Saturday, December 18, 2010


Alcohol consumption did not influence the risk of hormone receptor-positive ductal carcinoma.

You have doubtless read some version of this from late this summer:

Women who averaged one alcoholic drink a day had almost double the risk of hormone-sensitive breast cancer of nondrinkers, data from the Women's Health Initiative (WHI) showed.

Alcohol consumption had a significant association with invasive breast cancer overall, invasive lobular carcinoma, and hormone receptor-positive tumors (P≤0.022), but the risk of receptor-negative breast cancer was unaffected.

The analysis, reported online in the Journal of the National Cancer Institute, also showed that the association between alcohol and hormone-sensitive breast cancer applied only to lobular invasive breast cancer and not to ductal invasive cancer.

Just a little lesson in journalism: log line: "almost double the risk" for ER+ cancers.

"Almost double" is a lot, for ER+ cancers: the vast majority of cancers of any type in premenopausal women.

Not until the third line do we learn does NOT apply to DCIS or anything originally arising in the duct, which over 90% of all cancers, and... invasive lobular... even fewer...

Oh, but look at this! It doesn't apply to anyone premenopause. And the findings are a bit klugy because they didn't correct for various types of hormone supplements and therapies. We know this only from the title of the real paper in the footnote:

Primary source: Journal of the National Cancer Institute
Source reference:
Li CI, et al "Alcohol consumption and risk of postmenopausal breast cancer by subtype: the Women's Health Initiative observational study" J Natl Cancer Inst 2010; DOI: 10.1093/jnci/djq316.

Going there we see the assumption that I am checking out:

Alcohol consumption is a well-established risk factor for breast cancer.

And some more facts -- again, for all postmenopausal women, not premenopausal women or postmenopausal women who have had breast cancer.

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.

So, a 2% risk increase in getting a type of cancer that one 5%-8% (per 10000 years? so is that .01%?... risk of 11% risk of getting. It is -- I think -- "background" risk -- all women are subject to this risk.

This said, they are thinking that there are distinctions in ways cancers are made (etiology), and this points that this is a way that -- some cancer survivors could be making a different cancer from the initial one.

What I am receiving is that definitely this is a risk that is there, but that it is a risk that when measured between "never having had a drink" and "drinking moderately" is small. And, unavoidable if you drank ever, especially even in teens and 20s, and even moderately.

This, on the surface (I haven't read about the topic), seems to indicate that this might explain why red wine isn't quite as good for women as men.

From Mayo:

In fact, if you're a woman and drink alcohol, talk to your doctor about taking supplemental folate to help reduce the risk of breast cancer associated with alcohol use. UNLESS YOU DON"T WANT TO INCREASE YOUR RISK OF ER- BREAST CANCERS... FOLIATE has as a direct tie to ER- breast cancer.

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