Alcohol

I enjoy a glass - or two - of wine with dinner most evenings.  No guilt here.

The research on alcohol consumption and breast cancer risk is really a mixed bag.  I'd say that there is enough evidence to suggest that there is some connection, but the connection is weak and it most certainly doesn't affect everyone. It's easy to come up with a long list of women who never consumed alcohol who were diagnosed with breast cancer, and an even longer list of women who consumed a lot of alcohol but who were never diagnosed with breast cancer.

Alcohol is considered to be a "low risk" factor for breast cancer (Breast Cancer Risk Factors Table), and it's important to keep in mind that moderate alcohol consumption actually reduces mortality from other conditions such as heart disease. Therefore the net affect of moderate alcohol consumption (considering breast cancer and other diseases) is either neutral or possibly even positive (i.e. a slight reduction in over-all mortality). 

Some of the research:

- From May of this year, out of the UK:  Breast cancer rates in under-50s at record high

"Alcohol is an established risk factor for breast cancer. Cancer Research UK reports that the combined results of two large systematic reviews of the published evidence, in addition to findings from the UK Million Women Study, suggest that each additional unit of alcohol per day can increase a woman’s risk of the disease by between 7% and 12%. The research suggests that by the age of 80, roughly the following number of women will have developed breast cancer:

• 9 out of 100 if they don’t drink at all
• 10 out of 100 if they have two drinks a day
• 13 out of 100 if they have six drinks a day

However, as Cancer Research UK does say, the possible risk increase from alcohol is less compared to the greater influence of other factors – particularly hormonal factors."

This is saying that if I have 2 drinks a day, over the course of my entire life to the age of 80, I will increase my breast cancer risk from 9% to 10%.  That's an 11% relative increase in risk, but in absolute terms it's only a 1 percentage point increase. I appreciate that the medical community is concerned about alcohol consumption because for the population as a whole, 1% of women is a lot of women.  So this can represent many more cases of breast cancer.  But for an individual, a 10% risk up to age 80 vs. a 9% risk up to age 80 isn't much of an increase - it's not something I'm going to worry about.  I do think however that women who have 6 drinks a day probably should consider cutting back. 

- From November 2012, also from the UK:  Glass of wine a day 'fights breast cancer'

"They looked at 13,525 women who had been diagnosed and treated for breast cancer, who they followed for up to 15 years. Those who drank seven units a week cut the chance of dying from breast cancer in a decade from 20 to 18 per cent, and those who drank 14 units weekly reduced the chance to 16 per cent." 

WOOHOO to having a drink a day!!

- From January 2012:  Alcohol intake and mortality among women with invasive breast cancer.

"Women who consumed 10 g per day (corresponding to approximately 0.75 to 1 drinks) or more of alcohol had an adjusted HR (95% CI) of breast cancer-specific death of 1.36 (0.82-2.26;p(trend)=0.47) compared with non-drinkers. A significant inverse association was observed between alcohol and non-breast cancer deaths. Those who consumed 3.4-9.9 g per day of alcohol had a 33% lower risk of death compared with non-drinkers (95% CI 0.50-0.90;p(trend)=0.04). CONCLUSION: Our findings suggest that alcohol intake up to approximately one small drink per day does not negatively impact breast cancer-specific survival and a half drink per day is associated with a decreased risk of mortality from other causes."

- From July 2009:  Alcohol consumption and risk of cardiovascular disease and death in women: potential mediating mechanisms.

This study says that moderate alcohol consumption reduces the risk of dying of heart disease by 21.8%. 

- This study is older (1995) but they found even more positive numbers when it comes to heart disease:  Alcohol Consumption and Mortality among Women

"among women 50 or older, light-to-moderate drinkers (1.5 to 29.9 g per day) had a significant reduction in mortality from all causes, which appeared to be the result of a substantially lower risk of fatal cardiovascular disease. Among light-to-moderate drinkers, the relative risk of death from a cardiovascular cause was 0.59 (95 percent confidence interval, 0.47 to 0.73) for women 50 years of age or older. "  

A 41% reduction in mortality from heart disease?? And according to the table in the article, an overall reduction in mortality (from all causes) of 12%?  Hand me the glass!

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Seriously, I'm not suggesting that anyone who doesn't drink should take up drinking. But I am suggesting that if you enjoy a drink and if you maintain moderate consumption, the breast cancer risk is low and may in fact be outweighed (from an overall health and survival standpoint) by the benefits related to heart disease. 

For myself, I also consider that stress is probably not helpful when it comes to the development of cancer.  I doubt that stress causes cancer but I suspect that if you have some cancer cells in your body, stress might be a trigger to move those cells out of dormancy. I know that if I worry about my wine consumption, I get stressed.  But if I allow myself to enjoy my evening glass of wine without concern, I relax.  So I figure that in this way, my evening glass of wine really is good for my health!

I rarely drink...I go in "spurts"....weeks of a drink like a margarita every Friday then a month or two of no drinking at all.

Great post, Beesie!



Janet, I have a similar diet to you, I think.



It is said that alcohol has a greater association with lobular breast cancer, which is the type I had. But that does not prove that alcohol caused my cancer.



My doctor told me that being as thin as possible is the best way of reducing risk. This may be because fat is associated with raised estrogen level, which is a risk factor for the most common types of bc.



It could be that drinkers may carry more weight because of the calories in alcohol or because it increases appetite, resulting in increased estrogen and hence risk. Hence exercise is important to counter the calories. That is my theory anyway.

I never drink and as soon as I was told DON'T - I wanted to.  :-)

So it will be one drink a week for me.

It is hard to have to give up so many things we enjoy but just as we expect our doctors to do their best for us - I think we need to do our best for ourselves too.

I hate exercise too but I am doing it.

The trick is to find other healthy treats to replace those we know are bad for us.

Alcohol raises estrogen levels.  So if your cancer was ER+ and you are a drinker than it stands to reason that the alcohol was also contributing to the level estrogen in your body which gave the tumor fuel to grow.  It makes me wonder if it contributed to mine.  I did drink before diagnosis 1-2 beers a night and I know my weight was not a factor in it at all (I'm 5'7" and 120 lbs.).  I would say my risk factors was the alcohol and dense breast.  Per pre-op orders I had to stop alcohol two weeks before surgery.  I have not had anything yet since surgery (5 weeks since surgery). 

Now I've begun taking Tamoxifen and have been leery of drinking anything.  Has anyone else taken Tamoxifen and still had the occasional drink?

Grasping at straws, I wish we really knew how to avoid BC but we don't. However, eating right, exercising and moderation is good for your overall health. Don't forget reducing your stress level also good for you.

I was never told to stop drinking alcohol before any of my many surgeries . In fact, the night before my BMX we went out to a Mexican place for margaritas. After having a hip replacement  my husband removed the staples at home in bed while I sipped on a glass of wine.! Moderation at all times.

Most of this "drink alcohol and you're toast" comes from a study presented at the December 2009 San Antonio Breast Cancer Symposium. In this study, the authors looked at women post treatment and did see a significant difference in mortality among alcohol drinkers. However, since overall mortality was the same between the two groups, guess what??? I am indifferent as to where my risk lies, but of course anyone treating breast cancer wants as high a success rate as possible. There was no difference in risk in triple negative patients. It was quite the sensation at that time.

Since then, the two studies Beesie cites have been published, essentially refuting these findings. When I looked at the data back then, I realized that they didn't look at ER+ women who are treated with either Tamoxifen or an AI. This is because there weren't enough in the population for a meaningful sample, but it does mean that the comparison isn't the same. Here is the WebMD synopsis of the study. http://www.webmd.com/breast-cancer/news/20091210/alcohol-raises-risk-of-breast-cancer-recurrence

I continue to enjoy my wine.

The reason I mention this study is that a lot of recommendations appear to be based on these findings, and not on the more recent work which Beesie referenced, one out of the Seattle Cancer Care Alliance and the other out of the University of Cambridge.

One other thing I will mention is that most of my wine-drinking friends also exercise. We hike, cycle, and ski so are active. I think this makes an even greater difference. This is certainly true of the new guy in my life and also of the wine bar manager. She runs marathons, but I got her cycling. She got me running.

It's really about moderation. Eating a healthy base, and doing reasonably healthy things MOST of the time. But it's also OK to indulge in a champagne truffle or 2, or have an extra glass of champagne.

Because I didn't go down this journey to be less than whole at the end. And I don't think that wheat germ quite cuts it for "celebrate every day"!!! - Claire

organic wine and small beers get my vote!