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ARTICLE

Use of Postmenopausal Hormones, Alcohol, and Risk for Invasive Breast Cancer

Wendy Y. Chen, MD, MPH; Graham A. Colditz, MBBS, DrPH; Bernard Rosner, PhD; Susan E. Hankinson, ScD; David J. Hunter, MBBS, ScD; JoAnn E. Manson, MD, DrPH; Meir J. Stampfer, MD, DrPH; Walter C. Willett, MD, DrPH; and Frank E. Speizer, MD

19 November 2002 | Volume 137 Issue 10 | Pages 798-804

Background: Physiologic evidence suggests that use of alcohol increases the risk for breast cancer through a hormonal mechanism, but the relationship among breast cancer, alcohol, and postmenopausal hormones (PMH) remains unclear.

Objective: To examine the relation between concurrent use of alcohol and PMH and invasive breast cancer.

Design: Prospective cohort study

Setting: Nurses' Health Study.

Participants: 44 187 postmenopausal women.

Measurements: Self-reported data on PMH use and breast cancer obtained from biennial questionnaires completed from 1980 to 1994 and average alcohol consumption in 1980, 1984, 1986, and 1990.

Results: 1722 women developed invasive breast cancer. Risk for breast cancer was elevated in women who currently used PMH for 5 or more years and did not drink alcohol (relative risk, 1.32 [95% CI, 1.05 to 1.66]) and those who never used PMH but drank 20 or more g (1.5 to 2 drinks) of alcohol daily (relative risk, 1.28 [CI, 0.97 to 1.69]). Current users of PMH for 5 or more years who consumed 20 or more g of alcohol daily had a relative risk for breast cancer nearly twice (1.99 [CI, 1.42 to 2.79]) that of nondrinking nonusers of PMH. A hypothetical postmenopausal woman whose lifetime risk for breast cancer is 4% could increase her risk to 8% with 5 or more years of current PMH use and consumption of more than one alcoholic drink daily.

Conclusions: Both alcohol consumption and PMH use were associated with an increased incidence of breast cancer. Women who are currently taking PMH may want to consider the added risks of regular alcohol consumption.

Editors' Notes Context Evidence links alcohol and breast cancer and suggests a hormonal mechanism. However, the relationships between alcohol, postmenopausal hormone use, and breast cancer are unclear. Contribution Using self-reported data from a cohort of nurses, this study showed that 1.5 drinks/d and 5 years of postmenopausal hormone replacement therapy are associated with increased risk for breast cancer. The relative risk for breast cancer was 1.32 for postmenopausal hormones alone, 1.28 for alcohol alone, and 1.99 for both. Implications Women should consider increased risk for breast cancer when deciding about drinking alcohol, taking postmenopausal hormones, and, especially, both together. –The Editors

 

Author and Article Information

From Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School, and Dana Farber Cancer Institute, Boston, Massachusetts.

Acknowledgments: The authors thank the participants in the Nurses' Health Study for their continuing dedication and commitment and Karen Corsano, MA, and Barbara Egan for assistance.

Grant Support: By research grant CA40356 from the National Institutes of Health. Dr. Chen was supported by a training grant in the Harvard Education Program in Cancer Prevention Control (5-R25-CA577011-08).

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Wendy Y. Chen, MD, MPH, Channing Laboratory, 181 Longwood Avenue, Boston, MA 02115.

Current Author Addresses: Drs. Chen, Colditz, Rosner, Hankinson, Hunter, Manson, Stampfer, Willett, and Speizer: Channing Laboratory, 181 Longwood Avenue, Boston, MA 02115.

Author Contributions: Conception and design: W.Y. Chen, G.A. Colditz, B. Rosner, W.C. Willett.

Analysis and interpretation of the data: W.Y. Chen, G.A. Colditz, B. Rosner, S.E. Hankinson, D.J. Hunter, J.E. Manson, M.J. Stampfer, W.C. Willett, F.E. Speizer.

Drafting of the article: W.Y. Chen, G.A. Colditz.

Critical revision of the article for important intellectual content: W.Y. Chen, G.A. Colditz, B. Rosner, S.E. Hankinson, D.J. Hunter, J.E. Manson, M.J. Stampfer, W.C. Willett, F.E. Speizer.

Final approval of the article: W.Y. Chen, G.A. Colditz, B. Rosner, S.E. Hankinson, D.J. Hunter, J.E. Manson, M.J. Stampfer, W.C. Willett, F.E. Speizer.

Statistical expertise: B. Rosner, W.C. Willett.

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Alcohol, Postmenopausal Hormone Therapy, and Breast Cancer

Annals 2002 137: I-43. [Full Text]  

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Alcohol, Postmenopausal Hormones, and Breast Cancer
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Annals 2003 139: 601-602. [Full Text]  

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