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Alcohol Use and Breast Cancer Survival among Participants in the Women's Health Initiative.
Cancer Epidemiol Biomarkers Prev 2016; 25(8):1268-73CE

Abstract

BACKGROUND

Alcohol increases the risk of breast cancer even at moderate levels of intake. However, the relationship between alcohol consumption and mortality among breast cancer patients is less clear.

METHODS

This study included women from the Women's Health Initiative observational study and randomized trial diagnosed with breast cancer (n = 7,835). Cox proportional hazards regression was used to estimate adjusted HRs and 95% confidence intervals (CI) for overall and breast cancer-specific (BCS) mortality associated with drinking alcohol before or after a breast cancer diagnosis. We also assessed whether changes in drinking habits after diagnosis are related to mortality.

RESULTS

Women who were consuming alcohol prior to their breast cancer diagnosis had a nonstatistically significant 24% (95% CI, 0.56-1.04) reduced risk of BCS mortality and a 26% (95% CI, 0.61-0.89) reduced risk of all-cause mortality. Some variation was observed by estrogen receptor (ER) status as alcohol consumption was associated with a 49% (95% CI, 0.31-0.83) reduced risk of BCS mortality among ER(-) patients with no change in risk observed among ER(+) patients (HR = 0.97; 95% CI, 0.31-1.54), though the difference between these risks was not statistically significant (P for interaction = 0.39). Postdiagnosis alcohol consumption, and change in consumption patterns after diagnosis, did not appear to be associated with all-cause or BCS mortality.

CONCLUSION

In this large study, consumption of alcohol before or after breast cancer diagnosis did not increase risks of overall or cause-specific mortality.

IMPACT

Coupled with existing evidence, alcohol consumption is unlikely to have a substantial impact on mortality among breast cancer patients. Cancer Epidemiol Biomarkers Prev; 25(8); 1268-73. ©2016 AACR.

Authors+Show Affiliations

Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.Med/Quantitative Sciences Unit, Stanford University School of Medicine, Palo Alto, California.Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California.Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington. cili@fredhutch.org.

Pub Type(s)

Journal Article
Multicenter Study
Observational Study
Randomized Controlled Trial

Language

eng

PubMed ID

27197280

Citation

Lowry, Sarah J., et al. "Alcohol Use and Breast Cancer Survival Among Participants in the Women's Health Initiative." Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, vol. 25, no. 8, 2016, pp. 1268-73.
Lowry SJ, Kapphahn K, Chlebowski R, et al. Alcohol Use and Breast Cancer Survival among Participants in the Women's Health Initiative. Cancer Epidemiol Biomarkers Prev. 2016;25(8):1268-73.
Lowry, S. J., Kapphahn, K., Chlebowski, R., & Li, C. I. (2016). Alcohol Use and Breast Cancer Survival among Participants in the Women's Health Initiative. Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored By the American Society of Preventive Oncology, 25(8), pp. 1268-73. doi:10.1158/1055-9965.EPI-16-0151.
Lowry SJ, et al. Alcohol Use and Breast Cancer Survival Among Participants in the Women's Health Initiative. Cancer Epidemiol Biomarkers Prev. 2016;25(8):1268-73. PubMed PMID: 27197280.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Alcohol Use and Breast Cancer Survival among Participants in the Women's Health Initiative. AU - Lowry,Sarah J, AU - Kapphahn,Kris, AU - Chlebowski,Rowan, AU - Li,Christopher I, Y1 - 2016/05/19/ PY - 2016/03/02/received PY - 2016/05/11/accepted PY - 2016/5/20/entrez PY - 2016/5/20/pubmed PY - 2018/1/13/medline SP - 1268 EP - 73 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 - 25 IS - 8 N2 - BACKGROUND: Alcohol increases the risk of breast cancer even at moderate levels of intake. However, the relationship between alcohol consumption and mortality among breast cancer patients is less clear. METHODS: This study included women from the Women's Health Initiative observational study and randomized trial diagnosed with breast cancer (n = 7,835). Cox proportional hazards regression was used to estimate adjusted HRs and 95% confidence intervals (CI) for overall and breast cancer-specific (BCS) mortality associated with drinking alcohol before or after a breast cancer diagnosis. We also assessed whether changes in drinking habits after diagnosis are related to mortality. RESULTS: Women who were consuming alcohol prior to their breast cancer diagnosis had a nonstatistically significant 24% (95% CI, 0.56-1.04) reduced risk of BCS mortality and a 26% (95% CI, 0.61-0.89) reduced risk of all-cause mortality. Some variation was observed by estrogen receptor (ER) status as alcohol consumption was associated with a 49% (95% CI, 0.31-0.83) reduced risk of BCS mortality among ER(-) patients with no change in risk observed among ER(+) patients (HR = 0.97; 95% CI, 0.31-1.54), though the difference between these risks was not statistically significant (P for interaction = 0.39). Postdiagnosis alcohol consumption, and change in consumption patterns after diagnosis, did not appear to be associated with all-cause or BCS mortality. CONCLUSION: In this large study, consumption of alcohol before or after breast cancer diagnosis did not increase risks of overall or cause-specific mortality. IMPACT: Coupled with existing evidence, alcohol consumption is unlikely to have a substantial impact on mortality among breast cancer patients. Cancer Epidemiol Biomarkers Prev; 25(8); 1268-73. ©2016 AACR. SN - 1538-7755 UR - https://www.unboundmedicine.com/medline/citation/27197280/Alcohol_Use_and_Breast_Cancer_Survival_among_Participants_in_the_Women's_Health_Initiative_ L2 - http://cebp.aacrjournals.org/cgi/pmidlookup?view=long&pmid=27197280 DB - PRIME DP - Unbound Medicine ER -