Alcohol dose, frequency and age at first exposure in relation to the risk of breast cancer.

Habitual alcohol consumption, in terms of dose and frequency, average daily intake, as well as drinking alcohol at age 25 were compared between 120 incident breast cancer cases and 164 population controls in The Netherlands. Dietary and lifestyle factors, past and present alcohol consumption were established in 1985-1987 in home interviews. In premenopausal women a protective effect of low alcohol consumption (1-4 g/day) as compared to non-drinkers was suggested. The multivariate adjusted odds ratio (OR) comparing women drinking greater than or equal to 30 g with women drinking 1 to 4 g alcohol daily was 8.5 (95% confidence interval: (Cl) = 1.1-65.1). The OR for a dose of alcohol of greater than or equal to 15 g versus 1-14 g was 4.0 (Cl = 1.0-15.6) and for drinking more versus less than three times a week the OR was 2.8 (Cl = 0.8-9.8). In post-menopausal women no association was observed between recent drinking habits and breast cancer risk. In these women, however, the adjusted OR for drinking alcohol before the age of 25 was 2.4 (Cl = 1.0-5.6). Although causal inference is hampered by the cultural aspects of drinking habits, the results suggest that moderate drinking does not increase risk. Drinking more than 30 g daily or a high dose may enhance risk in premenopausal women. Furthermore, an early start to drinking alcohol may increase the relative risk for breast cancer even beyond menopause.