In Response: We read with interest the letter from Franceschi et al. presenting their findings on alcohol and mortality after breast cancer as a follow-up to our recent article. Our study sought to determine the effect of prediagnostic alcohol consumption, an established breast cancer etiologic risk factor, on the risk of mortality after breast cancer in women diagnosed before age 45 years. In our study, those who consumed alcohol, particularly wine, were at a lower risk of mortality after diagnosis compared with women who did not consume alcohol.

One major design difference between our study and that of Franceschi was the targeted age range. The study by Franceschi included women ages 23 to 74 years, whereas ours was restricted to women under age 45 years at breast cancer diagnosis. As we previously noted (1), differences in effects observed for some factors in relation to the development of premenopausal...

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