Adolescent exposures may be important in the development of breast cancer later in life. We examined the association of adolescent alcohol consumption and adult mammographic density, a strong risk factor for breast cancer. Women within the Minnesota Breast Cancer Family Cohort with detailed mammogram and risk factor information (n 5 1,893) formed our sample. Breast cancer cases were excluded. Adolescent alcohol consumption (before age 18) was solicited through a mailed questionnaire. Percent density (PD) was estimated using the computer-assisted thresholding program, Cumulus. Statistical analyses were performed using linear mixed effect models. Women who reported ever drinking alcohol before age 18 (n 5 390; 21%) had a higher unadjusted PD than women who never drank during adolescence (l unadj 5 26.5% vs. 22.2%), but this difference disappeared with adjustment for risk factors for mammographic density (l adj 5 21.0% vs. 21.2%, p 5 0.94). Adult PD was not associated with age at initiation, amount of alcohol consumed at one sitting or frequency of alcohol use before age 18. The lack of differences was seen across strata of menopausal status. There was suggestion of higher PD among heavy and more frequent drinkers (24.0%, 95% CI 21.1-26.8%) compared to lighter (21.3%, 95% CI 20.3-22.3%) and never drinkers (21.4%, 95% CI 20.9-21.9%) and also among regular adolescent drinkers who were daily or weekly adult drinkers (25.0%, 95% CI 23.0-27.0%) compared to less regular drinkers in these 2 time periods (23.0-23.4%). However, these associations were not statistically significant (p 5 0.27 and p 5 0.22, respectively). In summary, there was no evidence that adolescent alcohol use was associated with large and persistent effects on adult PD. ' 2005 Wiley-Liss, Inc.Key words: mammographic density; adolescent alcohol; breast cancerThe high number of cell divisions during adolescence and young adulthood may render the breast especially susceptible to carcinogenic influence and signify this as an especially critical time period.1 Usual adult alcohol consumption is a consistent risk factor for breast cancer, with a 7% (95% CI: 5.5-8.7%) increase in risk for each additional 10 g/day of alcohol (approximately 0.75-1 drink) compared to nondrinkers.2 However, the potential influence of alcohol consumption during adolescence on breast cancer remains unsettled. Epidemiologic evidence is inconsistent, with some studies finding an increased risk for breast cancer with age of initiation before age 25, 3-6 whereas others do not. 7-17 A recent review of the literature on adolescent alcohol consumption and breast cancer concluded that there is no clear association.
18One strategy to help resolve the inconsistency is to examine the association of alcohol use in adolescence with mammographic density, which is an established risk factor for breast cancer 19 and is a measurable phenotype closer in time to the exposure of interest.Women with percent mammographic density >50% have a 3-5-fold greater risk of breast cancer than women with low densit...