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Postdiagnosis alcohol consumption and breast cancer prognosis in the after breast cancer pooling project.
Cancer Epidemiol Biomarkers Prev. 2013 Jan; 22(1):32-41.CE

Abstract

BACKGROUND

Alcohol consumption is an established risk factor for incident breast cancer. However, its role in breast cancer prognosis remains unclear.

METHODS

We conducted an investigation of postdiagnosis alcohol consumption with recurrence and mortality among 9,329 breast cancer patients in the After Breast Cancer Pooling Project. Women were diagnosed from 1990 to 2006 with AJCC Stage I-III breast tumors from three prospective US cohorts. Alcohol intake was assessed at cohort entry (mean 2.1 years postdiagnosis) using a food frequency questionnaire. HR and 95% confidence intervals (CI) were estimated using delayed entry Cox proportional hazards models with adjustment for known prognostic factors.

RESULTS

After a mean follow-up of 10.3 years, 1,646 recurrences and 1,543 deaths were ascertained. 5,422 women (58%) were considered drinkers (≥0.36 g/day of alcohol, ≥0.25 drinks/week) with a median of 5.3 g/day. Overall, compared with nondrinking, regular alcohol intake (≥6.0 g/day) was not associated with risk of recurrence (HR for 6 to less than 12 g/day, 1.03; 95% CI, 0.86-1.24; HR for 12 to less than 24 g/day, 1.12; 95% CI, 0.93-1.34; HR for ≥24 g/day, 1.04; 95% CI, 0.84-1.31). However, risk varied significantly by menopausal status (P for interaction < 0.05). Postmenopausal women who regularly consumed alcohol (≥6.0 g/day) had increased risk of recurrence (HR, 1.19; 95% CI, 1.01-1.40). Alcohol intake was not associated with mortality.

CONCLUSIONS

Regular alcohol consumption was not associated with breast cancer recurrence and total mortality overall, yet recurrence risk was only elevated in postmenopausal women.

IMPACT

The association between alcohol intake and recurrence may depend on menopausal status at breast cancer diagnosis.

Links

  • PMC Free PDF
    • Publisher Full Text
    ncbi.nlm.nih.gov
    cebp.aacrjournals.org

    Authors+Show Affiliations

    Kwan ML
    Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA. Marilyn.L.Kwan@kp.org
    Chen WY
    No affiliation info available
    Flatt SW
    No affiliation info available
    Weltzien EK
    No affiliation info available
    Nechuta SJ
    No affiliation info available
    Poole EM
    No affiliation info available
    Holmes MD
    No affiliation info available
    Patterson RE
    No affiliation info available
    Shu XO
    No affiliation info available
    Pierce JP
    No affiliation info available
    Caan BJ
    No affiliation info available

    MeSH

    AdultAge DistributionAgedAged, 80 and overAlcohol DrinkingBreast NeoplasmsChinaCohort StudiesCombined Modality TherapyConfidence IntervalsDatabases, FactualFemaleHumansMiddle AgedNeoplasm InvasivenessNeoplasm Recurrence, LocalNeoplasm StagingPrognosisProspective StudiesRisk AssessmentSurvival AnalysisSurvivorsUnited States

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, U.S. Gov't, Non-P.H.S.

    Language

    eng

    PubMed ID

    23150063

    Citation

    Kwan, Marilyn L., et al. "Postdiagnosis Alcohol Consumption and Breast Cancer Prognosis in the After Breast Cancer Pooling Project." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 22, no. 1, 2013, pp. 32-41.
    Kwan ML, Chen WY, Flatt SW, et al. Postdiagnosis alcohol consumption and breast cancer prognosis in the after breast cancer pooling project. Cancer Epidemiol Biomarkers Prev. 2013;22(1):32-41.
    Kwan, M. L., Chen, W. Y., Flatt, S. W., Weltzien, E. K., Nechuta, S. J., Poole, E. M., Holmes, M. D., Patterson, R. E., Shu, X. O., Pierce, J. P., & Caan, B. J. (2013). Postdiagnosis alcohol consumption and breast cancer prognosis in the after breast cancer pooling project. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 22(1), 32-41. https://doi.org/10.1158/1055-9965.EPI-12-1022
    Kwan ML, et al. Postdiagnosis Alcohol Consumption and Breast Cancer Prognosis in the After Breast Cancer Pooling Project. Cancer Epidemiol Biomarkers Prev. 2013;22(1):32-41. PubMed PMID: 23150063.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Postdiagnosis alcohol consumption and breast cancer prognosis in the after breast cancer pooling project. AU - Kwan,Marilyn L, AU - Chen,Wendy Y, AU - Flatt,Shirley W, AU - Weltzien,Erin K, AU - Nechuta,Sarah J, AU - Poole,Elizabeth M, AU - Holmes,Michelle D, AU - Patterson,Ruth E, AU - Shu,Xiao Ou, AU - Pierce,John P, AU - Caan,Bette J, Y1 - 2012/11/13/ PY - 2012/11/15/entrez PY - 2012/11/15/pubmed PY - 2013/7/26/medline SP - 32 EP - 41 JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology JO - Cancer Epidemiol. Biomarkers Prev. VL - 22 IS - 1 N2 - BACKGROUND: Alcohol consumption is an established risk factor for incident breast cancer. However, its role in breast cancer prognosis remains unclear. METHODS: We conducted an investigation of postdiagnosis alcohol consumption with recurrence and mortality among 9,329 breast cancer patients in the After Breast Cancer Pooling Project. Women were diagnosed from 1990 to 2006 with AJCC Stage I-III breast tumors from three prospective US cohorts. Alcohol intake was assessed at cohort entry (mean 2.1 years postdiagnosis) using a food frequency questionnaire. HR and 95% confidence intervals (CI) were estimated using delayed entry Cox proportional hazards models with adjustment for known prognostic factors. RESULTS: After a mean follow-up of 10.3 years, 1,646 recurrences and 1,543 deaths were ascertained. 5,422 women (58%) were considered drinkers (≥0.36 g/day of alcohol, ≥0.25 drinks/week) with a median of 5.3 g/day. Overall, compared with nondrinking, regular alcohol intake (≥6.0 g/day) was not associated with risk of recurrence (HR for 6 to less than 12 g/day, 1.03; 95% CI, 0.86-1.24; HR for 12 to less than 24 g/day, 1.12; 95% CI, 0.93-1.34; HR for ≥24 g/day, 1.04; 95% CI, 0.84-1.31). However, risk varied significantly by menopausal status (P for interaction < 0.05). Postmenopausal women who regularly consumed alcohol (≥6.0 g/day) had increased risk of recurrence (HR, 1.19; 95% CI, 1.01-1.40). Alcohol intake was not associated with mortality. CONCLUSIONS: Regular alcohol consumption was not associated with breast cancer recurrence and total mortality overall, yet recurrence risk was only elevated in postmenopausal women. IMPACT: The association between alcohol intake and recurrence may depend on menopausal status at breast cancer diagnosis. SN - 1538-7755 UR - https://www.unboundmedicine.com/medline/citation/23150063/Postdiagnosis_alcohol_consumption_and_breast_cancer_prognosis_in_the_after_breast_cancer_pooling_project_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&amp;pmid=23150063 DB - PRIME DP - Unbound Medicine ER -