Alcohol, Postmenopausal Hormone Therapy, and Breast Cancer. Ann Intern Med. 2002;137:I-43. doi: 10.7326/0003-4819-137-10-200211190-00003
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Published: Ann Intern Med. 2002;137(10):I-43.
Women who drink alcohol have a higher risk for breast cancer than women who do not drink alcohol. Some scientists think that this is because alcohol affects female hormones, such as estrogen, that are related to breast cancer risk. Women who take estrogen after menopause (postmenopausal hormone therapy) have a higher risk for breast cancer than women who do not use postmenopausal estrogen. However, the combined effect of drinking alcohol and taking postmenopausal hormones is poorly understood. Since both drinking alcohol and taking hormones are risk factors that women can control, it is important to know about the relationships between these factors and breast cancer risk.
To find out whether the combined use of alcohol and postmenopausal hormones puts women at higher risk for breast cancer than either of these risk factors alone.
44,187 postmenopausal nurses who were participating in the Nurses' Health Study, a large study of health issues affecting women.
The Nurses' Health Study mailed questionnaires to participating nurses every 2 years to collect information related to their health. In this analysis, the researchers used 1980–1994 survey information on alcohol use, postmenopausal hormone use, and breast cancer diagnoses. The researchers compared the frequency of breast cancer in women who drank alcohol, women who used postmenopausal hormones, and women who used both.
Of the 44,187 nurses, 1722 developed breast cancer during the study years. Women who used postmenopausal hormones for 5 years or longer and drank no alcohol had about a 30% higher risk for breast cancer than women who used neither. Women who drank at least 20 grams of alcohol per day but used no hormones also had about a 30% higher risk for breast cancer than women who used neither. Women who both drank more than 20 grams of alcohol per day and used postmenopausal hormones for at least 5 years had almost twice the risk for breast cancer as women who used neither. The researchers calculated grams of alcohol from women's reported intake of beverages as 12.8 grams of alcohol per 12-ounce serving of beer, 11 grams per 4-ounce serving of wine, and 14 grams per standard serving of spirits.
This study was based on women's reports of hormone use and alcohol intake and on breast cancer diagnosis. The accuracy of their reports of alcohol and postmenopausal hormone use is not known. In addition, this study did not separate the various types of hormone regimens (for example, estrogen alone or with progesterone).
Women who are making decisions about alcohol and postmenopausal hormone use should consider the associated risks for breast cancer. Of course, they will also need to factor the potential protective effects of small amounts of alcohol on cardiovascular disease into their decisions.
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Hematology/Oncology, Breast Cancer.
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