Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Current Breast Cancer Reports
Published in: Current Breast Cancer Reports 3/2013

01-09-2013 | Risk, Prevention, and Screening (DL Hershman, Section Editor)

Alcohol Intake and Breast Cancer Risk: Weighing the Overall Evidence

Authors: Jasmine A. McDonald, Abhishek Goyal, Mary Beth Terry

Published in: Current Breast Cancer Reports | Issue 3/2013

Login to get access

Abstract

Moderate alcohol consumption has been linked to an approximate 30 %–50 % increased risk in breast cancer. Case-control and cohort studies have consistently observed this modest increase. We highlight recent evidence from molecular epidemiologic studies and studies of intermediate markers like mammographic density that provide additional evidence that this association is real and not solely explained by factors/correlates of the exposure and outcome present in nonrandomized studies. We also review evidence from studies of higher risk women including BRCA1 and BRCA2 mutation carriers. Given the incidence of heart disease is higher than breast cancer and modest alcohol consumption is associated with reduced risk of heart disease, we examine the latest evidence to evaluate if alcohol reduction should be targeted to women at high risk for breast cancer. We also review the most recent evidence on the effect of alcohol use on tumor recurrence and survival for those diagnosed with breast cancer.
Literature
1.
Seitz HK, Pelucchi C, Bagnardi V, La Vecchia C. Epidemiology and pathophysiology of alcohol and breast cancer: Update 2012. Alcohol Alcoholism. 2012;47:204–12.
2.
Dumitrescu RG, Shields PG. The etiology of alcohol-induced breast cancer. Alcohol. 2005;35:213–25.PubMedCrossRef
3.
Oyesanmi O, Snyder D, Sullivan N, et al. Alcohol consumption and cancer risk: understanding possible causal mechanisms for breast and colorectal cancers. Evid Rep Technol Assess. 2010;197:1–151.
4.
Fernandez SV. Estrogen, alcohol consumption, and breast cancer. Alcohol Clin Exp Res. 2011;35:389–91.PubMedCrossRef
5.
Singletary KW, Gapstur SM. Alcohol and breast cancer: review of epidemiologic and experimental evidence and potential mechanisms. JAMA. 2001;286:2143–51.PubMedCrossRef
6.
Terry MB, Zhang FF, Kabat G, et al. Lifetime alcohol intake and breast cancer risk. Ann Epidemiol. 2006;16:230–40.PubMedCrossRef
7.
• Chen WY, Rosner B, Hankinson SE, et al. Moderate alcohol consumption during adult life, drinking patterns, and breast cancer risk. JAMA. 2011;306:1884–90. The prospective Nurses’ Health Study found levels as low as 3–6 drinks/wk were associated with increased breast cancer risk. Stratified analysis found that alcohol consumption at ages 18–40 years and after age 40 was independently associated with increased breast cancer risk. Alcohol consumption was also strongly associated with hormone receptor positive tumor status.PubMedCrossRef
8.
Smith-Warner SA, Spiegelman D, Yaun SS, et al. Alcohol and breast cancer in women: a pooled analysis of cohort studies. JAMA. 1998;279:535–40.PubMedCrossRef
9.
10.
Hamajima N, Hirose K, Tajima K, et al. Alcohol, tobacco and breast cancer—collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 women without the disease. Br J Cancer. 2002;87:1234–45.PubMedCrossRef
11.
Bosron WF, Li TK. Genetic polymorphism of human liver alcohol and aldehyde dehydrogenases, and their relationship to alcohol metabolism and alcoholism. Hepatology. 1986;6:502–10.PubMedCrossRef
12.
Seitz HK, Oneta CM. Gastrointestinal alcohol dehydrogenase. Nutr Rev. 1998;56(2 Pt 1):52–60.PubMed
13.
Wright RM, McManaman JL, Repine JE. Alcohol-induced breast cancer: a proposed mechanism. Free Radic Biol Med. 1999;26:348–54.PubMedCrossRef
14.
Crabb DW, Matsumoto M, Chang D, You M. Overview of the role of alcohol dehydrogenase and aldehyde dehydrogenase and their variants in the genesis of alcohol-related pathology. Proc Nutr Soc. 2004;63:49–63.PubMedCrossRef
15.
Druesne-Pecollo N, Tehard B, Mallet Y, et al. Alcohol and genetic polymorphisms: effect on risk of alcohol-related cancer. Lancet Oncol. 2009;10:173–80.PubMedCrossRef
16.
Fan S, Meng Q, Gao B, et al. Alcohol stimulates estrogen receptor signaling in human breast cancer cell lines. Cancer Res. 2000;60:5635–9.PubMed
17.
Seitz HK, Stickel F. Acetaldehyde as an underestimated risk factor for cancer development: role of genetics in ethanol metabolism. Genes Nutr. 2010;5:121–8.
18.
Hines LM, Hankinson SE, Smith-Warner SA, et al. A prospective study of the effect of alcohol consumption and ADH3 genotype on plasma steroid hormone levels and breast cancer risk. Cancer Epidemiol Biomark Prev. 2000;9:1099–105.
19.
Freudenheim JL, Ambrosone CB, Moysich KB, et al. Alcohol dehydrogenase 3 genotype modification of the association of alcohol consumption with breast cancer risk. Cancer Causes Control. 1999;10:369–77.
20.
Coutelle C, Hohn B, Benesova M, et al. Risk factors in alcohol associated breast cancer: alcohol dehydrogenase polymorphism and estrogens. Int J Oncol. 2004;25:1127–32.PubMed
21.
Terry MB, Gammon MD, Zhang FF, et al. ADH3 genotype, alcohol intake and breast cancer risk. Carcinogenesis. 2006;27:840–7.PubMedCrossRef
22.
Terry MB, Knight JA, Zablotska L, et al. Alcohol metabolism, alcohol intake, and breast cancer risk: a sister-set analysis using the Breast Cancer Family Registry. Breast Cancer Res Treat. 2007;106:281–8.PubMedCrossRef
23.
Visvanathan K, Crum RM, Strickland PT, et al. Alcohol dehydrogenase genetic polymorphisms, low-to-moderate alcohol consumption, and risk of breast cancer. Alcohol Clin Exp Res. 2007;31:467–76.
24.
McCarty CA, Reding DJ, Commins J, et al. Alcohol, genetics, and risk of breast cancer in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. Breast Cancer Res Treat. 2012;133:785–92.PubMedCrossRef
25.
Benzon Larsen S, Vogel U, Christensen J, et al. Interaction between ADH1C Arg(272)Gln and alcohol intake in relation to breast cancer risk suggests that ethanol is the causal factor in alcohol related breast cancer. Cancer Lett. 2010;295:191–7.PubMedCrossRef
26.
Sturmer T, Wang-Gohrke S, Arndt V, et al. Interaction between alcohol dehydrogenase II gene, alcohol consumption, and risk for breast cancer. Br J Cancer. 2002;87:519–23.PubMedCrossRef
27.
Lilla C, Koehler T, Kropp S, et al. Alcohol dehydrogenase 1B (ADH1B) genotype, alcohol consumption and breast cancer risk by age 50 years in a German case-control study. Br J Cancer. 2005;92:2039–41.PubMedCrossRef
28.
Kawase T, Matsuo K, Hiraki A, et al. Interaction of the effects of alcohol drinking and polymorphisms in alcohol-metabolizing enzymes on the risk of female breast cancer in Japan. J Epidemiol. 2009;19:244–50.PubMedCrossRef
29.
Brennan P, Lewis S, Hashibe M, et al. Pooled analysis of alcohol dehydrogenase genotypes and head and neck cancer: a huge review. Am J Epidemiol. 2004;159:1–16.PubMedCrossRef
30.
Martin LJ, Boyd NF. Mammographic density. Potential mechanisms of breast cancer risk associated with mammographic density: hypotheses based on epidemiological evidence. Breast Cancer Res. 2008;10:201.PubMedCrossRef
31.
Boyd NF, Martin LJ, Yaffe MJ, Minkin S. Mammographic density and breast cancer risk: current understanding and future prospects. Breast Cancer Res. 2011;13:223.PubMedCrossRef
32.
Herrinton LJ, Saftlas AF, Stanford JL, et al. Do alcohol intake and mammographic densities interact in regard to the risk of breast cancer? Cancer. 1993;71:3029–35.PubMedCrossRef
33.
Byrne C, Schairer C, Wolfe J, et al. Mammographic features and breast cancer risk: effects with time, age, and menopause status. J Natl Cancer Inst. 1995;87:1622–9.PubMedCrossRef
34.
Conroy SM, Koga K, Woolcott CG, et al. Higher alcohol intake may modify the association between mammographic density and breast cancer: an analysis of 3 case-control studies. Cancer Epidemiol. 2012;36:458–60.PubMedCrossRef
35.
Wolfe JN. Breast patterns as an index of risk for developing breast cancer. Am J Roentgenol. 1976;126:1130–7.CrossRef
36.
Wolfe JN. Risk for breast cancer development determined by mammographic parenchymal pattern. Cancer. 1976;37:2486–92.PubMedCrossRef
37.
American College of Radiology. Breast imaging reporting and data system Atlas (BI-RADS). 4th ed. Reston, VA: American College of Radiology; 2003.
38.
Boyd NF, Martin LJ, Yaffe M, Minkin S. Mammographic density. Breast Cancer Res. 2009;11 Suppl 3:S4.PubMedCrossRef
39.
Yaffe M. Mammographic density. Measurement of mammographic density. Breast Cancer Res. 2008;10:209.PubMedCrossRef
40.
Funkhouser E, Waterbor JW, Cole P, Rubin E. Mammographic patterns and breast cancer risk factors among women having elective screening. South Med J. 1993;86:177–80.
41.
Sala E, Warren R, Duffy S, et al. High risk mammographic parenchymal patterns and diet: a case-control study. Br J Cancer. 2000;83:121–6.PubMedCrossRef
42.
Brisson J, Verreault R, Morrison AS, et al. Diet, mammographic features of breast tissue, and breast cancer risk. Am J Epidemiol. 1989;130:14–24.PubMed
43.
Masala G, Ambrogetti D, Assedi M, et al. Dietary and lifestyle determinants of mammographic breast density. A longitudinal study in a Mediterranean population. Int J Cancer. 2006;118:1782–9.PubMedCrossRef
44.
Tseng M, Byrne C, Evers KA, Daly MB. Dietary intake and breast density in high-risk women: a cross-sectional study. Breast Cancer Res. 2007;9:R72.PubMedCrossRef
45.
Gapstur SM, Lopez P, Colangelo LA, et al. Associations of breast cancer risk factors with breast density in Hispanic women. Cancer Epidemiol Biomark Prev. 2003;12:1074–80.
46.
Qureshi SA, Couto E, Hofvind S, et al. Alcohol intake and mammographic density in postmenopausal Norwegian women. Breast Cancer Res Treat. 2012;131:993–1002.PubMedCrossRef
47.
• Yaghjyan L, Mahoney MC, Succop P, et al. Relationship between breast cancer risk factors and mammographic breast density in the Fernald Community Cohort. Br J Cancer. 2012;106:996–1003. The longitudinal Fernald Community Cohort study defined low density (BI-RADS I) and high density (BI-RADS IV) as sustained low or high densities throughout the cohort’s follow-up. They found that among both pre- and postmenopausal women, ever users of alcohol were at twice the risk of having high breast density (BIRADS density IV vs I: OR 2.0; 95% CI 1.4–2.8) compared with never users.PubMedCrossRef
48.
Jeon JH, Kang JH, Kim Y, et al. Reproductive and hormonal factors associated with fatty or dense breast patterns among Korean Women. Cancer Res Treat. 2011;43:42–8.PubMedCrossRef
49.
Boyd NF, Connelly P, Byng J, et al. Plasma lipids, lipoproteins, and mammographic densities. Cancer Epidemiol Biomark Prev. 1995;4:727–33.
50.
Vachon CM, Kuni CC, Anderson K, et al. Association of mammographically defined percent breast density with epidemiologic risk factors for breast cancer (United States). Cancer Causes Control. 2000;11:653–62.PubMedCrossRef
51.
Vachon CM, Kushi LH, Cerhan JR, et al. Association of diet and mammographic breast density in the Minnesota breast cancer family cohort. Cancer Epidemiol Biomark Prev. 2000;9:151–60.
52.
Flom JD, Ferris JS, Tehranifar P, Terry MB. Alcohol intake over the life course and mammographic density. Breast Cancer Res Treat. 2009;117:643–51.PubMedCrossRef
53.
Cabanes A, Pastor-Barriuso R, Garcia-Lopez M, et al. Alcohol, tobacco, and mammographic density: a population-based study. Breast Cancer Res Treat. 2011;129:135–47.PubMedCrossRef
54.
Maskarinec G, Takata Y, Pagano I, et al. Alcohol consumption and mammographic density in a multiethnic population. Int J Cancer. 2006;118:2579–83.PubMedCrossRef
55.
Vachon CM, Sellers TA, Janney CA, et al. Alcohol intake in adolescence and mammographic density. Int J Cancer. 2005;117:837–41.PubMedCrossRef
56.
Boyd NF, McGuire V, Fishell E, et al. Plasma lipids in premenopausal women with mammographic dysplasia. Br J Cancer. 1989;59:766–71.PubMedCrossRef
57.
Boyd NF, Melnichouk O, Martin LJ, et al. Mammographic density, response to hormones, and breast cancer risk. J Clin Oncol. 2011;29:2985–92.PubMedCrossRef
58.
Vanderweele TJ, Adami HO, Tamimi RM. Mammographic density as a mediator for breast cancer risk: analytic approaches. Breast Cancer Res. 2012;14:317.PubMed
59.
Horn-Ross PL, Canchola AJ, Bernstein L, et al. Alcohol consumption and breast cancer risk among postmenopausal women following the cessation of hormone therapy use: the California Teachers Study. Cancer Epidemiol Biomark Prev. 2012;21:2006–13.CrossRef
60.
61.
Ronksley PE, Brien SE, Turner BJ, et al. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ. 2011;342:d671.PubMedCrossRef
62.
63.
64.
The U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans. 7th ed. Washington, D.C: U.S. Government Printing Office; 2010.
65.
66.
67.
Chiung M Chen, Hsiao-ye Yi PD, Deborah A Dawson, et al. Alcohol use and alcohol use disorders in the United States, a 3-year follow-up: main findings from the 2004–2005 Wave 2 National Epidemiologic Survey On Alcohol And Related Conditions (NESARC). National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health. September 2010;8.
68.
Willett WC, Stampfer MJ, Colditz GA, et al. Moderate alcohol consumption and the risk of breast cancer. N Engl J Med. 1987;316:1174–80.PubMedCrossRef
69.
Schatzkin A, Jones DY, Hoover RN, et al. Alcohol consumption and breast cancer in the epidemiologic follow-up study of the first National Health and Nutrition Examination Survey. N Engl J Med. 1987;316:1169–73.PubMedCrossRef
70.
Vachon CM, Cerhan JR, Vierkant RA, Sellers TA. Investigation of an interaction of alcohol intake and family history on breast cancer risk in the Minnesota Breast Cancer Family Study. Cancer. 2001;92:240–8.PubMedCrossRef
71.
Dennis J, Krewski D, Cote FS, et al. Breast cancer risk in relation to alcohol consumption and BRCA gene mutations—a case-only study of gene-environment interaction. Breast J. 2011;17:477–84.PubMedCrossRef
72.
McGuire V, John EM, Felberg A, et al. No increased risk of breast cancer associated with alcohol consumption among carriers of BRCA1 and BRCA2 mutations ages <50 years. Cancer Epidemiol Biomark Prev. 2006;15:1565–7.CrossRef
73.
Nkondjock A, Robidoux A, Paredes Y, et al. Diet, lifestyle and BRCA-related breast cancer risk among French-Canadians. Breast Cancer Res Treat. 2006;98:285–94.PubMedCrossRef
74.
Moorman PG, Iversen ES, Marcom PK, et al. Evaluation of established breast cancer risk factors as modifiers of BRCA1 or BRCA2: a multi-center case-only analysis. Breast Cancer Res Treat. 2010;124:441–51.PubMedCrossRef
75.
• Dennis J, Ghadirian P, Little J, et al. Alcohol consumption and the risk of breast cancer among BRCA1 and BRCA2 mutation carriers. Breast. 2010;19:479–83. In a case-control study of 1925 matched pairs in primarily postmenopausal BRCA1 or BRCA2 mutation carriers, alcohol intake was not associated with BRCA-related breast cancer. They also found, compared with non-drinkers, an inverse association between exclusive wine consumers and breast cancer risk in BRCA1 mutation carriers (P trend   = 0.01).PubMedCrossRef
76.
Lecarpentier J, Nogues C, Mouret-Fourme E, et al. Variation in breast cancer risk with mutation position, smoking, alcohol, and chest X-ray history, in the French National BRCA1/2 carrier cohort (GENEPSO). Breast Cancer Res Treat. 2011;130:927–38.PubMedCrossRef
77.
Patterson RE, Cadmus LA, Emond JA, Pierce JP. Physical activity, diet, adiposity and female breast cancer prognosis: a review of the epidemiologic literature. Maturitas. 2010;66:5–15.PubMedCrossRef
78.
79.
Brooks PJ, Zakhari S. Moderate alcohol consumption and breast cancer in women: from epidemiology to mechanisms and interventions. Alcohol Clin Exp Res. 2013;37:23–30.PubMedCrossRef
80.
81.
82.
• Newcomb PA, Kampman E, Trentham-Dietz A, et al. Alcohol consumption before and after breast cancer diagnosis: associations with survival from breast cancer, cardiovascular disease, and other causes. J Clin Oncol. 2013. The Collaborative Breast Cancer Study found that moderate alcohol intake before breast cancer diagnosis was associated with improved breast cancer survival, but there was no association with alcohol intake after diagnosis. Furthermore, compared with nondrinkers, alcohol intake before or after breast cancer diagnosis was associated with increased cardiovascular disease survival.
83.
Holm M, Olsen A, Christensen J, et al. Pre-diagnostic alcohol consumption and breast cancer recurrence and mortality: Results from a prospective cohort with a wide range of variation in alcohol intake. Int J Cancer. 2013;132:686–94.
84.
• Kwan ML, Chen WY, Flatt SW, et al. Postdiagnosis alcohol consumption and breast cancer prognosis in the after breast cancer pooling project. Cancer Epidemiol Biomark Prev. 2013;22:32–41. This is one of the largest studies to date to assess the effects of post-diagnostic alcohol use and recurrence. Post-diagnosis alcohol consumption (average 2 years) was not associated with breast cancer recurrence or mortality; however, in women who were postmenopausal and ER + there was a marginal association between higher levels of alcohol use and breast cancer recurrence.
85.
Li Y, Baer D, Friedman GD, et al. Wine, liquor, beer and risk of breast cancer in a large population. Eur J Cancer. 2009;45:843–50.PubMedCrossRef
86.
Suzuki R, Orsini N, Mignone L, et al. Alcohol intake and risk of breast cancer defined by estrogen and progesterone receptor status—a meta-analysis of epidemiological studies. Int J Cancer. 2008;122:1832–41.PubMedCrossRef
87.
Lew JQ, Freedman ND, Leitzmann MF, et al. Alcohol and risk of breast cancer by histologic type and hormone receptor status in postmenopausal women: the NIH-AARP Diet and Health Study. Am J Epidemiol. 2009;170:308–17.PubMedCrossRef
Metadata
Title
Alcohol Intake and Breast Cancer Risk: Weighing the Overall Evidence
Authors
Jasmine A. McDonald
Abhishek Goyal
Mary Beth Terry
Publication date
01-09-2013
Publisher
Springer US
Published in
Current Breast Cancer Reports / Issue 3/2013
Print ISSN: 1943-4588
Electronic ISSN: 1943-4596
DOI
https://doi.org/10.1007/s12609-013-0114-z

Other articles of this Issue 3/2013

Current Breast Cancer Reports 3/2013 Go to the issue

Risk, Prevention, and Screening (DL Hershman, Section Editor)

Omega-3 Fatty Acids for Prevention of Breast Cancer: an Update and the State of the Science

Risk, Prevention, and Screening (DL Hershman, Section Editor)

Aspirin and Breast Cancer Prevention

Risk, Prevention, and Screening (DL Hershman, Section Editor)

Mammographic Density: Potential as a Risk Factor and Surrogate Marker in the Clinical Setting

Risk, Prevention, and Screening (DL Hershman, Section Editor)

Breast Surveillance of Patients with BRCA1 and BRCA2 Mutations

Risk, Prevention, and Screening (DL Hershman, Section Editor)

Weight Loss Intervention for Breast Cancer Survivors: A Systematic Review

Risk, Prevention, and Screening (DL Hershman, Section Editor)

Biomarker Endpoints for Early-Phase Cancer-Prevention Studies
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits