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Moderate Alcohol Consumption During Adult Life, Drinking Patterns, and Breast Cancer Risk
Open accessAbstract
CONTEXT: Multiple studies have linked alcohol consumption to breast cancer risk, but the risk of lower levels of consumption has not been well quantified. In addition, the role of drinking patterns (ie, frequency of drinking and "binge" drinking) and consumption at different times of adult life are not well understood. OBJECTIVE: To evaluate the association of breast cancer with alcohol consumption during adult life, including quantity, frequency, and age at consumption. DESIGN, SETTING, AND PARTICIPANTS: Prospective observational study of 105,986 women enrolled in the Nurses' Health Study followed up from 1980 until 2008 with an early adult alcohol assessment and 8 updated alcohol assessments. MAIN OUTCOME MEASURES: Relative risks of developing invasive breast cancer. RESULTS: During 2.4 million person-years of follow-up, 7690 cases of invasive breast cancer were diagnosed. Increasing alcohol consumption was associated with increased breast cancer risk that was statistically significant at levels as low as 5.0 to 9.9 g per day, equivalent to 3 to 6 drinks per week (relative risk, 1.15; 95% CI, 1.06-1.24; 333 cases/100,000 person-years). Binge drinking, but not frequency of drinking, was associated with breast cancer risk after controlling for cumulative alcohol intake. Alcohol intake both earlier and later in adult life was independently associated with risk. CONCLUSIONS: Low levels of alcohol consumption were associated with a small increase in breast cancer risk, with the most consistent measure being cumulative alcohol intake throughout adult life. Alcohol intake both earlier and later in adult life was independently associated with risk.
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“The main biological pathway seems to be through overall tissue exposure to acetaldehyde, which may not be affected by drinking patterns; however, through modifications of insulin‐like growth factor (IGF) serum levels, drinking patterns may have an effect on the risk of developing breast cancer (as well as other cancers, where modifications to IGF serum levels play a role 180).”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [180]
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“through modifications of insulin‐like growth factor (IGF) serum levels, drinking patterns may have an effect on the risk of developing breast cancer (as well as other cancers, where modifications to IGF serum levels play a role 180).”
From The relationship between different dimensions of alcohol use and the burden of disease—an update (2017) · cites this paper as [180]
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Benign Breast Diseases: Evaluation and Management
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Self-citationIntakes of Alcohol and Folate During Adolescence and Risk of Proliferative Benign Breast Disease
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InfluentialSelf-citationModerate Alcohol Intake in Non-Alcoholic Fatty Liver Disease: To Drink or Not to Drink?
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Can the breast screening appointment be used to provide risk assessment and prevention advice?
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“Because control monkeys were ethanol-naive and thus do not have an ‘age of onset of ethanol drinking’, age at necropsy is used as a predictor variable in the models for all monkeys; (2) cumulative LEI—recent research has indicated that the amount of ethanol consumed across the lifespan in humans is highly correlated w…”
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InfluentialMasala, G., Bendinelli, B., Assedi, M., Occhini, D., Zanna, I., Sieri, S., Agnoli, C., Sacerdote, C., Ricceri, F., Mattiello, A., et al. (2016) · Breast Cancer Research and Treatment · doi:10.1007/s10549-016-4047-x · Cited by 31
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“Other covariates such as race, BMI at age 18, age at first birth, parity, age at diagnosis, year of diagnosis, menopausal status, recent post-menopausal hormone therapy (HT), smoking, cumulative average physical activity (metabolic equivalent hours/week) [34], and cumulative average alcohol consumption (grams/day) [28…”
MethodSelf-citationOutpatient management of alcohol-related liver disease
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“In women, the risk of breast cancer is increased with up to one standard drink per day.(17, 18)”
BackgroundLow-level alcohol consumption and cancer mortality
Ko, H., Chang, Y., Kim, H., Kang, J., Shin, H. C., Sung, E., & Ryu, S. (2021) · Scientific Reports · doi:10.1038/s41598-021-84181-1 · Cited by 30
Ashat, M., Puri, S., Pandey, A. K., Goel, N. K., Singh, A., & Kaushal, V. (2014) · Indian Journal of Cancer · doi:10.4103/0019-509x.134593 · Cited by 30
“[19] Various studies[20] have substantiated enough evidence that alcoholism is associated with varied cancers like ca oral cavity, oesophagus, liver, pancreas, colon and rectal cancer substantiated in many studies.”
BackgroundFisher, B., Wilkinson, L., & Valencia, A. (2016) · Journal of Public Health · doi:10.1093/pubmed/fdv211 · Cited by 30
Targeting the purinergic pathway in breast cancer and its therapeutic applications
de Araújo, J. B., Kerkhoff, V. V., Maciel, S. F. V. D. O., & Silva, D. T. D. R. E. (2021) · Purinergic Signalling · doi:10.1007/s11302-020-09760-9 · Cited by 33
NCCN Guidelines® Insights: Survivorship, Version 1.2022
Sanft, T. B., Day, A., Peterson, L. L., Rodriguez, M. A., Ansbaugh, S. M., Armenian, S. H., Baker, K. S., Ballinger, T. J., Broderick, G. A., Demark‐Wahnefried, W., et al. (2022) · Journal of the National Comprehensive Cancer Network · doi:10.6004/jnccn.2022.0052 · Cited by 30
Trinh, T., Christensen, S. E., Brand, J. S., Cuzick, J. M., Czene, K., Sjölander, A., Bälter, K. A., & Hall, P. N. (2015) · British Journal of Cancer · doi:10.1038/bjc.2015.185 · Cited by 28
“Boyd NF, Melnichouk O, Martin LJ, Hislop G, Chiarelli AM, Yaffe MJ, Minkin S (2011) Mammographic density, response to hormones, and breast cancer risk.”
BackgroundMethodInfluentialRisk assessment model for invasive breast cancer in Hong Kong women
Wang, F., Dai, J., Li, M., Chan, W.-C., Kwok, C. C.-H., Leung, S.-L., Wu, Ç., Li, W., Yu, W.-C., Tsang, K.-H., et al. (2016) · Medicine · doi:10.1097/md.0000000000004515 · Cited by 28
Springfield, S., Odoms‐Young, A. M., Tussing-Humphreys, L. M., Freels, S. A., & Stolley, M. R. (2019) · Journal of Cancer Survivorship · doi:10.1007/s11764-019-00748-y · Cited by 31
Zhao, M., Howard, E. W., Guo, Z., Parris, A. B., & Yang, X. (2017) · PLoS ONE · doi:10.1371/journal.pone.0175121 · Cited by 31
Cancer Etiology and Prevention Principle: “1 + X”
Liu, H., & Dong, Z. (2021) · Cancer Research · doi:10.1158/0008-5472.can-21-1862 · Cited by 29
Barbhaiya, M., Hart, J. E., Malspeis, S., Tedeschi, S. K., VoPham, T., Sparks, J. A., Karlson, E. W., Laden, F., & Costenbader, K. H. (2022) · Arthritis Care & Research · doi:10.1002/acr.24974 · Cited by 27
Liu, P., Burke, K. E., Ananthakrishnan, A. N., Lochhead, P. J., Olén, O., Ludvigsson, J. F., Richter, J. M., Chan, A. T., & Khalili, H. (2018) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2018.11.057 · Cited by 27
Rainey, L., Eriksson, M., Trinh, T., Czene, K., Broeders, M. J. M., van der Waal, D., & Hall, P. N. (2019) · International Journal of Cancer · doi:10.1002/ijc.32846 · Cited by 27
“Women with high levels of alcohol consumption have a 40–50% higher risk of developing breast cancer than abstainers, regardless of the type of alcoholic beverage consumed.(4,5,22,24) A dose– response relationship between alcohol consumption and breast cancer has been reported, with every 10 g of alcohol consumed per d…”
BackgroundEpidemiology of Moderate Alcohol Consumption and Breast Cancer: Association or Causation?
Zakhari, S., & Hoek, J. B. (2018) · Cancers · doi:10.3390/cancers10100349 · Cited by 28
“47]) • Low levels of alcohol were associated with a small increase in breast cancer risk [120]”
BackgroundIsmail, H., Shibani, M., Zahrawi, H. W., Slitin, A., Alzabibi, M. A., Mohsen, F., Armashi, H., Bakr, A., Turkmani, K., & Sawaf, B. (2021) · BMC Medical Education · doi:10.1186/s12909-021-02673-0 · Cited by 25
A Review of Breast Cancer Risk Factors in Adolescents and Young Adults
McVeigh, U. M., Tepper, J. W., & McVeigh, T. P. (2021) · Cancers · doi:10.3390/cancers13215552 · Cited by 29
Falk, R. T., Maas, P., Schairer, C., Chatterjee, N., Mabie, J. E., Cunningham, C., Buys, S. S., Isaacs, C. J., & Ziegler, R. G. (2014) · American Journal of Epidemiology · doi:10.1093/aje/kwu189 · Cited by 25
“others considering it a unique histological type (4) or excluding it (8, 15).”
BackgroundModifiable Risk Factors for the Development of Breast Cancer in Young Women
Cathcart-Rake, E. J., Ruddy, K. J., & Johnson, R. H. (2018) · The Cancer Journal · doi:10.1097/ppo.0000000000000340 · Cited by 24
Coping strategies and anxiety in young breast cancer survivors
Krasne, M. D., Ruddy, K. J., Poorvu, P. D., Gelber, S. I., Tamimi, R. M., Schapira, L., Peppercorn, J. M., Come, S. E., Borges, V. F., Partridge, A. H., et al. (2022) · Supportive Care in Cancer · doi:10.1007/s00520-022-07325-7 · Cited by 24
Are people aware of the link between alcohol and different types of Cancer?
Calvert, C., Toomey, T. L., & Jones‐Webb, R. (2021) · BMC Public Health · doi:10.1186/s12889-021-10780-2 · Cited by 24
“Using data from the Nurses’ Health Study, researchers found that three to six drinks of alcohol per week was associated with a 15% increased risk of breast cancer [14].”
MethodRisk factors for young-onset invasive and in situ breast cancer
O’Brien, K. M., Sun, F. X., Sandler, D. P., DeRoo, L. A., & Weinberg, C. R. (2015) · Cancer Causes & Control · doi:10.1007/s10552-015-0670-9 · Cited by 24
Long-term exposure of MCF-7 breast cancer cells to ethanol stimulates oncogenic features
Gelfand, R., Vernet, D. A., Bruhn, K. W., Sarkissyan, S., Heber, D., Vadgama, J. V., & González-Cadavid, N. F. (2016) · International Journal of Oncology · doi:10.3892/ijo.2016.3800 · Cited by 24
“There is a greater risk for lobular rather than ductal breast cancer (5-7), and tumors are more likely to be ER - and HER2 + in the women with high alcohol consumption (8,9).”
Alcohol Intake and Breast Cancer Risk in African American Women from the AMBER Consortium
Williams, L. A., Olshan, A. F., Hong, C., Bandera, E. V., Rosenberg, L. A., Cheng, T. D., Lunetta, K. L., McCann, S. E., Poole, C., Kolonel, L. N., et al. (2017) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-16-0792 · Cited by 23
“Previous studies have suggested that drinking prior to 40–50 years of age has a greater impact on breast cancer risk relative to drinking at older ages (8,51) These previous studies have been conducted predominantly in white women, and different patterns of co-exposures such as reproductive behavior may underlie incon…”
BackgroundPre- and postoperative alcohol consumption in breast cancer patients: impact on early events
Simonsson, M., Markkula, A., Bendahl, P., Rose, C., Ingvar, C., & Jernström, H. (2014) · SpringerPlus · doi:10.1186/2193-1801-3-261 · Cited by 23
“Alcohol intake, both light and heavy drinking, is now identified as a risk factor for pre- and postmenopausal breast cancer (Singletary and Gapstur 2001; Hamajima et al. 2002; Pelucchi et al. 2011; Chen et al. 2011; Seitz et al. 2012).”
Moslehi, R., Freedman, E., Zeinomar, N., Veneroso, C. C., & Levine, P. H. (2016) · BMC Cancer · doi:10.1186/s12885-016-2369-z · Cited by 23
“established risk factor for non-inflammatory breast cancer [34–37] but has not been previously reported in association with the risk of IBC.”
BackgroundSobh, A., Loguinov, A. V., Stornetta, A., Balbo, S., Tagmount, A., Zhang, L., & Vulpe, C. D. (2019) · Toxicological Sciences · doi:10.1093/toxsci/kfz037 · Cited by 23
“, 2009; Yokoyama and Omori, 2003), liver (McKillop and Schrum, 2009), and breast cancer (Chen et al., 2011).”
BackgroundDietary patterns and risk of systemic lupus erythematosus in women
Tedeschi, S. K., Barbhaiya, M., Sparks, J. A., Karlson, E. W., Kubzansky, L. D., Roberts, A. L., Willett, W. C., Lü, B., & Costenbader, K. H. (2019) · Lupus · doi:10.1177/0961203319888791 · Cited by 23
Self-citationMediterranean diet and breast cancer risk: a narrative review
LAUDISIO, D., CASTELLUCCI, B., Barrea, L., PUGLIESE, G., Savastano, S., COLAO, A., & MUSCOGIURI, G. (2022) · Minerva Endocrinology · doi:10.23736/s2724-6507.20.03266-6 · Cited by 24
Fortner, R. T., Tworoger, S. S., Wu, T.-Y., & Eliassen, A. H. (2013) · Breast Cancer Research and Treatment · doi:10.1007/s10549-013-2673-0 · Cited by 22
Lifestyle Risk Factors for Breast Cancer in BRCA1/2‐Mutation Carriers Around Childbearing Age
van Erkelens, A., Derks, L., Sie, A. S., Egbers, L., Woldringh, G. H., Prins, J. B., Manders, P., & Hoogerbrugge, N. (2016) · Journal of Genetic Counseling · doi:10.1007/s10897-016-0049-4 · Cited by 22
Dose-Dependent Associations between Wine Drinking and Breast Cancer Risk - Meta-Analysis Findings
Chen, J., Zhu, H., Guo, Q., Zheng, S. S., Bao, X.-H., Sun, F., Qin, Q., Yang, X., Zhang, C., Cheng, H.-Y., et al. (2016) · Asian Pacific Journal of Cancer Prevention · doi:10.7314/apjcp.2016.17.3.1221 · Cited by 25
“Several epidemiological studies have demonstrated that alcohol consumption was associated with an increased risk of breast cancer (Smith-Warner et al., 1998; Corrao et al., 1999; Ellison et al., 2001; Singletary and Gapstur, 2001; Hamajima et al., 2002; Chen et al., 2011).”
BackgroundUsher‐Smith, J. A., Sharp, S. J., Luben, R., & Griffin, S. J. (2018) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-18-0400 · Cited by 22
Assi, N., Rinaldi, S., Viallon, V., Dashti, S. G., Dossus, L., Fournier, A., Cervenka, I., Kvaskoff, M., Fortner, R. T., Bergmann, M. M., et al. (2019) · International Journal of Cancer · doi:10.1002/ijc.32324 · Cited by 22
Vegetable-Fruit-Soybean Dietary Pattern and Breast Cancer: A Meta-Analysis of Observational Studies
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Sánchez-Bayona, R., Gea, A., Gardeazábal, I., Romanos-Nanclares, A., Martínez‐González, M. Á., Bes‐Rastrollo, M., Santisteban, M., & Toledo, E. (2020) · Nutrients · doi:10.3390/nu12030731 · Cited by 21
“This is slightly lower than the previously reported associated risk [9] and may be due to a higher adherence to a Mediterranean alcohol‐drinking pattern [6].”
BackgroundInfluentialTeissèdre, P., Rasines-Perea, Z., Ruf, J.-C., Stockley, C. S., Antoce, A. O., Romano, R., Fradera, U., & Kosti, R. I. (2020) · OENO One · doi:10.20870/oeno-one.2020.54.4.3569 · Cited by 23
“breast cancer has been shown in heavy drinkers compared to abstainers and light consumers (Longnecker, 1994; Fuchs et al., 1995; Swanson et al., 1997; Chen et al., 2011).”
BackgroundModerate Alcohol Consumption During Adult Life, Drinking Patterns, and Breast Cancer Risk
Cook, E. D. (2012) · Breast Diseases A Year Book Quarterly · doi:10.1016/j.breastdis.2012.06.010 · Cited by 21
Alcohol and Risk of Breast Cancer
Narod, S. A. (2011) · JAMA · doi:10.1001/jama.2011.1589 · Cited by 21
Llanos, A. A. M., Dumitrescu, R., Brasky, T. M., Liu, Z., Mason, J. B., Marian, C., Makambi, K. H., Spear, S. L., Kallakury, B., Freudenheim, J. L., et al. (2014) · Carcinogenesis · doi:10.1093/carcin/bgu219 · Cited by 21
Chen, C., Wang, W., Hsu, M., & Mochly‐Rosen, D. (2022) · Life · doi:10.3390/life12030348 · Cited by 18
“For example, the relative risk of breast cancer increases by about 10% with increasing alcohol intake of every 10 g per day [21,22].”
BackgroundAlcohol and Breast Cancer: Reconciling Epidemiological and Molecular Data
Zakhari, S., & Hoek, J. B. (2014) · Advances in experimental medicine and biology · doi:10.1007/978-3-319-09614-8_2 · Cited by 21
“An update of the Nurses’ Health Study (1) was published in 2011 [ 17 ].”
Background
Metadata
- Authors
- Chen, W. Y., Rosner, B., Hankinson, S. E., Colditz, G. A., & Willett, W. C.
- Affiliations
- Brigham and Women's Hospital (US)
- Harvard University (US)
- Corresponding author
- Chen, Wendy Y.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2011-11-02
- Volume
- 306
- Issue
- 17
- Pages
- 1884
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC3292347
- OpenAlex
- W2062112003
- Cited by
- 509
- References
- 43
- Citations by year
- 2026: 23 · 2025: 20 · 2024: 29 · 2023: 32 · 2022: 28 · 2021: 43 · 2020: 34 · 2019: 45 · 2018: 21 · 2017: 30 · 2016: 46 · 2015: 46 · 2014: 32 · 2013: 32 · 2012: 41
- FWCI
- 24.98
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (P01CA087969, [P01 CA87969)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Oncology › Cancer Risks and Factors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- breast cancer risk, alcohol consumption, binge drinking, drinking frequency, moderate drinking, women, Nurses' Health Study
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Alcohol Drinking, Ethanol, Central Nervous System Stimulants, Breast Neoplasms, Dose-Response Relationship, Drug, Estrogens, Female, Humans, Middle Aged, Prospective Studies, Receptors, Estrogen, Risk Assessment, Young Adult
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