Williams Lindsay A, Olshan Andrew F, Hong Chi-Chen, Bandera Elisa V, Rosenberg Lynn, Cheng Ting-Yuan David, Lunetta Kathryn L, McCann Susan E, Poole Charles, Kolonel Laurence N, Palmer Julie R, Ambrosone Christine B, Troester Melissa A
Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York.
Cancer Epidemiol Biomarkers Prev. 2017 May;26(5):787-794. doi: 10.1158/1055-9965.EPI-16-0792. Epub 2017 Apr 18.
Alcohol is a recognized risk factor for invasive breast cancer, but few studies involve African American women. The current analysis included 22,338 women (5,108 cases of invasive breast cancer) from the African American Breast Cancer Epidemiology and Risk (AMBER) Consortium. The association between number of alcoholic drinks per week (dpw) and breast cancer was estimated using logistic regression, adjusting for potential confounders, and stratifying by breast cancer subtype. Approximately 35% of controls were current drinkers at interview. Women who reported current drinking of ≥14 dpw had an elevated risk of breast cancer compared with light drinkers (>0-<4 dpw) [adjusted OR (OR), 1.33; 95% confidence interval (CI), 1.07-1.64]. We observed elevated risk among women drinking ≥7 dpw for ER [OR, 1.31; 95% CI, 1.00-1.72], PR [OR, 1.28; 95% CI, 1.00-1.63], HER2 [OR, 1.36; 95% CI, 1.09-1.70], and triple-negative [OR, 1.39; 95% CI, 0.98-2.00] molecular subtype. Among receptor-positive cases, ORs remained elevated but attenuated relative to receptor-negative cases. Sensitivity analysis of age-defined windows of exposure (<30 years, 30-49, 50+ years of age) did not reveal variation in patterns of association. Risk associated with alcohol intake did not vary significantly by oral contraceptive use, smoking status, or menopausal status. Among African American women, similar to women of European descent, drinking ≥7 alcoholic dpw was associated with an increased risk of breast cancer regardless of subtype. Alcohol intake is a modifiable risk factor for breast cancer, and reduced intake among African American women should be encouraged. .
酒精是浸润性乳腺癌公认的风险因素,但涉及非裔美国女性的研究较少。当前分析纳入了来自非裔美国乳腺癌流行病学与风险(AMBER)联盟的22338名女性(5108例浸润性乳腺癌病例)。使用逻辑回归估计每周饮酒量(dpw)与乳腺癌之间的关联,并对潜在混杂因素进行校正,同时按乳腺癌亚型进行分层。约35%的对照在访谈时为当前饮酒者。报告当前饮酒量≥14 dpw的女性与轻度饮酒者(>0 - <4 dpw)相比,患乳腺癌的风险升高[校正比值比(OR)为1.33;95%置信区间(CI)为1.07 - 1.64]。我们观察到,饮酒量≥7 dpw的女性在雌激素受体(ER)[OR为1.31;95% CI为1.00 - 1.72]、孕激素受体(PR)[OR为1.28;95% CI为1.00 - 1.63]、人表皮生长因子受体2(HER2)[OR为1.36;95% CI为1.09 - 1.70]以及三阴性[OR为1.39;95% CI为0.98 - 2.00]分子亚型方面风险升高。在受体阳性病例中,OR值仍升高,但相对于受体阴性病例有所减弱。对按年龄定义的暴露窗口期(<30岁、30 - 49岁、50岁及以上)进行的敏感性分析未发现关联模式存在差异。与酒精摄入相关的风险在口服避孕药使用情况、吸烟状况或绝经状态方面无显著差异。在非裔美国女性中,与欧洲裔女性类似,无论亚型如何,每周饮用≥7份酒精饮料均与乳腺癌风险增加相关。酒精摄入是乳腺癌的一个可改变的风险因素,应鼓励非裔美国女性减少酒精摄入量。