New evidence presented today by U.S. researchers suggests that women who drink at least three alcoholic drinks per day have a 30 per cent increase in the risk of developing breast cancer. Why is this important? Could it be because we don't want more women to acquire this disease? ¹ Could it be because there are individuals in this country ² who are keenly interested in getting as many adults as possible into the habit of drinking those same alcoholic beverages now linked to an increase in the incidence of breast cancer? Well, could it? ³
"Studies have consistently linked drinking alcohol to an increased risk of female breast cancer, but until now there has been little data, most of it conflicting, about an independent role played by the choice of beverage type," Arthur Klatsky of Kaiser Permanente in California and one of the researchers said.
Breast cancer is the second most common cancer killer of women, after lung cancer. It will be diagnosed in 1.2 million people globally this year and will kill 500,000.
What Klatsky is referring to is that it made no difference what type of alcoholic drink was consumed in this review, be it beer, wine or spirits. The increased incidence of breast cancer was the same for different age groups and ethnic groups, too.
Is it reasonable now to add "contributing to the risk of breast cancer" to the list of accusations against Big Alcohol? Well, that's probably taking ire a bit too far; after all, no one is forcing women to drink. It's just that...it's just that...
It's just that this country is loaded, saturated, plastered, flushed, soaked and snockered with advertisements for alcoholic beverages, and there are data to suggest that this increases the risk of underage drinking, to wit:
"Effects of Alcohol Advertising Exposure on Drinking Among Youth"
"Exposure to Televised Alcohol Ads and Subsequent Adolescent Alcohol Use"
Sigh...I need to do a better job of counseling my patients about alcohol. I wonder if other doctors find this task as awkward as I do. Courage!
Footnotes:
1. Duh! What kind of a stupid question is that?
2. This is just a rumor, of course, completely unsubstantiated as of the time of this writing.
3. Hmmmmmm..................could be!
Comments
Picked up my chip already, but thanks for the advise.
Posted by: emmy | September 28, 2007 7:45 AM
It may just be me, but didn't people drink alcohol before TV? And isn't "underage" just an arbitrary boundary that is three to five years lower in most other countries?
I'm not saying that the findings aren't real and genuine, but I'd be a little wary about saying that women only drink because the evil companies are poisoning their brains with their clever insidious advertising. People do lots of things that are bad for them, day in and day out, and sometimes there's never an advertisment in sight.
Posted by: McDuff | September 28, 2007 11:25 AM
I just think it's funny that breasts are used to advertise beer to men, but any drinking is now bad for womens' breasts.
Life is weird.
Posted by: Celeste | September 28, 2007 12:08 PM
As with most studies like this, the only conclusion we can draw is that there might be a tenuous association between alcohol consumption and breast cancer... but we can't say for sure and there is no possible way to definitively prove it.
Now hand me my bottle of scotch, please.
Posted by: fierce lioness | September 28, 2007 2:20 PM
By the time gals are at the Oncologists I think the damage has been done already.
They don't mention if it contributes to re-occurrences. Alcohol never really helped anybody stay on their diet. Perhaps a gentle suggestion that reducing alcohol is a good place to start for weight control would be as tactful.
People are notorious about self-reporting. If someone admits to 3+ drinks per day they're probably downing a lot more than that.
Posted by: AnnR | September 28, 2007 4:40 PM
"People are notorious about self-reporting. If someone admits to 3+ drinks per day they're probably downing a lot more than that."
During a pre-op chat one time the anethetist asked:
"How many alcoholic drinks do you take a day, more or less than 14". We laughed. He said, if I start really high like that I find I more often get a truthful answer"
Posted by: sailor | September 28, 2007 8:27 PM
Ummh,(raising my hand)just a brief question. Rueters talks about the study containing 70,000 participants; 3000 of which developed breast cancer. That is 4.29%. The American Cancer Society places a woman's life time risk of developing breast cancer at 12%. How is that an increased risk?
Posted by: emmy | September 29, 2007 2:31 PM
As a BC patient, I also wonder how this effects risk of recurrance. What is the mechanism by which alcohol effects BC risk? Is it by causing a rise in estrogen levels? If so, how does endocrine therapy like tamoxifen effected by alcohol? Can endocrine therapy counteract the negative effects of alcohol? Is it possilbe that people who tend to drink that much have other risk factors, like obesity? Does one drink a day, or three drinks twice a week, also raise one's risk? What do you think, good Cheerful Doctor?
Posted by: laura | September 30, 2007 12:50 AM
E - I think this is one of those relative vs absolute risks things.
They took the initial measurements in 1978-198? At that time the women were probably between 20-65? Anyway, some younger, some older - all within the age range where breast cancer is a risk. Probably no 13 y/o, or 90 y/o.
Then they checked back in in 2004. Some of the originals had developed cancer. Others hadn't but they might still. They caught about a 20 year period. The average age for a diagnosis of breast cancer is supposed to be around 65, but you can get it anytime, so you could have a 40-50 year window of risk. The 4% they saw here might translate into something close to 8-10% over another 20-30 years.
Posted by: AnnR | September 30, 2007 7:38 PM
Ann: Might still? How do you quantitatively measure that and include it in empiracal statements as the outcome of a trial?
Posted by: emmy | October 1, 2007 7:57 AM
I read the news about this study with some interest, as I am a breast cancer survivor.
This is not the first time that consumption of alcoholic beverages has been linked to breast cancer; other studies have said the same thing. Additionally, there are studies relating activity levels and diet to breast cancer risk. (This, I'm sure, is not news to you.) What is interesting to me is that the breast cancer communities that I belong to do not appear to want to hear it. To the contrary, they say, "My friend X drinks way more than I do and she doesn't have breast cancer!" and "Cancer made me NEED to drink ha ha ha," and "It's about quality of life and cancer took too much away from me already and I'm not giving up my glass of wine or a good time with my friends," or other such arguments.
Nobody in the online communities I visit, or the few support group meetings I have attended, takes the research on lifestyle factors and breast cancer very seriously, and I have yet to meet many who actually consider applying the research to their own lives. None has told me "I won't drink alcohol any more" as a result of this type of study. These women are willing to submit themselves to mastectomy(s), chemo, radiation, and awful drugs (well, great drugs with awful side effects) in order to prevent cancer from reoccurring, but they are not willing to refrain from a glass of wine with dinner, to lose 30 pounds (when needed), or to take up running or swimming or whatever.
The women that I have met feel that such studies point a finger of blame at cancer patients, and they are resentful of such finger pointing.
I tend to believe that we will find out more and more about the influence of lifestyle (diet, exercise, and alcohol consumption) on breast cancer, and that at some point the evidence will mount until it is unavoidable. Until then, however, an oncologist like yourself has an uphill battle. Most women don't want to hear it. They find it hard enough to shake their extra weight, to make it to the gym, and they like to enjoy a glass of wine or a beer or whatever at the end of a hard day. I do not envy you having to deliver such a message, but if you figure it out, I'm interested in hearing about it.
And me? I lost 40 pounds (new BMI: 21), and took up running, and cut back on my alcohol consumption; I now have a glass of wine a couple of times a week rather than with every dinner. But I wonder if I do need to give up all alcohol; it's certainly easier than dealing with chemo again, but it's still a hard pill to swallow.
Posted by: Kristina | October 4, 2007 11:48 PM
"I now have a glass of wine a couple of times a week rather than with every dinner. But I wonder if I do need to give up all alcohol"
My reading of the research is that if you had a drink a day it probably would not make any difference. They are talking three or over, and as someone pointed out anyone admitting to three drinks may be having more. I would have thought the exercise, the weight loss and the fact you are taking control would all be helpful.
Posted by: sailor | October 6, 2007 9:11 PM
"Women who drank between one and two alcoholic drinks per day increased their risk of breast cancer by 10 percent compared with people who consumed less than one drink each day, the study found. The risk of breast cancer jumped by 30 percent in women who drank more than three drinks a day." (from the study article, posted in the link in the original post)
I am sure that the exercise and weight loss are helpful in reducing my risk of recurrence; I just wonder if I'm deluding myself into believing I've done enough, or if the study indicates that I'm a fool for drinking at all. Earlier research that I'd read showed little impact for one drink a day, but I don't consider 10% statistically insignificant, and that's what this study shows.
Posted by: Kristina | October 8, 2007 5:32 PM
Did you all miss the place in the book that states that being a woman over the age of 40 is the single most significant risk factor for breast cancer? Still, even with that there is a significant number of breast cancer patients who are younger than 40. Yes, I do resent studies that point fingers at cancer patients. But it's not that they give a clue that may help someone from developing the disease initially, it's that the research is often used by many to say "see here! you did this to yourself." And if you don't believe me ask a lung cancer patient, they get it much more than breast cancer survivors. It's like the woman who after hearing that I had breast cancer saying "well, did you breast feed your babies?" and when I answered yes, she said "you must not have continued it long enough." The point is that beyond being over 40 or having a genetic defect, there isn't much evidence that ties any one thing to breast cancer risk. There are no smoking guns, or cigarettes, if you will for this disease. All that this suggestive rule setting does is make some people who are afraid of the disease feel like it's something that they can control, and they can't. Living a healthy lifestyle is probably a good idea, but it's not going to guarantee you a disease free life. There are no guarantees for that, so get over it and quit pointing fingers at the survivors.
Posted by: emmy | October 9, 2007 9:01 AM
Emmy writes, "there isn't much evidence that ties any one thing to breast cancer risk" but it seems to me that this study does exactly that. And that there are other studies, equally persuasive, about diet and exercise (and BMI) and their links to breast cancer.
Emmy is a perfect example of the people that I meet in online breast cancer communities when the subject of alcohol comes up. Her reaction is absolutely typical; mine is not. I just don't understand.
But it seems like most cancer patients would rather ignore this information. I'm willing to ask the questions of myself without taking on massive guilt: hey, if I knew now what I wish I knew then, my whole life would have changes. (Wouldn't all of us?)
It's not about finger pointing. It's about figuring it out. Why is that so hard?
I was diagnosed at age 35, by the way. And I eat organic. And I nursed my daughter for 15 months. And I exercise and stay active. Who knows what caused my breast cancer...but I would LIKE to know. And if I could, I'd like to keep it from coming back.
Posted by: Kristina | October 12, 2007 9:12 PM
If three glasses of alcohol (depressant) increases the risk of breast cancer, does that mean that three lines of cocaine (stimulant) decreases the risk? Just a thought
Posted by: Organic Chemistry | October 27, 2007 11:00 PM
What is the mechanism by which alcohol effects BC risk? Is it by causing a rise in estrogen levels? If so, how does endocrine therapy like tamoxifen effected by alcohol? Can endocrine therapy counteract the negative effects of alcohol?
Posted by: sex shop | December 22, 2007 9:26 AM