Moderate Drinking May Hasten Breast Cancer Return

Consuming moderate amounts of alcohol may raise the risk for breast cancer recurrence in some women, new research shows.

The association appears to be confined to former breast cancer patients who are postmenopausal, or overweight or obese.

However, drinking moderately (about three to four drinks per week) may lower the risk for dying from a non-breast cancer-related health issue, researchers say.

The observations are reported in the Journal of Clinical Oncology by a team led by Marilyn L. Kwan, Ph.D., a researcher at Kaiser Permanente in Oakland, Calif.

Looking at the Fine Details

Dr. Kwan says the findings are "consistent with what we already know about alcohol's role in increasing the risk for developing primary breast cancer. But I want to emphasize that women who consume less than three to four drinks per week didn't see any increased risk in terms of recurrence or breast cancer death."

Dr. Kwan says the research team did note that women who consume small amounts of alcohol get some protection against the risk of death due to cardiovascular disease.

Between 2000 and 2002, Kwan studied 1,900 women in California and Utah, most of whom had been diagnosed about two or three years earlier with early-stage breast cancer.

To explore the potential relationship between drinking and breast cancer risk, the researchers asked the women to complete a dietary survey, noting their routine consumption of wine, beer, and/or liquor.

Just over half the women were considered drinkers. Nearly nine in 10 drank wine, 40 percent consumed liquor, and 36 percent drank beer.

Over nearly seven and a half years of follow-up, 293 women experienced breast cancer recurrence, and 273 died from a variety of health complications.

Dr. Kwan found that study participants who were postmenopausal or overweight/obese raised their risk for breast cancer recurrence by nearly 1.5 times if they regularly consumed a minimum of three to four drinks of any type of alcohol a week.

Similarly, that group of women faced a 1.5 times greater risk of dying from breast cancer if they followed the same drinking patterns.

On the other hand, the research team unearthed indications that drinking any amount of alcohol may possibly decrease the risk of dying from causes other than breast cancer.

However, Dr. Kwan stresses that the findings will need to be confirmed by other studies.

Moving Toward Personalized Medicine

Dr. Paula Klein, at the Beth Israel Comprehensive Cancer Center in New York City, who was not involved in the research, described the observations as useful, as long as they are taken in context.

She stresses that the researchers only looked at moderate drinking, not heavy drinking, and their findings are confined to women who are postmenopausal and those who are overweight or obese.

"But that's a good thing, because information like this - where risks and benefits are confined to different subgroups - is part of the new push to personalize medicine," she says. "One size doesn't fit all in terms of risk factors and treatments."

The study is important because it adds to a woman's awareness of risk factors for the development and recurrence of breast cancer, she explains.

"And it's another gentle reminder of the risks associated with being overweight and obese, and how small additional factors can influence outcomes," she adds.

When patients ask what they can do to lower their risk, notes Dr. Klein, this is a modifiable change, alongside weight loss and exercise.

For those patients who are thin, physicians can assure them that a little bit of wine is not going to make a dramatic difference in their breast cancer risk, says Dr. Klein. But for those who are overweight or obese, physicians can ask them to control their alcohol intake, she says.

Always consult your physician or other healthcare provider for more information.