijc.22861.
Alcohol consumption has been associated with increased breast cancer risk and the increase in risk may be attenuated by adequate folate intake. However, their associations with the risk of benign proliferative epithelial disorders (BPEDs) of the breast, possible precursors of breast cancer, are not well understood. To investigate these associations, we conducted a cohort study among 68,132 postmenopausal women participating in the Women's Health Initiative randomized clinical trials. Women were prospectively followed and those reporting a breast procedure (open surgical biopsy or core needle biopsy) had histological sections obtained for central pathology review. A total of 1,792 women with BPED of the breast were identified over an average of 7.8 years of follow-up. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence limits (CLs) for the associations of interest. Compared to nondrinkers, total current alcohol intake of 30 g/day or more was not associated with BPED risk (HR = 0.98, 95% CL = 0.70, 1.38). The risk of BPED was not associated with folate intake from diet (highest vs. lowest quartile: HR = 1.10, 95% CL = 0.96, 1.26), from supplements (yes vs. no: HR = 1.05, 95% CL = 0.96, 1.16) or from all sources combined (highest vs. lowest quartile: HR = 1.11, 95% CL = 0.96, 1.27). Furthermore, there was no effect modification between alcohol and folate in relation to the risk of BPED. In conclusion, we observed that alcohol consumption and folate intake were not associated with altered risk of BPED, and that there was no effect modification between them in relation to the risk of BPED.
饮酒与乳腺癌风险增加有关,而充足的叶酸摄入可能会降低这种风险增加的幅度。然而,它们与乳腺癌可能的前体——乳腺良性增生性上皮疾病(BPEDs)风险之间的关联尚未得到充分了解。为了研究这些关联,我们在参与妇女健康倡议随机临床试验的68132名绝经后妇女中进行了一项队列研究。对妇女进行前瞻性随访,那些报告有乳房手术(开放式手术活检或空心针活检)的妇女获取组织切片进行中心病理检查。在平均7.8年的随访期间,共识别出1792名患有乳腺BPED的妇女。使用Cox比例风险模型来估计感兴趣关联的风险比(HRs)和95%置信区间(CLs)。与不饮酒者相比,当前总酒精摄入量为每天30克或更多与BPED风险无关(HR = 0.98,95% CL = 0.70,1.38)。BPED风险与饮食中叶酸摄入量(最高四分位数与最低四分位数:HR = 1.10,95% CL = 0.96,1.26)、补充剂中叶酸摄入量(是与否:HR = 1.05,95% CL = 0.96,1.16)或所有来源的叶酸摄入量总和(最高四分位数与最低四分位数:HR = 1.11,95% CL = 0.96,1.27)均无关。此外,在BPED风险方面,酒精和叶酸之间没有效应修饰。总之,我们观察到饮酒和叶酸摄入与BPED风险改变无关,并且它们在BPED风险方面没有效应修饰。