High alcohol intake and breast density increase breast cancer (BC) risk, but their interrelationship is unknown. We examined whether volumetric density modifies and/or mediates the alcohol-BC association. BC cases (n 2233) diagnosed from 2006 to 2013 in the San Francisco Bay area had screening mammograms 6 or more months before diagnosis; controls (n 4562) were matched on age, mammogram date, race or ethnicity, facility, and mammography machine. Logistic regression was used to estimate alcohol-BC associations adjusted for age, body mass index, and menopause; interaction terms assessed modification. Percent mediation was quantified as the ratio of log (odds ratios [ORs]) from models with and without density measures. Alcohol consumption was associated with increased BC risk (2-sided Ptrend .004), as were volumetric percent density (OR 1.45 per SD, 95% confidence interval [CI] 1.36 to 1.56) and dense volume (OR 1.30, 95% CI 1.24 to 1.37). Breast density did not modify the alcohol-BC association (2-sided P<.10 for all). Dense volume mediated 25.0% (95% CI 5.5% to 44.4%) of the alcohol-BC association (2-sided P .01), suggesting alcohol may partially increase BC risk by increasing fibroglandular tissue.
ASJC Scopus subject areas
- Cancer Research