What’s the Real Deal on Breast Cancer and Drinking Alcohol?

The holiday celebrations are right around the corner, so here is something to think about as you pop that champagne. This question often comes up when I am hanging out with my breasties (what I call my breast cancer survivor friends). I adore them, so I am always focused on how we can all keep ourselves healthy. I also want to make sure that our friends that aren’t in this “pink club” don’t get breast cancer.

Over 100 studies have been conducted to evaluate the association between alcohol consumption and breast cancer risk in women. All of them have consistently found an increased risk of breast cancer associated with drinking alcohol.

According to the American Society of Clinical Oncology, for women who have not had breast cancer, just one drink per day (or seven per week), raised the risk for premenopausal breast cancer by 5 percent and postmenopausal breast cancer by 9 percent. If a woman has a family history, these risk numbers could even be higher. “Compared to women who don’t drink at all, women who have three alcoholic drinks per week have a 15 percent higher risk of breast cancer. Experts estimate that the risk of breast cancer goes up another 10 percent for each additional drink women regularly have each day,” according to BreastCancer.org.

A Life After Cancer Epidemiology study found that for breast cancer survivors diagnosed after menopause, those who drank four or more alcoholic beverages per week had a 19 percent recurrence rate compared to non-drinkers. Among survivors who had estrogen receptor-positive breast cancers, those who drank seven or more drinks a week had a 28 percent increased risk of late breast cancer recurrence (five years or more after diagnosis). 

According to research conducted by the African American Breast Cancer Epidemiology and Risk Consortium, African American women who drink seven or more alcoholic beverages per week have an increased risk of developing breast cancer. Their risk increases to 33 percent if they drink 14 or more alcoholic beverages each week.

A study conducted by Fred Hutch epidemiologist Christopher Li did not find an association between moderate alcohol drinking after a breast cancer diagnosis and death. However, “one drink a day and your breast cancer risk goes up about 10 percent. Two drinks a day, it goes up 20 percent. Women who imbibe are particularly at risk for estrogen-receptor-positive, or ER+ breast cancer, since studies have shown that alcohol increases the level of estrogen in postmenopausal women.” Li said. “Moderation is very important, but our study supports previous studies in suggesting that the occasional glass of wine does not seem to impact a woman’s risk of dying of breast cancer.”

And for my Pink Sisters living with metastatic breast cancer, we could not find data about drinking alcohol to support a position specifically for these women. This is most likely because there are so many variables to consider.

So why does drinking alcohol have a negative effect? Here’s what we found:

• Alcohol can increase levels of estrogen and other hormones associated with hormone-receptor-positive breast cancer. Alcohol also may increase breast cancer risk by damaging DNA in cells. 
• Alcohol users are more likely to have increased amounts of folic acid in their systems, which can lead to increased cancer risk.
• Alcohol is empty calories and can lead to unwanted weight gain. Excess fat can lead to increased cancer risk.
• Drinking alcohol may weaken the body’s ability to process and absorb important nutrients, including vitamins A, C, D, and E and folate and carotenoids.

When I bring up this topic among friends, they always respond with, “Isn’t red wine good for you?” Well, the ASCO data says, “Do not make an exception for red wine. There is no clear evidence that drinking red wine helps to prevent cancer. Thus, the current recommended limits also apply to red wine.”

My trusted doc friend, Karen Godette, M.D., medical director of radiation oncology at Emory University Midtown Hospital, said, “The relationship between alcohol and breast cancer is not clearly understood and can be affected by many factors such as nutrition, menopausal status, hormone receptor status and the age that the patient starts drinking. The bottom line is that one drink per day is probably safe, but three drinks per week lowers breast cancer risk even more.  No alcohol is best, but not absolutely necessary.”

So that’s the story. Just remember, the risks are real and breast cancer is no joke for African American women. We are dying at a 42 percent higher rate than white women. As for me, I will continue to be the one saying, “Don’t drink; I love you” to my breasties. You have only one body. Breast cancer should not be a death sentence. Early detection is our best protection.  

And, as always, check the breasts that you love. I know you have a pair!