Breast cancer risk from alcohol reassessed

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Way back when say, in 2003 we thought we had all the information about risk factors for breast cancer that we needed, or at least that we were going to get. These included: early onset of menstruation, few (or no) full-term pregnancies, strong family history of the disease (especially those with the BRCA mutations), postmenopausal obesity, and advancing age, most prominently. The question of how much of a risk if any is posed by hormone therapy remains a puzzle, whose final outcome is pending.

Then about 10 years ago, news came from researchers indicating that alcohol, even in moderation, also increased the incidence of breast cancer. Some studies indicated that even 2-3 drinks daily raised the risk by 10-20 percent. Then, only three years ago, a newrisk factor was characterized: breast density. Women with particularly dense breasts meaning with greater concentration of fibro-glandular tissue which appears grey-white on mammograms got a double whammy: not only do dense breasts confer a higher risk of breast cancer, but the lighter shadowing pattern on mammograms make true cancers harder to detect. In fact, women with dense breasts are often advised to get an extra diagnostic test, such as an MRI; some states have even passed laws requiring doctorswho receive a mammogram report of dense breasts to share that information with the patient.

All these risks for breast cancer certainly amount to reason for concern among women, yet with few exceptions the risks are not susceptible to proactive intervention. One cannot change family history, age at menarche, or breast density, for example. Weight loss after menopause, while possible, is frightfully difficult, even with inspiration aimed at reducing the risk of cancer. One modifiable factor: alcohol intake. But now, research has yielded a new perspective: it appears that moderate alcohol intake may well not be of importance for the development of breast cancer after all. A new commentary report from the National Institute on Alcohol Abuse and Alcoholism re-assesses the suspected link between moderate alcohol ingestion and breast cancer.

Understanding how and when alcohol consumption increases breast cancer risk is important for a full understanding of how moderate alcohol drinking impacts women s overall health, says Philip J. Brooks, Ph.D., program officer in the NIAAA Division of Metabolism and Health Effects. He went on to explain that both the time course and drinking pattern must be considered in relating alcohol drinking to breast cancer risk. In other words, current or recent drinking patterns do not contribute as much as previous lifelong patterns: women who drank heavily in the past or binge drink have a significantly increased cancer risk, even if their current usage is reduced. On the other hand, women who drink only moderately throughout their adult life do not actually have an increased risk. Besides the obvious concerns about drinking and breast cancer, there is substantial evidence that moderate drinking confers various health benefits, especially relevant for heart and vascular benefits.

So avoiding an occasional cocktail may not only add to a woman s daily worries needlessly, but actually detracts from her overall health.