Monday, October 01, 2007
Alcohol linked to breast cancer?
I've been with women at every stage of breast cancer - from the disbelief at the diagnosis... to sitting with a single mom in the office of a patient navigator amid a sea of insurance claims and bills... to struggling to connect the dots on being out of work, chemo and child care. And I have been with women in end-stage breast cancer who have that "look"- an almost otherworldly mix of resignation, wisdom and fear. All wonder - why me?

Provocative new science adds booze - with an exclamation point- to that list of "what could have gone wrong."

Kaiser Permanente researchers looked at data on more than 70,000 women, and found that if a woman drinks just one or two alcoholic drinks a day, she's increasing her risk of breast cancer by 1o percent. If that consumption increases to three or more drinks a day, the risk shoots up to 30 percent.

It's fair to say not a whole lot of women drink three or more drinks a day. But researchers say that 30 percent increase in the relative risk of breast cancer from heavy drinking might translate into approximately an extra 5 percent of all women developing breast cancer as a result of their drinking.

The American Cancer Society has been telling women for some time now alcohol increases your breast cancer risk. This study really zeroed in, on the drink type. Researchers found it doesn't matter what you're drinking - white wine, red wine, beer, bourbon or another hard liquor-- each can raise your breast cancer risk. That certainly throws a wrench into the idea that red wine can be good for you.

Research has shown red wine does have protective benefits for your heart - but if just a drink or two a day raises your breast cancer risk, should you drink it? Every woman needs to balance her own risk of heart disease and breast cancer, says the American Cancer Society, which recommends that women who choose to drink limit consumption to one drink a day. Of course, there are other lifestyle factors that can reduce your risk, including keeping your weight down and being physically active -- which can reduce your risk of both breast cancer and heart disease.

Women, will this relationship between alcohol and breast cancer influence what, or how much you drink? We'd love to hear from you.
Someone on your staff needs to understand research articles, or lack there of. The study you're talking about has only been published in an abstract so far and the abstract does not indicate if the specific finding of a 10% increase in risk from 1-2 drinks per day was statistically significant. What they reported was a dose-response relationship, meaning that >3 drinks per day increases your risk more than 1-2 drinks per day increases your risk. The full paper that will be published in the future will indicate if the 10% effect was statistically significant.

The researchers also lumped alcohol consumption into a "1-2 drinks per day" category, instead of looking at 1 drink/day and 2 drinks/day separately. One drink per day for women is not normally considered at-risk drinking, although 2 drinks per day would be. One drink per day is actually recommended based on literature on heart disease. Lumping the 1 and 2 drinks/day consumption amounts together into a single category makes it difficult to really understand how much is too much. We're talking about a difference of 7 drinks per week between those two levels. It is possible that the effects of 2 drinks/day drove the results. I don’t know why the researchers put those two amounts into a single analysis variable, unless that’s just how the data was originally collected in the 1970 and 80s before anyone knew a study like this would be conducted. They also do not report for how many years the women consumed these amounts, since it appears the women were only interviewed once. Again, hopefully the future paper on this study will sort this out.
I hate to say that I consume at least 3 alcoholic beverages a day. I think it's time to reconsider.
Doesn't heart disease kill more women than breast cancer each year? Should this not be considered?
I'm a young women in my 40's and was recently diagnosed with DCIS (breast cancer localized within the milk ducts). Luckily, I caught it very early but had to go through surgery and radiation. Dr.'s were quick to act due to my family history: my mother died of breast cancer when she was 60 after a 10 year fight.

"Why me" certainly came up not only for me, but my two sisters as well, since I am the "healthy Californian who eats really well and is a surfer and triathlete". However, I recently went through the stress of a divorce, new job, moving, purchasing a new home, and remodeling. Some Dr,'s believed that these stresses and the luck of the draw with my genetics, may have been the driving force behind my cancer.

I do enjoy a glass of wine every other night and am well aware of the corrolation between alcohol consumption and breast cancer based on numerous studies/publications I've read. I have scaled back due to these studies but personally believe everything in moderation is O.K.

I have no family history pointing to heart conditions, but if I did, I'd be really torn to go back to my glass of red wine every night. My point, and the article states this, is I think people have to take a lot of things into consideration while making their choices....but don't get stressed out over it, as who knows, that could cause you to get what you are trying to prevent!!!
I was diagnosed with breast cancer at 36 and am in year three clean.. Had a mastectomy and full throttle chemo. I drink a glass or two of wine a few times a week and some times more. The numbers are part of the risks we take in "living" and if we choose to live then we do what we like or we choose to be careful, and get hit by a bus. Regardless, there is no "why me" in my story, there are some lovely glasses of wine, long walks with my love and an appreciation of each day I have to enjoy what makes me happy. There will always be new warnings and discoveries, thank goodness, and to those who change their lifestyles to prevent cancer or heart disease or whatever ailments, I hope they are successful in remaining healthy. To the rest of us, I will raise my glass to the life I actively live!
Hi Amy,

Kind greetings from the seaside. It’s so good of you to address this concern. My hairdresser told me that he finds that every time he turns around someone else is being diagnosed with breast cancer. I have 3 friends who have been diagnosed with it and treated for it.

And as part of my volunteer work, I am in contact with those living in the Indian reserves. (First Nations people) They have to be the dearest people – I feel totally at ease with them as they are exceptionally gentle and kind people. It’s true there has always been a problem with addiction, alcohol and drugs. They are the first to admit it. Yet, there is a root cause to their pain. What terrible injustice they have suffered! Hopelessness, despair – leads to self-destructive behavior.

One dear First Nations girl is 40 years old. She was diagnosed with breast cancer 2 years ago. All her life she was in foster care and had a very difficult life. It’s not her fault and it’s heartbreaking. Yes, she has had a drinking problem all her life. I have never judged her for this but I did mention to her over 2 years ago that I felt that she should try to cut back on her daily drinking in case it affected her immune system. She said she read that alcohol was actually good for a person’s immune system. I was stumped.

Now this past week this “new” information has come out and I wonder. It’s so hard to know what to think. I believe it must be true. But I have so many questions. I know it says it applies to ALL wine and beer. Is wine made from home-made kits less healthy compared to a beautiful wine from a vineyard in France or Italy that has been naturally distilled? Is wine any better than beer? It does say all alcohol so that must be the answer.

I am so very, very sorry for anyone dealing with breast cancer and their family. I have supported my dear friends. I know how their husbands have cried and hid it from them. I have seen the pain and suffering – all the tears and fears that go with it, the biopsy pain, the radiation and agony of chemo. And I know of the trauma of the surgery. There are no words. I’m so sorry. My heart goes out to those dealing with it. The comfort is that I have seen the good and wonderful results of sticking with the treatment plan. I know it’s not easy but it’s sure worth it. We feel incredibly inspired to see someone working so hard to get better. I wish those dealing with many blessings and think of the time when God will “wipe out every tear from their eyes.” Please take care and Hang in there.

Yours truly, A.G.

P.S. I myself am not a drinker. My family all love a beautiful glass of wine. And I used to have the odd glass of wine now and then. But now I must take daily painkillers and stronger ones on the more difficult days – so alcohol is out of the question for me.

Awhile ago we attended a romantic family wedding in a beautiful 19th century seaman’s Inn by the ocean in Nova Scotia. A glass of wine was served with the formal dinner. However I totally FORGOT I had taken extra painkillers on the way to the wedding. In the midst of this elegant black tie wedding event, I nearly fell head first down the narrow ancient staircase – that was the moment I realized my horrible mistake - which put my brother into stitches of laughter. Not cool, not cool. Then I sang all the way home – a 2 hour drive. The problem is this, I am not a good singer. So, no, no, no I don’t drink.
Didn't another study find that the correlation with alcohol consumption was mitigated or eliminated among women consistently consuming the US RDA of folic acid?
The alcohol link is fascinating to me. My mother was diagnosed with and died from an aggressive form of breast cancer when she was in her 60's -- we had no family history of breast cancer and I have often wondered about the cause. My mother was a lifelong smoker (since her teens) and also had two to three martinis a day for many years (which probably translates to more than 2-3 drinks since martinis are straight alcohol and generally, twice the amount of a standard mixed drink). It does make me think twice about whether I will consumer alcohol and how much is really safe.
Women need to know about the protective effect of dietary folate in reducing the risk of breast cancer.

An exhaustive review of the research evidence has found that women who drink alcohol and have a high folate intake are not at increased risk of breast cancer compared to those who abstain from alcohol.

For example, a study of over 17,000 Australian women aged 40-69 for a period of about ten years found that women who consumed 40 grams of alcohol (about three drinks) per day have a higher risk of breast cancer than did women who abstaind from alcohol. However, in women who took 200 micrograms of folate or folic acid (Vitamin B9) every day, the risk of breast cancer droped below that of alcohol abstainers.

For more information, see Baglietto, L., et al. Does dietary folate intake modify effect of alcohol consumption on breast cancer risk? Prospective cohort study. British Medical Journal, August 8, 2005.
As a Ph.D. scientist and Napa Valley winemaker devoted to the cause of ending breast cancer, this issue hits very close to home. We have thoroughly researched the scientific literature and found the following results:

1) There is consistent scientific evidence that alcohol intake increases the risk of breast cancer.

2) There is consistent scientific information from around the world indicating that adequate levels of folate (folic acid) may reduce the excess risk of breast cancer associated with alcohol consumption.

We are hopeful that future articles will enlighten people about folate’s ability to reduce the increased risk of breast cancer associated with alcohol consumption.

See our site
Click here to visit our site for more information

Dr. Jeff Murrell
This topic is a timely one for me, 'cause my sister just had surgery done for breast cancer yesterday. My sister rarely drinks alchol, and I think her cancer came from our family history. I don't doubt the research and I know those kinds of research article are reliable, though, I have a policy not to accept what they showed us without questioning. There are too much information about cancer around us.
Thank you for the comment above about the problem with the statistics in this story. And yes, heart disease is the number one killer of women in this country by far.
The current stats: 0.2 percent of adult women get breast cancer (based on United States census data) and 34% develop heart disease (from the American Heart Association). If one glass of wine decreases the risk of developing heart disease, that's something to consider.
I can certainly relate to the "why me?" question. I was diagnosed with breast cancer just a year ago, and still sometimes get that stunned feeling.
For years I'd been reading/hearing that having your first period not too early, your first baby not too early or not too late in life, as well as breast-feeding all decrease the risk. More recently it's about avoiding red meats, eating plenty of fruits & veggies, regular exercise, keeping a healthy weight and now this latest concerning alcohol.
I'd kept to all of the above (plus no family history), and still...
Now, to this latest bit of research I can add that when it comes to drinking, I can go for months without one drop, indulging only on special occasions, and even then only the one or two glasses of moderation. (Oh, and even after my chemo, my heart was declared one hundred percent healthy!)
Despite everything, I still can't help but be pleased whenever I read newer and newer research/study results, because I know that people are constantly working at finding causes and cures, however elusive they may be, and maybe someday soon, they might turn out to be just around the corner.
This is really a hard one, and family samples may not be enough.

But you notice them: my mother and my mother in law never drank a drop of alcohol,: my mother died twenty years ago at 55 of breast cancer, my mother in law has been under treatment since she was 72 (3 years ago). My two grand mothers were reasonnable drinkers, especially red wine (1 or 2 glasses per day), and they died very old (89 and 97) without developing any cancer. So I would be more enclined to blame the environment, the non breast-feeding (out of fashion in the 50s), too much fat in the diet....
I am a 7 year survivor, youngest of three sisters with NO family history. Two surgeries, to-hell-and-back chemo and radiaion. So I do pay attention when new data becomes available. But it is all too clear that in the realm of medical recommendations, the only thing that is constant is change. We are bombarded and confused by "new research" in direct conflict with not-so-old research. When I had my boys 20 years ago, breastfeeding moms were encouraged to have a glass of wine for milk let-down. For generations, babies were put to sleep on their tummies. The food pyramid of 10 years ago - all of these "must dos" are now "do nots!". To get too caught up in it can be, I feel, almost dangerous. Pay attention, but be realistic. Life is what you make it and it's shorter than we'd like. I'm determined to live and enjoy life with my husband, sons, friends and family. That's what will make me smile everyday.
My daughter comes from a family of cancer and she drinks a glass or 2 of red wine a day, is she more at risk then normal???concerned mom
I'll drink 2 - 5 alcoholic drinks every other week. I'll have the alcoholic drinks one day every other week. I don't drink 1 - 2 drinks a day. I think that much drinking would be a bit much and I see how that could pose a problem with your health. I have no family history of breast cancer. I do not think drinking heavily in moderation should pose that great of a risk of developing breast cancer.
The press release is here.

I read it very carefully, and found no indication what other known factors - even SMOKING - were taken into account in any way, let alone eliminated. I could not believe it, but it really looks like they were not. The authors reminded us, however, what smoking produces similar 30% increase.
If alcohol consumption is linked to higher risk of breast cancer does that mean that French and Italian women have more cases of breast cancer than non alcohol consuming societies? It is normal to have a glass or two of wine with dinner in these countries and I haven't heard any report that French and Italian women have higher numbers of breast cancer patients than any other western women.
In addition to all the great caveats about the most recenty study mentioned by others, I'd like to point-out that the women in this study were asked if they had a preference for a certain type of alcohol and that preference is how they were analyzed (wine vs. beer vs. hard liquor). These weren't women ONLY drinking one kind of alcohol for their entire lives; they just had a preference. Based on the news releases and abstract for the study, it doesn't appear that there was any information on how a "Preference" for a certian type of alcohol translated into how often they drank that certain type of alcohol. I personally prefer wine, but I often drink beer when I'm out with friends. I used to drink hard liquor in college and the few years afterwards, although I've cut that out almost entirely. If someone were to ask me today how much alcohol I drink and what I prefer, I would say "I prefer wine and have on-average 1 drink per day". That would not give anywhere near enough information to understand my current or historial drinking patterns.

Something to keep in mind.
Although I find the report interesting I often wonder who they speak to in the surveys. Whether it be smoking, drinking, etc.
As the daughter of an alcoholic, my mom is in her mid seventies and drinks a 26er a day and she is fine, although she is in year 5 after colon cancer (poor diet).
Last summer I had 3 friends diagnosed with breast cancer and all 3 rarely drink and live a healthy lifestyle.
And I have doubts on some research, no different than people who smoke all their lives and never develop any kind of lung issues, and those who never smoke and end up with cancer.
I am NOW a non smoker and try and eat right and excersise, and look at life as a roll of the dice.
Keep in mind that this study reports on correlations between variables, and correlations do not imply causation. Many epidemiological findings like this one have not stood up when randomized experimental studies have been conducted - remember when HRT was thought to be a heart attack preventive? Until an experimental study is done - or convincing biological correlates show that, e.g., increased alcohol consumption is linked with higher estrogen levels - this study should not guide public health. Based on current evidence, it is a fallacy for a woman to believe that she can protect herself from breast cancer by becoming a teetotaler.
There is a significant prevalence of heart disease my family, mother and grandmother both. There is also an absence of cancer. As I truly feel that heart disease is imminent based on elevated lipoprotein levels at the age of 34, I would definitely prefer to have a glass of red wine a few times a week and take the risk.
I'd like to thank you Amy for posting this blog, i am hoping it will help my mom realize what kinds of risks she may encounter on the road ahead. I think arguing about this subject only shows stubbornness to change living habits today. I agree that alcohol may lead to breast cancer. although not yet proven, giving this warning can help readers embrace themselves for the truth. I bet if any woman with breast cancer was asked they if could change any living habits before they were diagnosed, they would.
What does 10 % in risk mean? Does it mean that if the risk of an average woman is 10%, if she drinks 1-2 drinks a day her risk goes up to 20% and if she drinks 3 or more drinks her risk goes up to 40%? Or does it mean that the 10% original risk goes up to 11% (1-2 drinks) or 13% (3+ drinks)?

That was unclear... as also was the consideration of whether or not these women were smoking or exercising.
Your article should point out that this study was an observational study, and as such, cannot draw conclusions as to cause and effect. All it can tell us is that women who consumed alcohol regularly were 10%-30% more likely to develop breast cancer than those who did not in this study sample. It cannot, and should not be interpreted to, establish a cause-and-effect relationship between consuming alcohol regularly and increasing risk of breast cancer. There could be dozens of confounding variables that would skew the relationship, possibly making the alcohol-cancer risk association meaningless.
I'm the person who responded first on this thread questioning whether the finding that "if a woman drinks just one or two alcoholic drinks a day, she's increasing her risk of breast cancer by 10%" was statistically significant. I wanted to pop on again and say that I found an interview with the lead researcher on this study, who said that result was in-fact not statistically significant. I figured that was the case.
The pure "joy" of being drunk is surely going to cause many people to try and justify their drinking problems no matter how many studies come out against it.
I read that alcohol may increase the risk of breast cancer, including red wine - but if this is so, all or nearly all European women must have it as Italy, France, and Spain drink wine every day with meals- are we missing something in these studies or does this only apply to American women?
For about 10+ years, I drank one or two beers or glasses of wine each day. Then my mother came down with breast cancer, and the day that I learned that even one drink a week could increase my chances of getting breast cancer, I stopped drinking daily. For the past 14 years I may have 1 - 2 glasses of wine every couple of weeks when I am out to dinner with friends. So, yes, the risk of breast cancer essentially stopped me cold.
Info from Wikipedia below. Note that the risk of a woman in her 50s getting breast cancer is actually quite low. The average woman should pay more attention to heart disease. Keep in mind that the American medical institution is for profit, more is better and fears malpractice. Eat close to the source, eat organic whenever possible, eat more veggies, exercise 5-6 days a week, meditate and enjoy alcohol in moderation. Live people. Your genetics are out of your control.

A study showed that one or two alcoholic drinks a day increases the risk of breast cancer by 10 per cent compared with light drinkers who drank less than one drink a day. Women who have three or more drinks a day increase their risk of breast cancer by 30 per cent. The type of drink was not a factor.[26] "A typical 50-year-old woman has a five-year breast cancer risk of about 3 percent. If her risk jumps by 30 percent, her individual risk is still only about 4 percent" reports the New York Times. [27] It also has noted that "deaths from heart disease greatly exceed those caused by breast cancer. Each year more than 500,000 American women die of heart disease, compared with 43,500 who die from breast cancer" and that according to the American Cancer Society, "having one drink a day raises a woman's risk of dying of breast cancer by 11 percent but diminishes overall mortality by 20 percent because of alcohol's protective effects on the heart." [28]

"Folate intake counteracts breast cancer risk associated with alcohol consumption"[29] and "women who drink alcohol and have a high folate intake are not at increased risk of breast cancer".[30] Those who have a high (200 micrograms or more per day) level of folate (folic acid or Vitamin B9) in their diet are not at increased risk of breast cancer compared to those who abstain from alcohol.[31] A study of over 17,000 Australian women aged 40-69 over a period of about ten years found that those who consumed 40 grams of alcohol (about three to four drinks) per day have a higher risk of breast cancer than do women who abstain from alcohol. However, in women who take 200 micrograms of folate or folic acid (Vitamin B9) every day, the risk of breast cancer drops below that of alcohol abstainers
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