Influence of lifestyle factors on mammographic density in postmenopausal women

Judith S Brand, Kamila Czene, Louise Eriksson, Thang Trinh, Nirmala Bhoo-Pathy, Per Hall, Fuat Celebioglu

Research output: Contribution to journalArticle (Academic Journal)peer-review

30 Citations (Scopus)


BACKGROUND: Mammographic density is a strong risk factor for breast cancer. Apart from hormone replacement therapy (HRT), little is known about lifestyle factors that influence breast density.

METHODS: We examined the effect of smoking, alcohol and physical activity on mammographic density in a population-based sample of postmenopausal women without breast cancer. Lifestyle factors were assessed by a questionnaire and percentage and area measures of mammographic density were measured using computer-assisted software. General linear models were used to assess the association between lifestyle factors and mammographic density and effect modification by body mass index (BMI) and HRT was studied.

RESULTS: Overall, alcohol intake was positively associated with percent mammographic density (P trend  = 0.07). This association was modified by HRT use (P interaction  = 0.06): increasing alcohol intake was associated with increasing percent density in current HRT users (P trend  = 0.01) but not in non-current users (P trend  = 0.82). A similar interaction between alcohol and HRT was found for the absolute dense area, with a positive association being present in current HRT users only (P interaction  = 0.04). No differences in mammographic density were observed across categories of smoking and physical activity, neither overall nor in stratified analyses by BMI and HRT use.

CONCLUSIONS: Increasing alcohol intake is associated with an increase in mammography density, whereas smoking and physical activity do not seem to influence density. The observed interaction between alcohol and HRT may pose an opportunity for HRT users to lower their mammographic density and breast cancer risk.

Original languageEnglish
Pages (from-to)e81876
JournalPLoS ONE
Issue number12
Publication statusPublished - 2013


  • Aged
  • Alcohol Drinking
  • Body Mass Index
  • Breast Density
  • Breast Neoplasms
  • Case-Control Studies
  • Female
  • Hormone Replacement Therapy
  • Humans
  • Image Processing, Computer-Assisted
  • Life Style
  • Linear Models
  • Mammary Glands, Human
  • Mammography
  • Middle Aged
  • Motor Activity
  • Postmenopause
  • Risk Factors
  • Smoking
  • Surveys and Questionnaires
  • Journal Article


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