breast health


Moderate Alcohol Consumption and Breast Cancer PDF Print E-mail

JAMA. 2011 Nov 2;306(17):1884-90.
Moderate alcohol consumption during adult life, drinking patterns, and breast cancer risk.
Chen WY, Rosner B, Hankinson SE, Colditz GA, Willett WC.
Source
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA. This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Abstract
CONTEXT:
Multiple studies have linked alcohol consumption to breast cancer risk, but the risk of lower levels of consumption has not been well quantified. In addition, the role of drinking patterns (ie, frequency of drinking and "binge" drinking) and consumption at different times of adult life are not well understood.
OBJECTIVE:
To evaluate the association of breast cancer with alcohol consumption during adult life, including quantity, frequency, and age at consumption.
DESIGN, SETTING, AND PARTICIPANTS:
Prospective observational study of 105,986 women enrolled in the Nurses' Health Study followed up from 1980 until 2008 with an early adult alcohol assessment and 8 updated alcohol assessments.
MAIN OUTCOME MEASURES:
Relative risks of developing invasive breast cancer.
RESULTS:
During 2.4 million person-years of follow-up, 7690 cases of invasive breast cancer were diagnosed. Increasing alcohol consumption was associated with increased breast cancer risk that was statistically significant at levels as low as 5.0 to 9.9 g per day, equivalent to 3 to 6 drinks per week (relative risk, 1.15; 95% CI, 1.06-1.24; 333 cases/100,000 person-years). Binge drinking, but not frequency of drinking, was associated with breast cancer risk after controlling for cumulative alcohol intake. Alcohol intake both earlier and later in adult life was independently associated with risk.
CONCLUSIONS:
Low levels of alcohol consumption were associated with a small increase in breast cancer risk, with the most consistent measure being cumulative alcohol intake throughout adult life. Alcohol intake both earlier and later in adult life was independently associated with risk.

 
Smoking and alcohol consumption in relation to risk of triple-negative breast cancer in a cohort of postmenopausal women. PDF Print E-mail


Cancer Causes Control. 2011 Mar 1. [Epub ahead of print]
Smoking and alcohol consumption in relation to risk of triple-negative breast cancer in a cohort of postmenopausal women.
Kabat GC, Kim M, Phipps AI, Li CI, Messina CR, Wactawski-Wende J, Kuller L, Simon MS, Yasmeen S, Wassertheil-Smoller S, Rohan TE.
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA, This e-mail address is being protected from spambots. You need JavaScript enabled to view it .
Abstract
PURPOSE: Little is known about the risk factors for triple-negative breast cancer (TNBC), which has a worse prognosis compared to hormone receptor-positive breast cancer. We examined the association of smoking and alcohol intake with TNBC and estrogen receptor-positive (ER+) breast cancer.
METHODS: Among 148,030 women enrolled in the Women's Health Initiative, 300 TNBC cases and 2,479 ER+ cases were identified over a median of 8.0 years of follow-up. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI).
RESULTS: Cigarette smoking was not associated with TNBC, whereas drinkers had reduced risk compared to never drinkers. In contrast, both exposures showed slight positive associations with ER+ breast cancer: for women with ≥40 pack-years of smoking, the HR was 1.24, 95% CI 1.06-1.44; for women consuming ≥7 servings of alcohol per week, the HR was 1.26, 95% CI 1.06-1.50. Intakes of wine and hard liquor were also significantly positively associated with ER+ breast cancer.
CONCLUSIONS: These findings from a large cohort of postmenopausal women suggest that smoking and alcohol consumption are not associated with increased risk of TNBC, but may be modestly associated with increased risk of ER+ breast cancer.
PMID: 21360045 [PubMed - as supplied by publisher]

 
Alcohol consumption and survival in women with breast cancer PDF Print E-mail

Eur J Cancer Prev. 2010 Sep;19(5):366-73.
Modifiable risk factors and survival in women diagnosed with primary breast cancer: results from a prospective cohort study.
Hellmann SS, Thygesen LC, Tolstrup JS, Grønbaek M.
Centre for Alcohol Research, National Institute of Public Health, Copenhagen, Denmark.
Abstract
This study examines the impact of smoking, body mass index, alcohol consumption, hormone replacement therapy, and physical activity on all-cause mortality among 528 Danish women diagnosed with primary breast cancer. Participants were women enrolled in the Copenhagen City Heart Study. Prospective self-reported exposure information was collected from four points of follow-up in 1976-1978, 1981-1983, 1991-1994, and 2001-2003. Kaplan-Meier survival curves and multivariate Cox regression analyses were performed adjusting for age, disease stage, adjuvant treatment, menopausal status, parity, alcohol intake, smoking, physical activity, body mass index, and hormone replacement therapy. The study shows that smoking for total mortality [hazard ratio, 1.16; 95% confidence interval, 1.05-1.29] and obesity for both total mortality (1.61; 1.12-2.33) and breast cancer-specific mortality (1.82; 1.11-2.99) were significantly associated with decreased survival after breast cancer diagnosis. A moderate alcohol intake of 1-6 units/week (0.85; 0.64-1.12), 7-14 units/week (0.77; 0.56-1.08), and treatment with hormone replacement therapy (0.79; 0.59-1.05) were less than 1, but not statistically significantly associated with prolonged survival. A moderate physical activity of 2-4 h/week (1.07; 0.77-1.49) and a high physical activity of more than 4 h/week (1.00; 0.69-1.45) showed no association with survival after breast cancer diagnosis.
PMID: 20502344 [PubMed - in process]

 
Alcohol consumption and risk of DCIS of the breast PDF Print E-mail

Cancer Epidemiol Biomarkers Prev. 2010 Aug;19(8):2066-72. Epub 2010 Jul 20.
Alcohol consumption and risk of ductal carcinoma in situ of the breast in a cohort of postmenopausal women.
Kabat GC, Kim M, Shikany JM, Rodgers AK, Wactawski-Wende J, Lane D, Powell L, Stefanick ML, Freiberg MS, Kazlauskaite R, Chlebowski RT, Wassertheil-Smoller S, Rohan TE.
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA. This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Abstract
BACKGROUND: Observational studies have commonly linked higher alcohol consumption with a modest increase in invasive breast cancer risk, but cohort studies have not examined alcohol intake in relation to ductal carcinoma in situ (DCIS).
METHODS: The association between adulthood alcohol consumption assessed at baseline and subsequent DCIS risk was examined in a cohort of postmenopausal women participating in the Women's Health Initiative clinical trials, in which mammography was protocol-mandated. Alcohol intake was assessed by a semiquantitative food-frequency questionnaire. Reported DCIS cases were verified by central pathology report review. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals.
RESULTS: The cohort consisted of 63,822 women with information on alcohol intake, among whom 489 cases of DCIS were ascertained after a median follow-up of 8.0 years. For the primary analysis, invasive breast cancer was treated as a competing risk, and follow-up time was censored at the date of diagnosis of invasive breast cancer. After adjustment for covariates, the hazard ratio for DCIS among women who consumed 14 or more servings of alcohol per week, relative to nondrinkers, was 0.87 (95% confidence interval, 0.50-1.51). In addition, alcohol intake was not associated with risk of either high-grade or low-/moderate-grade DCIS.
CONCLUSIONS: In this large cohort study of postmenopausal women, alcohol consumption was not associated with risk of DCIS.
IMPACT: If other studies confirm our findings, this would suggest that alcohol may have an effect later in the carcinogenic process.
PMID: 20647412 [PubMed - in process]

 
Alcohol consumption and breast cancer amongst BRCA 1 and 2 mutation carriers PDF Print E-mail

Breast. 2010 Jun 11. [Epub ahead of print]
Alcohol consumption and the risk of breast cancer among BRCA1 and BRCA2 mutation carriers.
Dennis J, Ghadirian P, Little J, Lubinski J, Gronwald J, Kim-Sing C, Foulkes W, Moller P, Lynch HT, Neuhausen SL, Domchek S, Armel S, Isaacs C, Tung N, Sweet K, Ainsworth P, Sun P, Krewski D, Narod S; the Hereditary Breast Cancer Clinical Study Group.
Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada; McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada.
Abstract
Alcohol consumption increases the risk of breast cancer among women in the general population, but its effect on women who carry a BRCA gene mutation is unclear. We conducted a case-control study of 1925 matched pairs of predominantly premenopausal women who carry a BRCA1 or a BRCA2 mutation. Information on current alcohol consumption was obtained from a questionnaire administered during the course of genetic counselling or at the time of enrolment. A modest inverse association between breast cancer and reported current alcohol consumption was observed among women with a BRCA1 mutation (OR = 0.82, 95% CI 0.70-0.96), but not among women with a BRCA2 mutation (OR = 1.00; 95% CI 0.71-1.41). Compared to non-drinkers, exclusive consumption of wine was associated with a significant reduction in the risk of breast cancer among BRCA1 carriers (p-trend = 0.01). Alcohol consumption does not appear to increase breast cancer risk in women carrying a BRCA gene mutation.
PMID: 20541936 [PubMed - as supplied by publisher]

 
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