Alcohol and Breast Cancer in Women

Abstract

Objective.-To assess the risk of invasive breast cancer associated with total and beverage-specific alcohol consumption and to evaluate whether dietary and nondietary factors modify the association. Data Sources.-We included in these analyses 6 prospective studies that had at least 200 incident breast cancer cases, assessed long-term intake of food and nutrients, and used a validated diet assessment instrument. The studies were conducted in Canada, the Netherlands, Sweden, and the United States. Alcohol intake was estimated by food frequency questionnaires in each study. The studies included a total of 322 647 women evaluated for up to 11 years, including 4335 participants with a diagnosis of incident invasive breast cancer. Data Extraction.-Pooled analysis of primary data using analyses consistent with each study's original design and the random-effects model for the overall pooled analyses. Data Synthesis.-For alcohol intakes less than 60 g/d (reported by Ͼ99% of participants), risk increased linearly with increasing intake; the pooled multivariate relative risk for an increment of 10 g/d of alcohol (about 0.75-1 drink) was 1.09 (95% confidence interval [CI], 1.04-1.13; P for heterogeneity among studies, .71). The multivariate-adjusted relative risk for total alcohol intakes of 30 to less than 60 g/d (about 2-5 drinks) vs nondrinkers was 1.41 (95% CI, 1.18-1.69). Limited data suggested that alcohol intakes of at least 60 g/d were not associated with further increased risk. The specific type of alcoholic beverage did not strongly influence risk estimates. The association between alcohol intake and breast cancer was not modified by other factors. Conclusions.-Alcohol consumption is associated with a linear increase in breast cancer incidence in women over the range of consumption reported by most women. Among women who consume alcohol regularly, reducing alcohol consumption is a potential means to reduce breast cancer risk.

Breast cancer risk among women with psychiatric admission with affective or neurotic disorders: a nationwide cohort study in Denmark

“…Non-differential misclassification could, therefore, be the reason that alcohol abuse was not a significant risk factor in this cohort, in contrast to studies of females with alcohol abuse (Smith-Warner, 1998). Similarly, unspecified alcohol/drug abuse was not a risk factor in this cohort.…”

Medical risks for women who drink alcohol

“…Postmenopausal women who drink alcohol may have increased serum estrogen levels, further increasing the plausibility of gender differences in the medical risks of drinking. [53][54][55] Acute increases in estrogen levels, up to threefold higher than baseline, have been observed after alcohol ingestion among postmenopausal women taking estrogen replacement. 56 This acute effect was not observed in postmenopausal women not taking estrogen replacement.…”

“…56 However, some studies of non-estrogen-using postmenopausal women have observed increased estrogen levels in drinkers compared with abstainers, suggesting that chronic alcohol use may also be associated with increased estrogen levels. 53,55 For these reasons, increased estrogen levels associated with alcohol use may contribute to some of the observed relationship between alcohol and health in older women.…”

“…Specifically, women consuming more than about 2 drinks a day had a 31% to 41% increased risk of developing invasive breast cancer. 55 In another study, Longnecker evaluated data from 10 cohort and 28 case-control studies that met rigorous methodologic criteria. A random effects model revealed a dose-response relation, with RRs of developing breast cancer for those consuming 1, 2, and 3 drinks per day of 1.11 (95% CI 1.07, 1.16), 1.24 (95% CI 1.15, 1.34), and 1.38 (95% CI 1.23, 1.55), respectively.…”

Overexpression of ErbB2 enhances ethanol-stimulated intracellular signaling and invasion of human mammary epithelial and breast cancer cells in vitro

“…Most of the studies agree that there is a positive correlation between ethanol intake and the risk of breast cancer (see review by Hiatt, 1990;Plant, 1992;Rosenberg et al, 1993;Longnecker, 1994;Singletary and Gapstur, 2001). In general, studies show that risk is directly correlated with the duration of drinking, that is, the greater the total number of years drinking, the greater the risk (Bowlin et al, 1997;Swanson et al, 1997;Smith-Warner et al, 1998;Kuper et al, 2000). Furthermore, epidemiological data indicate that alcohol consumption is associated with advanced and invasive breast tumors (Weiss et al, 1996;Vaeth and Schlessinger, 1998).…”