Author Affiliations: Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign (Dr Singletary); and Department of Preventive Medicine, Northwestern University Medical School, Chicago, Ill (Dr Gapstur).
The association of alcohol consumption with increased risk for breast
cancer has been a consistent finding in a majority of epidemiologic studies
during the past 2 decades. Herein, we summarize information on this association
from human and animal investigations, with particular reference to epidemiologic
data published since 1995. Increased estrogen and androgen levels in women
consuming alcohol appear to be important mechanisms underlying the association.
Other plausible mechanisms include enhanced mammary gland susceptibility to
carcinogenesis, increased mammary carcinogen DNA damage, and greater metastatic
potential of breast cancer cells, processes for which the magnitude likely
depends on the amount of alcohol consumed. Susceptibility to the breast cancer–enhancing
effect of alcohol may also be affected by other dietary factors (such as low
folate intake), lifestyle habits (such as use of hormone replacement therapy),
or biological characteristics (such as tumor hormone receptor status). Additional
progress in understanding alcohol's enhancing effect on breast cancer will
depend on a better understanding of the interactions between alcohol and other
risk factors and on additional insights into the multiple biological mechanisms
Singletary KW, Gapstur SM. Alcohol and Breast Cancer: Review of Epidemiologic and Experimental Evidence and Potential Mechanisms. JAMA. 2001;286(17):2143–2151. doi:10.1001/jama.286.17.2143
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