IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain.
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid-IdiPaz, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
Br J Cancer. 2021 Oct;125(8):1168-1176. doi: 10.1038/s41416-021-01492-w. Epub 2021 Sep 6.
Whether there are lifetime points of greater sensitivity to the deleterious effects of alcohol intake on the breasts remains inconclusive.
To compare the influence of distinctive trajectories of alcohol consumption throughout a woman's life on development of breast cancer (BC).
1278 confirmed invasive BC cases and matched (by age and residence) controls from the Epi-GEICAM study (Spain) were used. The novel group-based trajectory modelling was used to identify different alcohol consumption trajectories throughout women's lifetime.
Four alcohol trajectories were identified. The first comprised women (45%) with low alcohol consumption (<5 g/day) throughout their life. The second included those (33%) who gradually moved from a low alcohol consumption in adolescence to a moderate in adulthood (5 to <15 g/day), never having a high consumption; and oppositely, women in the third trajectory (16%) moved from moderate consumption in adolescence, to a lower consumption in adulthood. Women in the fourth (6%) moved from a moderate alcohol consumption in adolescence to the highest consumption in adulthood (≥15 g/day), never having a low alcohol consumption. Comparing with the first trajectory, the fourth doubled BC risk (OR 2.19; 95% CI 1.27, 3.77), followed by the third (OR 1.44; 0.96, 2.16) and ultimately by the second trajectory (OR 1.17; 0.86, 1.58). The magnitude of BC risk was greater in postmenopausal women, especially in those with underweight or normal weight. When alcohol consumption was independently examined at each life stage, ≥15 g/day of alcohol consumption in adolescence was strongly associated with BC risk followed by consumption in adulthood.
The greater the alcohol consumption accumulated throughout life, the greater the risk of BC, especially in postmenopausal women. Alcohol consumption during adolescence may particularly influence BC risk.
关于女性一生中有哪些特定的敏感点会因饮酒而更容易受到伤害，目前尚无定论。
比较女性一生中不同的饮酒轨迹对乳腺癌（BC）发展的影响。
本研究使用了来自 Epi-GEICAM 研究（西班牙）的 1278 例确诊的浸润性 BC 病例和匹配（按年龄和居住地）的对照。采用新的基于群组的轨迹建模方法来识别女性一生中不同的饮酒轨迹。
共确定了 4 种饮酒轨迹。第一个轨迹包括 45%的女性，她们一生的饮酒量都很低（<5g/天）。第二个轨迹包括 33%的女性，她们逐渐从青春期的低饮酒量过渡到成年期的中等饮酒量（5 到 <15g/天），从不饮酒过量；相反，第三个轨迹中的女性（16%）则从青春期的中等饮酒量减少到成年期的较低饮酒量。第四个轨迹（6%）的女性从青春期的中等饮酒量过渡到成年期的最高饮酒量（≥15g/天），从不饮酒过量。与第一个轨迹相比，第四个轨迹使 BC 风险增加了一倍（OR 2.19；95%CI 1.27，3.77），其次是第三个（OR 1.44；0.96，2.16），最后是第二个轨迹（OR 1.17；0.86，1.58）。绝经后妇女的 BC 风险更高，尤其是体重不足或正常的妇女。当分别在每个生命阶段检查饮酒量时，青春期时的酒精摄入量≥15g/天与 BC 风险强烈相关，其次是成年期时的酒精摄入量。
一生中累积的饮酒量越大，BC 的风险就越高，尤其是在绝经后妇女中。青春期饮酒可能特别影响 BC 风险。
