Alcohol link to breast cancer recurrence
 

http://news.bbc.co.uk/2/hi/health/8406273.stm

Hopeful

Re: Alcohol link to breast cancer recurrence
 

Okay, now I'm feeling scared as we're in Orlando and last night we consumed almost an entire bottle of Pinot Noir with dinner and then I saw HLN reporting on Kaiser Permanente's study this morning and immediately went to the her2 site and read Hopeful's posting.

My husband loves wine and buys it weekly and I have a glass with dinner. I hope I haven't hurt myself in the process.

Re: Alcohol link to breast cancer recurrence
 

Vic,

For what it's worth, wine tasting and collecting are my hobby and my passion. Almost every vacation I take is centered around visiting a wine growing region and meeting with the wine growers, touring vineyards, etc. Through my SO, I also get to a lot of trade events. Mind you, at these mega events and on trips, you have to spit the wine out, not drink it down. I do have a sizeable cellar and have wine with dinner 2 to 3 times per week. All of my docs (internist, onc, rads onc, surgeon) are aware of it, and none have ever told me to do anything differently - they are all interested in the details of the places I have been and things I have seen.

I think this info, like a lot of other things we read about diet and supplements, is still a ways out from being a solid predictor for any one individual. I know it is an area of interest, so I make it a point to post any studies I see related to the topic. Don't beat yourself up over it. If you think these results are important enough to change your lifestyle, all you can change is what you do going forward.

Best of luck to you,

Hopeful

Re: Alcohol link to breast cancer recurrence
 

Thanks, Hopeful, I truly appreciate your personal experiences and advice. I won't beat myself up anymore, but simply use a bit more reservation with decision to order or have a glass of wine, respecting and appreciating my choice when I do.

What an awesome field of interest you have (what does "Through my SO" mean?) and I'm sure a very nice wine collection and a cellar to be coveted by many. I'm sure you've enjoyed some wonderful vacations, with the combination of the beauty of the vineyards, the great food and interesting people all a part of it. I live in California and have been to Sonoma and Napa. I also visited the Provence region of France, which was quite nice. Do you enjoy Paul Hobbs? There was wine we had recently from South America with a different label, but a Paul Hobbs connection, that was very good.

I appreciate your input in this area and plan to enjoy a glass once or twice a week, which I think will give me enjoyment and peace of mind. Thanks, Hopeful.

Vicki

Re: Alcohol link to breast cancer recurrence
 

Vic,

SO is shorthand for "significant other." I am almost 56 years old, and feel weird calling him my "boyfriend." We met through wine; he is in the retail wine and liquor business, and we enjoy doing this together. He is very lucky, in that his hobby is his work, and he enjoys it very much.

I do know of Paul Hobbs, and have tasted the wines a few times, but they are not on my regular list. I do love CA pinot noir and syrah, particularly Sonoma Coast. My area of expertise is in whites, with an emphasis on Germany, Alsace and Loire. I have visited Napa/Sonoma many times and always enjoy it. I have been to Germany 10 times, but not to France - when we looked into it, France was much more expensive to travel in. He has been there on business trips without me, and loved it. He has also been to Portugal and Italy for wine business. We are thinking about a vacation to northern Italy, to explore the wines there.

I think that Becky made some excellent points about the study in her response to you on the main board (she "gets" stats and surveys and is a good resource for their interpretation.) I am glad that you are feeling more relaxed for getting her input, and will continue to enjoy your occasional glass of wine.

Regards,

Hopeful

Re: Alcohol link to breast cancer recurrence
 

I've read a number of different reports on the BC-alcohol link but none have been clear about whether the general conclusions apply to HER2+ cancers. This latest report seems to suggest the link between alcohol and BC is in the way alcohol can affect circulating estrogen, so is there also a link with occurrence/recurrence of ER-/HER2+? And somewhere I read that folic acid supplements mitigate the risk . . . or am I just looking for an excuse to continue my imbibing?

Re: Alcohol link to breast cancer recurrence
 

Something I find confusing in this article is the statement:

"But alcohol consumption was not associated with overall mortality."

What does this mean---if you drink, you have a higher risk of recurrence but if you don't drink, your life expectacy is the same as a woman with BC who does drink?? This doesn't make sense to me.

Re: Alcohol link to breast cancer recurrence
 

Rather than guess, here is a link to the abstract, presented at SABCS this year, upon which the article was based: http://www.abstracts2view.com/sabcs0...9L_2214&terms=

There seems to be an increased risk of death among women who consume 6 g per day of alcohol or more.

Hopeful

Re: Alcohol link to breast cancer recurrence
 

This letter makes thought provoking reading.
http://alcalc.oxfordjournals.org/cgi...t/36/3/276.pdf

Re: Alcohol link to breast cancer recurrence
 

Very interesting letter. It would be interesting to see more research on this topic.

Re: Alcohol link to breast cancer recurrence
 

Hopeful,

My family came from Alsace, the Eglys. Have you ever tasted any of the Egly-Ouriet wines?

'lizbeth

Re: Alcohol link to breast cancer recurrence
 

http://www.clinicaloptions.com/Oncol.../Page%201.aspx

Alcohol and Breast Cancer Outcomes

Robert S. Mocharnuk, MD:
This expert analysis discussion will focus on clinically significant abstracts pertaining to breast cancer prognosis and prediction of response to breast cancer treatment, all of which were presented at the 2009 Annual AACR-CTRC San Antonio Breast Cancer Symposium. The outcomes of these studies have provided us further insights in understanding the biology of breast cancer and understanding whether patients will respond to treatments, both important factors in improving overall outcomes. We will begin by discussing several studies that focused on breast cancer risk factors.

William J. Gradishar, MD, FACP:
Kwan and colleagues[1] conducted a nonrandomized analysis of the prospective LACE cohort study[2] and found that consuming at least 3-4 alcoholic drinks (beer, wine, spirits) per week was independently associated with an increased risk of recurrence and breast cancer–related death in women previously diagnosed with early-stage breast cancer (Capsule Summary). In total, 1897 patients were included in the analysis. Alcohol consumption of ≥ 6.0 g/day was associated with a 34% increased risk of recurrence compared with a consumption of 0 g/day (P = .04).During a mean follow-up of 3-4 years, the researchers also found that that the association between alcohol consumption and recurrence was strongest among postmenopausal women and overweight/obese women, although no significant association between alcohol consumption and overall risk of death was observed. The findings indicate that women, particularly if postmenopausal or overweight/obese, should limit alcohol consumption following breast cancer diagnosis.

This is one of many reports in the literature highlighting a relationship between alcohol intake and increased risk or worse outcomes in breast cancer. The important take-home message from this study is that the findings are interesting, but this type of study is exceedingly difficult to perform in terms of trying to obtain accurate information and account for confounders that could influence risk of recurrence. Clearly, there is always a risk of under-reporting, both with respect to alcohol intake and dietary factors. Notably, the amount of alcohol that was correlated with an increased risk of recurrence was quite modest, which may reflect under-reporting in the study. In addition, confounders could have influenced the results. Therefore, in my opinion, this study does not change clinical practice or how we might counsel patients; however, it does suggest that, as with other things, moderation is key.

Paul E. Goss, MD, PhD, FRCPC, FRCP:
I agree with Dr. Gradishar. The investigators reported a hazard ratio of 1.42, which reflects the increased risk between an intake of < 0.5 g vs > 6.0 g. This is a comparison between the very upper end of a range vs the lowest, and only a modest increase in the hazard ratio for risk was observed. There are many lifestyle risk factors that increase the risk of breast cancer from a hazard ratio of between 1.0 and 2.0 in this type of study. Alcohol intake is only one of them. I agree that the clinical implications of these findings are unclear given the potential confounders and statistical variables that may be present in this study. These data are interesting, but should not impact clinical practice at this point.

Daniel F. Hayes, MD:
It seems we all agree that these findings are plausible and consistent with previous findings.We could also agree that these findings may help support a biological mechanism between alcohol and breast cancer—specifically, many believe that the link is probably related to estrogen metabolism, although this has been hard to prove. However, a third point is whether the findings should influence clinical practice. This is the kind of study that will prompt patients to ask, “Should I quit drinking?” I tell my patients that they should not quit drinking because of the study, but that drinking in moderation is appropriate relative to a variety of health issues, including breast cancer outcomes. A glass of wine occasionally is fine, although of course heavy alcohol use has many health consequences including those related to breast cancer outcomes and should be avoided.

Hopeful

Re: Alcohol link to breast cancer recurrence
 

Thanks for that post, Hopeful.

Alcohol is a source of empty calories. Low consumption = fewer calories. Greater consumption = greater caloric intake, and greater caloric intake + slower metabolism leads to weight gain.

The weight gain itself would seem to be the culprit, with alcohol just being a strong contributor for those with a slower metabolism brought on by chemopause.

Re: Alcohol link to breast cancer recurrence
 

Thanks, Hopeful, for posting more on this interesting topic!

Vicki