Alcohol and Hormone-Negative

How many drinks a week are healthy? According to a new study published in JAMA, the Journal of the American Medical Association, as few as three a week can raise your risk of breast cancer by 15 percent. BUT, according to a story on The New York Times’ blogs, if you have no other risk factors, that can mean going from a risk of 3 percent to 3.45 percent, not a significant threat. Alcohol is just one piece of a complex puzzle in which family history, genetics, diet, exercise, and environment all play a role.

The effects of alcohol on breast cancer have been studied for decades, with varied results. Several studies have linked alcohol and the risk of breast cancer, most notably associating a family history of breast cancer, alcohol consumption, and hormone-negative disease. Notice, though, that this includes a family history, which in itself increases the risk of breast cancer.

Others have found less of a risk, or have found the risk limited to hormone-positive breast cancer.

A 2008 study categories the risk, which again is limited to hormone-positive, showing that one drink a day of alcohol of any type—beer, wine, spirits—increased breast cancer risk by ten percent. The risk rose by the drink—three daily drinks equaled a 30 percent risk. This is a relative risk—it is compared to the risk faced by a woman who drinks no alcohol or less than one drink a day.

Rather than trying to decipher the studies, a healthy approach is to limit alcohol to an average of less than one drink a day, even if the research is not definitive in terms of hormone status.

ALCOHOL AND HORMONE REPLACEMENT THERAPY: It may not just be alcohol that increases the risk of breast cancer—it could be hormone replacement therapy (HRT) plus alcohol. According to Danish research published in the International Journal of Cancer (2008), postmenopausal women taking oral estrogen who had one or two alcoholic drinks a day increased their breast cancer risk by three times that of women who neither drank nor took HRT. Those who took HRT and had more than two drinks a day increased their risk to five times that of those who ingested neither HRT nor alcohol. The research did not narrow its findings by receptor status, but HRT is more strongly associated with hormone-positive than with hormone-negative disease.

SOURCES

Althuis, Michelle D., Fergenbaum, Jennifer H., Garcia-Closas, Montserrat, Brinton, Louise A., Madigan, M. Patricia, and Sherman, Mark E., “Etiology of Hormone Receptor-Defined Breast Cancer: A Systematic Review of the Literature,” Cancer Epidemiology, Biomarkers & Prevention, vol. 13, no. 10, 1558-1568 (2004). Find a full copy at

Lew, Jasmine Q., Freedman, Neal D., Leitzmann, Michael F., Brinton, Louise A., Hoover, Robert N., Hollenbeck, Albert R., Schatzkin, Arthur, and Park, Yikyung, “Alcohol and Risk of Breast Cancer by Histologic Type and Hormone Receptor Status in Postmenopausal Women: The NIH-AARP Diet and Health Study.” American Journal of Epidemiology, vol. 170, no. 3, 308-317 (2009). http://www.ncbi.nlm.nih.gov/pubmed/19541857

Kabat, Geoffrey C., Kim, Mimi, Phipps, Amanda I., Li, Christopher I., Messina, Catherine R., Wactawski-Wende, Jean, Kuller, Lewis, Simon, Michael S., Yasmeen, Shagufta, Wassertheil-Smoller, Sylvia Rohan, Thomas E., “Smoking and alcohol consumption in relation to risk of triple-negative breast cancer in a cohort of postmenopausal women.” Cancer Causes and Control : CCC , pp. 1-9

Li, Yan, Baer, David, Friedman, Gary D., Udaltsova, Natalia, Shim, Veronica, and Klatsky, Arthur L. “Wine, liquor, beer and risk of breast cancer in a large population,” 
European Journal of Cancer, vol. 45, no. 5, 843-850 (2008).

Nielsen, Naja Rod and Grønbæk, Morten. “Interactions Between Intakes of Alcohol and Postmenopausal Hormones on Risk of Breast Cancer.” International Journal of Cancer, vol. 122, no. 5, 1109-1113 (2008).