Alcohol and Breast Cancer: November News and Research

This month, there's been a lot of buzz (forgive the pun) about alcohol use and breast cancer. As the holidays approach, we thought it might be a good time to share the latest news and research. Links may be found on the alcoholic beverages page of our LATESTBreastCancer.com website.

The JAMA study: Even moderate drinking increases risk

The big story this month was a November 1 JAMA (Journal of the American Medical Association) study which followed over 100,000 nurses for almost 30 years. The New York Times, Los Angeles Times and Reuters covered the study.

According to the study, "Low levels of alcohol consumption were associated with a small increase in breast cancer risk." Greater consumption was associated with greater risk. The "most consistent measure" of risk was "cumulative alcohol intake throughout adult life."

The media attempted to sort out the details and put the findings in perspective.

All sources reported that moderate consumption (three to six drinks a week) was associated with a 15% increased risk. For women with a lifetime risk of 12%, three to six drinks a week would correlate with a 13.8% risk.

According to Reuters, the 10-year risk would be 2.8% for abstainers, 3.3% for three to six drinks a week and 3.5% for up to 13 drinks a week.

The Los Angeles Times further explained that women who consumed at least two drinks a day were 51% more likely to develop breast cancer than those who did not drink at all. Binge drinking (six or more drinks in one sitting) increased risk regardless of total consumption. Alcohol use between the ages of 18 and 40 was associated with increased risk, regardless of alcohol use after 40.

The New York Times highlighted some of the study limitations. First, the increase in risk associated with three to six drinks a week was "modest", and "for many women may not be enough to outweigh the heart-healthy benefits of drinking in moderation." Plus, "the new study was observational and lacked a control group, and it drew from self-reports, which can be unreliable."

The Los Angeles Times revisited the study and the balance between breast cancer risk and heart disease in a November 21 piece, "Women, the occasional drink, breast cancer and heart disease." In balancing the risks and benefits of drinking, the story was careful to note that any benefits associated with alcohol consumption relate to moderate, not heavy drinking.

The CANCER study: Alcohol and girls with a family history

Adults aren't the only ones who drink alcohol. How does adolescent alcohol consumption affect breast cancer risk?

A November 14 study in the journal Cancer examined the risk of benign breast disease, a "well-documented" breast cancer risk factor, among young women. A EurekAlert! press release covered the details.

The participants, aged 9 to 15 at the start of the study in 1996, completed periodic questionnaires until 2007 about family history of breast cancer and benign breast disease, alcohol use, height and weight.

The study found that young women with a family history of breast cancer or maternal history of benign breast disease had an increased risk of developing benign breast disease. Consuming seven alcoholic drinks a week doubled that already increased risk. The authors concluded, "Adolescents with family history may reduce their risk by avoiding alcohol."

Interestingly, among girls with no family history, the risk of benign breast disease was associated with other factors, such as weight, waist size and adult height. The authors note that this may possibly reflect different causes of breast cancer.

Alcoholics more likely to die of cancer

The JAMA study above addressed moderate alcohol use. On the other extreme, a November 15 US News and World Report/HealthDay story covered an Italian study of 2,300 alcoholics in Florence.

Compared to the general population, alcoholics were more likely to die from oral cancers, liver cancer, pancreatic cancer and breast cancer. They were also more likely to die from infections, diabetes, other diseases and violent crimes. Female alcoholics had higher survival rates than males, "possibly because women are more likely to get help for alcoholism."

The study author noted that the increased risk of death may be due to the effects of alcohol on human organs and lifestyle factors such as smoking, drug abuse, promiscuity and poor diet.

At LATESTBreastCancer.com, we follow breast cancer news and research daily. New studies and media stories are added to our website and database, sorted by topic. Topics include imaging, diagnostic testing, chemotherapy, radiation, targeted drugs, surgeries, complementary therapies and lifestyle options, such as alcohol use. We highlight the latest developments in this blog. However, topics may be explored on our website anytime. Simply click the Treatments tab to get started.

Our goal is to make internet research easy. Please stay tuned!

Breast Cancer News for July 29: Risk, Prevention and Screening

Breast cancer research news is not always about breast cancer treatment. Today, we'll examine the latest data on breast cancer in America and highlight the latest breast cancer research on risk and prevention.

U.S. breast cancer incidence rates vary by estrogen receptor status

Yesterday, msnbc.com, citing a Journal of the National Cancer Institute study, revealed that although American breast cancer incidence rates appear to be stable, rates of estrogen-receptor negative breast cancer are actually falling and rates of estrogen-receptor positive breast cancer are on the rise. The decline in ER-negative breast cancer, which is more difficult to treat, is good news. The rise in ER-positive tumors, however, is concerning, and will likely be the focus of future research on risk and prevention.

Three new risk studies: fiber, breast density and BRCA biology

According to Reuters, a Chinese study in the American Journal of Clinical Nutrition found that women who were in the top fifth of fiber consumers were 11 percent less likely to develop breast cancer than those who were in the bottom fifth. Reuters notes that the findings do not prove that fiber lowers breast cancer risk. Fiber consumers may just be healthier overall. Also, Dr. Linos, from Stanford, noted that the potential effect of fiber was "very small." More on diet and breast cancer can be found on the fruits, vegetables and nuts page of the LATESTBreastCancer.com website.

Medical News Today reports that a Harvard study in the Journal of the National Cancer Institute discovered that women whose mammograms reveal dense breasts have not only a greater risk of breast cancer, but a greater risk of developing more aggressive tumors. The women in the study were postmenopausal. Higher breast density was associated with larger tumors, higher-grade tumors, estrogen receptor-negative status and a higher risk of developing ductal carcinoma in situ (DCIS). This was the first study to link breast density with tumor characteristics.

From the biology labs, BRCA 1/2 gene mutations have long been associated with a higher risk of breast cancer. Yesterday, a EurekAlert! press release discussed a Spanish study which examined the chromosomes of BRCA carriers. It found that BRCA 1/2 carriers have chromosomes with short telomeres, which are complex structures that protect the end of chromosomes. Interestingly, it also found "genetic anticipation" of breast cancer in daughters whose telomeres were shorter than their mother's. According to the press release, "The significance of generational changes in telomere length has interesting potential clinical applications in the management of familial breast cancer, and could be extended to other hereditary cancer syndromes."

Low risk of some serious side effects when Tamoxifen is taken for prevention

According to a July 18 study in Cancer Treatment Reviews, women younger than 50 who take tamoxifen for breast cancer prevention have only a low risk of developing endometrial cancer, deep vein thrombosis and pulmonary embolism. The risk decreases from the active to follow-up phase of treatment. The authors note that education and counseling are "the cornerstones of breast cancer chemoprevention."

Please check back on Monday for the weekend breast cancer news highlights. Even though we don't write the daily news blog on the weekends, we continue to add the latest breast cancer news and research to the LATESTBreastCancer.com website and database.

The Breast Cancer News Update: July 22

There's been a lot of buzz about a recent study which found that tall women have a higher risk of breast cancer. According to the story in the Los Angeles Times, breast cancer risk increased 17% with every 4 inches in height. While this may be interesting, it's not really useful. Height is not a modifiable risk. Today we'll look at recent studies on modifiable risk factors such as diet, exercise, and alcohol use. All of the studies below can be found on the complementary therapy and lifestyle pages of the LATESTBreastCancer.com website.

Diet and breast cancer risk: soy, omega-3s and vitamins

Breast cancer research does not always have a positive ending. This month, two studies found that soy and omega-3 fatty acids do not reduce the hormones associated with breast cancer risk. Another study found that while vitamin A may reduce risk, vitamins C and E do not appear to have an effect.

Dietary soy does not modify estrogen levels

A July 8 study in Cancer Epidemiology, Biomarkers & Prevention examined the effect of dietary soy on blood and nipple aspirate fluid estrogen levels to assess impact on breast cancer risk. The authors concluded that soy in the amounts typically consumed by Asians did not significantly modify blood or nipple fluid estrogen levels. They did observe a non-significant trend towards lower estrogen levels in nipple fluid during the high-soy diet, which "counters concerns about adverse effects of soy foods on breast cancer risk."

Omega-3 fatty acids do not reduce hormones associated with risk

A July 11 study in Nutrition and Cancer found, contrary to expectations, that omega-3 fatty acids did not reduce the hormones associated with breast cancer risk.

Retinol and vitamin A may reduce breast cancer risk

A July 15 review in Cancer Causes & Control analysed the research on retinol, vitamin A, vitamin C and vitamin E and breast cancer risk. The authors concluded that intake of retinol and vitamin A "could reduce breast cancer risk," but the association between vitamins C and E and risk "seem to be limited."

Lifetime exercise reduces precancerous benign breast disease

According to a July 12 study in Cancer Causes & Control, "exercise may be inversely associated with the risk of developing proliferative benign breast disease, one of the earliest steps in the development of breast cancer." The study followed over 40,000 women for four years. Women in the study reported on levels of physical activity during adolescence and adulthood. A significant inverse association was found between walking and the risk of benign breast disease.

Alcohol and breast cancer risk

This month there have been two stories on the use of alcohol and breast cancer risk.

First, a July 11 story in the Los Angeles Times reported that although government health agencies often publish recommended drinking limits, no amount of alcohol is safe in terms of breast cancer risk.

On July 19 and 20, BBC News and Cancer Research UK reported on a study which found that obesity has the greatest effect on the hormones associated with breast cancer risk, followed by alcohol use then smoking. Women who drank 2.5 units of alcohol a day had higher levels of all hormones. A large glass of wine is 3 units of alcohol.

Please check back Monday for highlights of the weekend breast cancer news. Until then, all the latest breast cancer news and research may be found on the treatment pages of the LATESTBreastCancer.com website.

The Breast Cancer News Update: July 21

Today in breast cancer news, we'll look at the latest recommendations on screening mammography and two new studies on sentinel lymph node biopsy recurrence rates.

ACOG weighs in on the screening mammography debate

Another influential group, the American College of Obstetrics and Gynecology (ACOG), has weighed in on the debate over when to start and how often to have screening mammography. Reuters, US News and World Report and The Boston Globe covered the story.

In 2009, the US Preventative Services Task Force stirred up controversy when it noted that the benefit of screening mammography before age 50 was very small compared to the risk of false positives and unnecessary biopsies. Even after age 50, the Task Force recommended screening every two years. By contrast, the American Cancer Society and the National Comprehensive Cancer Network recommend annual screening mammography starting at age 40. The National Cancer Institute recommends screening every one or two years starting at age 40. The public has been vocal on both sides of the issue.

This week, the ACOG recommended that doctors offer annual screenings starting at age 40. Media coverage of the new guidelines varied in emphasis. The Reuters story highlighted the offering of a choice. Reuters quoted Dr. Jennifer Griffin, one of the authors of the new recommendation as saying, "We believe it is our job to help women make the best health decision for themselves. We believe that many women will choose to have a screening mammogram every year, (and) of course there are women that will choose not to." By contrast, the US News and World Report coverage highlighted the incidence of breast cancer among women in their 40s and also quoted Dr. Griffin,

"I think the main point we considered was that about 40,000 women every year in their 40s are diagnosed with breast cancer, and about 20 percent of them will die from it," said Griffin, an assistant professor of OB/GYN at the University of Nebraska Medical Center. "Screening mammograms reduce the risk of dying by 15 percent" in this population.

The ACOG guidelines only apply to women with average risk of breast cancer.

Sentinel lymph node biopsies for node negative and micrometastatic nodes

A sentinel lymph node biopsy (SLNB) is generally preferred over complete axillary lymph node dissection (ALND) due to the less severe side effects and better quality of life associated with SLNB. Back in February, a Journal of the American Medical Association study concluded that for women with one or two positive sentinel lymph nodes, the use of SLNB instead of ALND did not result in inferior overall survival.

This month, two studies evaluated the recurrence rates associated with SLNB without complete axillary dissection for women with negative or micrometastatic nodes.

A July 1 study in The Breast Journal assessed the incidence of recurrence in 481 patients from a hospital in Belgium who were treated with SLNB. In this study, the sentinel nodes were either negative or contained micrometastases. At a median follow-up of 4 years, only one patient (from the node negative group) experienced axillary relapse. The authors concluded, "This study confirms that the axillary recurrence rate after long-term follow-up of patients with a negative sentinel lymph node is very rare, provided that the selection criteria are judicious."

A July 9 study from China in Breast Cancer Research and Treatment reviewed recurrence and survival rates from 8 randomized controlled trials of SLNB and ALND. The authors concluded that "SLNB can be recommended as preferred care for SLN-negative patients and selected patients with SLN-micrometastasis."

Please check back tomorrow for more breast cancer news from LATESTBreastCancer.com.

The Breast Cancer News Update: July 12

Today in breast cancer news, we'll discuss alcohol and breast cancer risk, increased risk of blood diseases after radiation therapy and survivor awareness of diagnosis and treatments received. As always, all of the news and research discussed below can be found on the relevant pages of the LATESTBreastCancer.com website.

No amount of alcohol safe when it comes to breast cancer risk

Back in early May, the Cancer Council Australia increased its estimates of the number of breast cancers caused by alcohol. The Council's chief executive, Ian Olver, told the Sydney Morning Herald that although the National Health & Medical Research Council still recommended alcohol be taken in moderation,

[P]eople should also be told there was no evidence of a safe alcohol dose below which cancer-causing effects did not occur - either from direct DNA damage, increased oestrogen levels or excessive weight gain. ''If you want to reduce your cancer risk as far as possible [abstinence] would be the option you have,'' he said.

Well, it's not just Australians who recommend no alcohol to lower breast cancer risk. Yesterday, the Los Angeles Times reported on an article in the Canadian Medical Association Journal, in which French researchers cautioned health authorities "against telling consumers that any amount of drinking is truly safe, at least, when it comes to cancer risk." According to the authors,

It can be concluded that there is no level of alcohol consumption for which the cancer risk is null. . . Thus, for cancer prevention, the consumption of alcoholic beverages should not be recommended.

Some women treated with radiation may have an increased risk of blood diseases

According to a story in HemOnc Today, some women younger than 65 treated with radiation for breast cancer may be at an increased risk of myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML), two blood disorders. (For more on myelodysplastic syndrome, please see the National Cancer Institute overview.) Although breast cancer patients were four times more likely to be diagnosed with MDS or AML than non-patients, the overall risk only affected a small percentage of patients (0.29%). Among patients, women younger than 65 and those who were treated with surgery and radiation or surgery, radiation and chemotherapy had a higher risk than those treated with surgery and chemotherapy with no radiation. Overall, 30% of the MDS cases and 71% of the AML cases were fatal.

Not all breast cancer survivors are aware of their diagnosis details or treatment history

Because I work in the medical information field, the breast cancer patients I meet are typically very aware of the details of their diagnosis. I was surprised to read a recent study in the Journal of Cancer Survivorship (see the Adriamycin link below) which found that 40% of breast cancer survivors were unable to identify the stage of their disease. 7% did not know if they had positive nodes and 42% did not know their estrogen or progesterone receptor status.

It's very important for survivors to be aware of the breast cancer treatments they received. Future health care providers will need to know if a patient has previously been treated with drugs such as Adriamycin (doxorubicin) or tamoxifen. According to the study, only 43% of those treated with Adriamycin could correctly identify it. Fortunately, more than 90% of those on tamoxifen or aromatase inhibitors could identify the correct drug. This may be because hormone treatment typically lasts for five years. Logically, accurate recollection of diagnosis and treatment declined with patient age.

The study authors suggest written treatment summaries to help cancer patients obtain the best future medical care.

Please check back tomorrow for more breast cancer news and research updates.