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Several mechanisms have been proposed for how alcohol affects breast cancer risk (1). These mechanisms may include both early and late stage influences and may involve DNA damage, enhanced gland susceptibility, and elevated levels of steroid hormones (1, 10).The objective of this analysis was to evaluate the effects of patterns of alcohol use (including age at drinking and ‘‘sporadic’’ versus ‘‘daily’’ drinking) on invasive breast cancer risk in the California Teachers Study (CTS) cohort, that is, a group of women among whom alcohol consumption of 20 or more grams per day is associated with elevated breast cancer risk (4). We also examined effect modification by a variety of health and lifestyle factors.
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