Alcohol consumption and risk of postmenopausal breast cancer by subtype: The Women's health initiative observational study

Christopher I. Li, Rowan T. Chlebowski, Matthew Freiberg, Karen C. Johnson, Lewis Kuller, Dorothy Lane, Lawrence Lessin, Mary Jo O'Sullivan, Jean Wactawski-Wende, Shagufta Yasmeen, Ross Prentice

Research output: Contribution to journalArticle

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Abstract

Background Alcohol consumption is a well-established risk factor for breast cancer. This association is thought to be largely hormonally driven, so alcohol use may be more strongly associated with hormonally sensitive breast cancers. Few studies have evaluated how alcohol-related risk varies by breast cancer subtype. Methods We assessed the relationship between self-reported alcohol consumption and postmenopausal breast cancer risk among 87724 women in the Women's Health Initiative Observational Study prospective cohort from 1993 through 1998. Multivariable adjusted Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). All statistical tests were two-sided. Results A total of 2944 invasive breast cancer patients were diagnosed during follow-up through September 15, 2005. In multivariable adjusted analyses, alcohol consumption was positively related to risk of invasive breast cancer overall, invasive lobular carcinoma, and hormone receptor-positive tumors (all Ptrend ≤. 022). However, alcohol consumption was more strongly related to risk of certain types of invasive breast cancer compared with others. Compared with never drinkers, women who consumed seven or more alcoholic beverages per week had an almost twofold increased risk of hormone receptor-positive invasive lobular carcinoma (HR = 1.82; 95% CI = 1.18 to 2.81) but not a statistically significant increased risk of hormone receptor-positive invasive ductal carcinoma (HR = 1.14; 95% CI = 0.87 to 1.50; difference in HRs per drink per day among current drinkers = 1.15; 95% CI = 1.01 to 1.32, P =. 042). The absolute rates of hormone receptor-positive lobular cancer among never drinkers and current drinkers were, 5.2 and 8.5 per 10000 person-years, respectively, whereas for hormne receptor-positive ductal cancer they were 15.2 and 17.9 per 10000 person-years, respectively. ConclusionsAlcohol use may be more strongly associated with risk of hormone-sensitive breast cancers than hormone-insensitive subtypes, suggesting distinct etiologic pathways for these two breast cancer subtypes.

Original languageEnglish
Pages (from-to)1422-1431
Number of pages10
JournalJournal of the National Cancer Institute
Volume102
Issue number18
DOIs
StatePublished - Sep 22 2010
Externally publishedYes

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Women's Health
Alcohol Drinking
Observational Studies
Breast Neoplasms
Hormones
Confidence Intervals
Lobular Carcinoma
Alcohols
Alcoholic Beverages
Neoplasms
Ductal Carcinoma
Proportional Hazards Models

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Alcohol consumption and risk of postmenopausal breast cancer by subtype : The Women's health initiative observational study. / Li, Christopher I.; Chlebowski, Rowan T.; Freiberg, Matthew; Johnson, Karen C.; Kuller, Lewis; Lane, Dorothy; Lessin, Lawrence; O'Sullivan, Mary Jo; Wactawski-Wende, Jean; Yasmeen, Shagufta; Prentice, Ross.

In: Journal of the National Cancer Institute, Vol. 102, No. 18, 22.09.2010, p. 1422-1431.

Research output: Contribution to journalArticle

Li, CI, Chlebowski, RT, Freiberg, M, Johnson, KC, Kuller, L, Lane, D, Lessin, L, O'Sullivan, MJ, Wactawski-Wende, J, Yasmeen, S & Prentice, R 2010, 'Alcohol consumption and risk of postmenopausal breast cancer by subtype: The Women's health initiative observational study', Journal of the National Cancer Institute, vol. 102, no. 18, pp. 1422-1431. https://doi.org/10.1093/jnci/djq316
Li, Christopher I. ; Chlebowski, Rowan T. ; Freiberg, Matthew ; Johnson, Karen C. ; Kuller, Lewis ; Lane, Dorothy ; Lessin, Lawrence ; O'Sullivan, Mary Jo ; Wactawski-Wende, Jean ; Yasmeen, Shagufta ; Prentice, Ross. / Alcohol consumption and risk of postmenopausal breast cancer by subtype : The Women's health initiative observational study. In: Journal of the National Cancer Institute. 2010 ; Vol. 102, No. 18. pp. 1422-1431.
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abstract = "Background Alcohol consumption is a well-established risk factor for breast cancer. This association is thought to be largely hormonally driven, so alcohol use may be more strongly associated with hormonally sensitive breast cancers. Few studies have evaluated how alcohol-related risk varies by breast cancer subtype. Methods We assessed the relationship between self-reported alcohol consumption and postmenopausal breast cancer risk among 87724 women in the Women's Health Initiative Observational Study prospective cohort from 1993 through 1998. Multivariable adjusted Cox regression models were used to calculate hazard ratios (HRs) and 95{\%} confidence intervals (CIs). All statistical tests were two-sided. Results A total of 2944 invasive breast cancer patients were diagnosed during follow-up through September 15, 2005. In multivariable adjusted analyses, alcohol consumption was positively related to risk of invasive breast cancer overall, invasive lobular carcinoma, and hormone receptor-positive tumors (all Ptrend ≤. 022). However, alcohol consumption was more strongly related to risk of certain types of invasive breast cancer compared with others. Compared with never drinkers, women who consumed seven or more alcoholic beverages per week had an almost twofold increased risk of hormone receptor-positive invasive lobular carcinoma (HR = 1.82; 95{\%} CI = 1.18 to 2.81) but not a statistically significant increased risk of hormone receptor-positive invasive ductal carcinoma (HR = 1.14; 95{\%} CI = 0.87 to 1.50; difference in HRs per drink per day among current drinkers = 1.15; 95{\%} CI = 1.01 to 1.32, P =. 042). The absolute rates of hormone receptor-positive lobular cancer among never drinkers and current drinkers were, 5.2 and 8.5 per 10000 person-years, respectively, whereas for hormne receptor-positive ductal cancer they were 15.2 and 17.9 per 10000 person-years, respectively. ConclusionsAlcohol use may be more strongly associated with risk of hormone-sensitive breast cancers than hormone-insensitive subtypes, suggesting distinct etiologic pathways for these two breast cancer subtypes.",
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AU - Li, Christopher I.

AU - Chlebowski, Rowan T.

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AU - Johnson, Karen C.

AU - Kuller, Lewis

AU - Lane, Dorothy

AU - Lessin, Lawrence

AU - O'Sullivan, Mary Jo

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AU - Yasmeen, Shagufta

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N2 - Background Alcohol consumption is a well-established risk factor for breast cancer. This association is thought to be largely hormonally driven, so alcohol use may be more strongly associated with hormonally sensitive breast cancers. Few studies have evaluated how alcohol-related risk varies by breast cancer subtype. Methods We assessed the relationship between self-reported alcohol consumption and postmenopausal breast cancer risk among 87724 women in the Women's Health Initiative Observational Study prospective cohort from 1993 through 1998. Multivariable adjusted Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). All statistical tests were two-sided. Results A total of 2944 invasive breast cancer patients were diagnosed during follow-up through September 15, 2005. In multivariable adjusted analyses, alcohol consumption was positively related to risk of invasive breast cancer overall, invasive lobular carcinoma, and hormone receptor-positive tumors (all Ptrend ≤. 022). However, alcohol consumption was more strongly related to risk of certain types of invasive breast cancer compared with others. Compared with never drinkers, women who consumed seven or more alcoholic beverages per week had an almost twofold increased risk of hormone receptor-positive invasive lobular carcinoma (HR = 1.82; 95% CI = 1.18 to 2.81) but not a statistically significant increased risk of hormone receptor-positive invasive ductal carcinoma (HR = 1.14; 95% CI = 0.87 to 1.50; difference in HRs per drink per day among current drinkers = 1.15; 95% CI = 1.01 to 1.32, P =. 042). The absolute rates of hormone receptor-positive lobular cancer among never drinkers and current drinkers were, 5.2 and 8.5 per 10000 person-years, respectively, whereas for hormne receptor-positive ductal cancer they were 15.2 and 17.9 per 10000 person-years, respectively. ConclusionsAlcohol use may be more strongly associated with risk of hormone-sensitive breast cancers than hormone-insensitive subtypes, suggesting distinct etiologic pathways for these two breast cancer subtypes.

AB - Background Alcohol consumption is a well-established risk factor for breast cancer. This association is thought to be largely hormonally driven, so alcohol use may be more strongly associated with hormonally sensitive breast cancers. Few studies have evaluated how alcohol-related risk varies by breast cancer subtype. Methods We assessed the relationship between self-reported alcohol consumption and postmenopausal breast cancer risk among 87724 women in the Women's Health Initiative Observational Study prospective cohort from 1993 through 1998. Multivariable adjusted Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). All statistical tests were two-sided. Results A total of 2944 invasive breast cancer patients were diagnosed during follow-up through September 15, 2005. In multivariable adjusted analyses, alcohol consumption was positively related to risk of invasive breast cancer overall, invasive lobular carcinoma, and hormone receptor-positive tumors (all Ptrend ≤. 022). However, alcohol consumption was more strongly related to risk of certain types of invasive breast cancer compared with others. Compared with never drinkers, women who consumed seven or more alcoholic beverages per week had an almost twofold increased risk of hormone receptor-positive invasive lobular carcinoma (HR = 1.82; 95% CI = 1.18 to 2.81) but not a statistically significant increased risk of hormone receptor-positive invasive ductal carcinoma (HR = 1.14; 95% CI = 0.87 to 1.50; difference in HRs per drink per day among current drinkers = 1.15; 95% CI = 1.01 to 1.32, P =. 042). The absolute rates of hormone receptor-positive lobular cancer among never drinkers and current drinkers were, 5.2 and 8.5 per 10000 person-years, respectively, whereas for hormne receptor-positive ductal cancer they were 15.2 and 17.9 per 10000 person-years, respectively. ConclusionsAlcohol use may be more strongly associated with risk of hormone-sensitive breast cancers than hormone-insensitive subtypes, suggesting distinct etiologic pathways for these two breast cancer subtypes.

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