Pre‐diagnostic alcohol consumption and breast cancer recurrence and mortality: Results from a prospective cohort with a wide range of variation in alcohol intake

Abstract

The association between pre-diagnostic alcohol consumption and breast cancer recurrence and breast cancer specific mortality was investigated in 1,052 women diagnosed with early breast cancer in a prospective cohort of 29,875 women. Known clinical, lifestyle and socioeconomic risk factors were evaluated and adjusted for in multivariate analysis. We found a modest but significant association between pre-diagnostic alcohol consumption and breast cancer recurrence with a median follow-up of six years after date of diagnosis, both when using baseline measures of alcohol intake (HR, 1.65; 95% CI, 1.02-2.67; >2 units/day vs. 1 unit/day) and cumulated alcohol intake (HR, 2.02; 95% CI, 1.06-3.85; >40 drinking years vs. 0<drinking years 10). Results for breast cancer specific mortality were also suggestive of a higher risk but were not statistically significant. In addition to being a risk factor for breast cancer, a high pre-diagnostic alcohol intake also seems to have an effect on the course of the disease. We could not relate the finding to a specific tumor presentation.

Alcohol Consumption and Breast Cancer Survival: A Metaanalysis of Cohort Studies

“…After reading full-texts, we excluded studies that were not cohort studies (n =61) and not about survival (n=61). Finally, 25 cohort studies (Hebert et al, 1989;Ewertz et al, 1991;Rohan et al, 1993;Fuchs et al, 1995;Zhang et al, 1995;Thun et al, 1997;Holmes et al, 1999;Saxe et al, 1999;Jain et al, 2000;McDonald et al, 2002;Borugian et al, 2004;Barnett et al, 2008;Dal Maso et al, 2008;Reding et al, 2008;Franceschi et al, 2009;Flatt et al, 2010;Hellmann et al, 2010;Kwan et al, 2010;Allemani et al, 2011;Beasley et al, 2011;Breslow et al, 2011;Harris et al, 2012;Vrieling et al, 2012;Holm et al, 2013;Kwan et al, 2013;Newcomb et al, 2013) (patients) were included ( Figure 1). …”

“…All studies focused on breast cancer mortality and only five studies (Hebert et al, 1989;Saxe et al, 1999;Kwan et al, 2010;Holm et al, 2013;Kwan et al, 2013) focused on breast cancer recurrence. Of 25 studies, 14 were from USA, three were from Denmark, two were from Germany, and the rest were from Italy, Australia, Canada, France, Sweden and UK, separately.…”

“…Both meta-analysis and pooled study showed that (Poli et al, 2012;Bagnardi et al, 2013) alcohol consumption increases risk of breast cancer. However, the information on whether alcohol consumption is related to breast cancer survival is mixed (Hebert et al, 1989;Ewertz et al, 1991;Rohan et al, 1993;Fuchs et al, 1995;Zhang et al, 1995;Thun et al, 1997;Holmes et al, 1999;Saxe et al, 1999;Jain et al, 2000;McDonald et al, 2002;Borugian et al, 2004;Barnett et al, 2008;Reding et al, 2008;Franceschi et al, 2009;Flatt et al, 2010;Hellmann et al, 2010;Kwan et al, 2010;Allemani et al, 2011;Beasley et al, 2011;Breslow et al, 2011;Harris et al, 2012;Vrieling et al, 2012;Holm et al, 2013; Newcomb et al, 2013). Some studies reported that alcohol consumption was associated with reduced breast cancer mortality (Barnett et al, 2008;Reding et al, 2008;Flatt et al, 2010), while other studies revealed that alcohol consumption was associated with increased breast cancer mortality (Hebert et al, 1989;Fuchs et al, 1995;Jain et al, 2000;McDonald et al, 2002;Allemani et al, 2011;Vrieling et al, 2012).…”

“…Some studies reported that alcohol consumption was associated with reduced breast cancer mortality (Barnett et al, 2008;Reding et al, 2008;Flatt et al, 2010), while other studies revealed that alcohol consumption was associated with increased breast cancer mortality (Hebert et al, 1989;Fuchs et al, 1995;Jain et al, 2000;McDonald et al, 2002;Allemani et al, 2011;Vrieling et al, 2012). Even though, most studies found no relationship between alcohol consumption and breast cancer mortality (Ewertz et al, 1991;Rohan et al, 1993;Zhang et al, 1995;Thun et al, 1997;Holmes et al, 1999;Saxe et al, 1999;Borugian et al, 2004;Franceschi et al, 2009;Hellmann et al, 2010;Kwan et al, 2010;Beasley et al, 2011;Breslow et al, 2011;Harris et al, 2012;Holm et al, 2013;Kwan et al, 2013;Newcomb et al, 2013). For the association of alcohol consumption with breast cancer recurrence, available evidence was also conflicted (Hebert et al, 1989;Saxe et al, 1999;Kwan et al, 2010;Holm et al, 2013;Kwan et al, 2013).…”

“…Even though, most studies found no relationship between alcohol consumption and breast cancer mortality (Ewertz et al, 1991;Rohan et al, 1993;Zhang et al, 1995;Thun et al, 1997;Holmes et al, 1999;Saxe et al, 1999;Borugian et al, 2004;Franceschi et al, 2009;Hellmann et al, 2010;Kwan et al, 2010;Beasley et al, 2011;Breslow et al, 2011;Harris et al, 2012;Holm et al, 2013;Kwan et al, 2013;Newcomb et al, 2013). For the association of alcohol consumption with breast cancer recurrence, available evidence was also conflicted (Hebert et al, 1989;Saxe et al, 1999;Kwan et al, 2010;Holm et al, 2013;Kwan et al, 2013). So a meta-analysis is necessary to investigate the relationship of alcohol intake and breast cancer survival (mortality and recurrence).…”