Study: Alcohol and breast cancer risk in African American women
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STUDY AT A GLANCE
This study is about:
The link between alcohol and breast cancer risk in African American women.
Why is this study important?
Alcohol, like tobacco, is considered a “” that can cause cancer and fuel its growth.
Past research has shown that alcohol is a risk factor for breast cancer. But these studies have focused mostly on breast cancer risk in White women. Their are differences in breast cancer risk and mortality between women of different ethnic and racial groups. Compared to White women, African American (AA) women who develop breast cancer are more likely to have an aggressive type of cancer. For this reason, it is important for researchers to make sure that studies include a diverse group of participants.
This study looked at alcohol and breast cancer risk in African American women. The study found that similar to White women, increased alcohol consumption is associated with a greater risk of breast cancer. This is important because women may be able to lower their breast cancer risk by drinking less alcohol.
- Among African American women, drinking 7 or more alcoholic drinks per week increased the risk of breast cancer.
- Women who reported drinking 14 or more drinks per week were at the highest risk.
- Never drinkers also had an increased risk of breast cancer compared to light drinkers (0-4 drinks per week). This increased risk was statistically significant.
What does this mean for me?
Breast cancer rates are nearly identical for African American and White women. About 12.4% of women born today will develop breast cancer sometime during their lifetime. Similar to previous studies in White women, this study found evidence that alcohol also increases breast cancer risk in African American women. However, this increase is small. For those who drink 14 or more drinks per week, the data in this study suggests that their risk would increase by only 4%. While the observation that "never drinkers" in this study also had increased risk of breast cancer, the authors indicate that they did not have information on the reasons why women did not drink. Knowing this information, could have shed light on the increased risk observed among never drinkers. The good news is that, unlike age or family history, alcohol is a modifiable risk factor—it can be changed and controlled. If you are an AA woman concerned about your risk of breast cancer, you may want to consider reducing your alcohol intake.
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Williams LA, Olshan AF, Hong C, et al. “Alcohol Intake and Breast Cancer Risk in African American Women from the AMBER Consortium.” Cancer Epidemiology, Biomarkers & Prevention. May 2017; 26(5).
World Cancer Research Fund/American Institute for Cancer Research; Continuous Update Report: “Diet, Nutrition, Physical Activity and Breast Cancer 2017.”
FORCE receives funding from industry sponsors, including companies that manufacture cancer drugs, tests and devices. All XRAYS articles are written independently of any sponsor and are reviewed by members of our Scientific Advisory Board prior to publication to assure scientific integrity.
This article is relevant for:
African American women who would like to lower their breast cancer risk
This article is also relevant for:
People with a genetic mutation linked to cancer risk
Women under 45
Women over 45
Healthy people with average cancer risk
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IN-DEPTH REVIEW OF RESEARCH
Breast cancer survival rates differ between non-Hispanic White women and AA women, who are almost twice as likely to die of breast cancer by age 50. This difference may be due in part to the of cancer at diagnosis and the higher rates of in Black women. Because breast cancer survival rates are worse for AA women, and most breast cancer risk factors have been identified by studying White women, it is important to better understand the risk factors that contribute to increased risk in African American women.
A recent report from The World Cancer Research Fund/American Institute for Cancer Research Continuous Update Project (CUP) reveals how much daily drinking might impact breast cancer risk for both premenopausal and postmenopausal women. “Sipping an average of 10 grams of alcohol a day—equivalent to a small glass of wine, an 8-ounce beer or 1 ounce of hard liquor—is associated with a 5% increased breast cancer risk in premenopausal women and 9% increase in postmenopausal women”, said Dr. Anne McTiernan, a lead author of the new report and a cancer prevention researcher at the Fred Hutchinson Cancer Research Center in Seattle. The CUP report showed a significantly greater risk in breast cancer with increasing alcohol consumption for both groups, leading the CUP to conclude that alcoholic drinks probably contribute to risk of premenopausal breast cancer and may contribute even greater risk of postmenopausal breast cancer. However, the CUP report was based on data from studies of women in Europe and North America and risks were not broken down by race.
The results of another study (which is the featured study of this review) by Lindsay A. Williams colleagues were published in Cancer Epidemiology, Biomarkers & Prevention in May 2017. Researchers analyzed questionnaire data on alcohol intake and breast cancer diagnoses from 22,338 women from the African American Breast Cancer Epidemiology and Risk (AMBER) consortium.
Researchers of this study wanted to:
Determine if alcohol consumption increased breast cancer risk among African American women.
Population(s) looked at in the study:
This analysis included 22,338 African American women from the AMBER consortium, which consists of four large epidemiologic studies on breast cancer: the Carolina Breast Cancer Study, the Black Women's Health Study, the Multiethnic Cohort Study and the Women's Circle of Health Study. Each study measured alcohol intake via questionnaires. The current analysis included 5,108 cases of invasive breast cancer and 17,230 controls, of whom approximately 35% were current drinkers at interview. Forty-five percent of participants were never drinkers and 20.8% were past drinkers.
The association between the number of alcoholic drinks per week (dpw) and breast cancer was estimated using statistical analysis, adjusting for any potential (factor that may affect the relationship between variables being studied, i.e. oral contraceptive use). Results were analyzed by breast cancer subtype:
- Compared to light drinkers, women who reported drinking 14 or more dpw were 33% more likely to develop breast cancer.
- Women who drank 7 or more dpw were almost 40% more likely to develop triple negative disease.
- "Never drinkers," who made up 45% of all women in this study, were 12% more likely to develop breast cancer than light drinkers.
- Risk associated with alcohol intake did not vary significantly by oral contraceptive use, smoking status or menopausal status.
Women who previously drank alcohol but later stopped had lower risk than women who reported that they recently drank alcohol, suggesting that women may be able to reduce their breast cancer risk by reducing their alcohol consumption.
The analysis included relatively few women who drank heavily, making the findings less statistically significant. In addition, researchers did not have information on reasons for alcohol abstinence, which could shed light on the elevated risk observed among never drinkers in this study. The results of this study were derived by pooling data from 4 individual studies, and thus may be affected by differences between the studies. Finally, the results are likely impacted by (a participant’s ability to remember their alcohol consumption).
Among African American women, drinking 7 or more alcoholic drinks per week was associated with an increased risk of breast cancer, regardless of breast cancer subtype. According to the senior researcher, Melissa A. Troester, PhD, the results of this study indicate that the same risk factors that have been documented in previous research apply to Black women as well. "Alcohol is an important modifiable exposure, whereas many other risk factors are not," she said. "Women who are concerned about their risk of breast cancer could consider reducing levels of exposure."
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The American Cancer Society (ACS) guidelines on exercise, nutrition and weight for cancer prevention recommend the following:
Diet and nutrition
- Follow a healthy eating pattern, including:
- foods that are high in nutrients in amounts that help you get to and stay at a healthy body weight.
- a variety of vegetables, fiber-rich legumes (beans and peas), and whole fruits in a variety of colors. Consume at least 2½ to 3 cups of vegetables and 1½ to 2 cups of fruit each day, depending on your calorie requirements.
- whole grains rather than refined grains. At least half of the grains you eat should be whole grains.
- A healthy eating pattern that limits or does not include:
- red and processed meats.
- sugar-sweetened beverages.
- highly processed foods and refined grain products.
- It is best not to drink alcohol. People who choose to drink alcohol should:
- have no more than 1 drink per day (women) or 2 drinks per day (men).
- Exercise regularly.
- Adults should get at least 150 minutes of moderate-intensity activity (equal to a brisk walk) or 75 minutes of vigorous activity (heart rate is increased, breathing is faster and you are sweating) each week, preferably spread throughout the week.
- Physical activity has been shown to lower the risk of several types of cancer, including breast, endometrial, and colon. It also reduces the risk of other serious diseases such as diabetes and heart disease.
- Achieve and keep a healthy weight.
- Being overweight or obese is a risk factor for many cancers, including breast, colon, endometrial and pancreatic. You can control your weight through regular exercise and healthy eating.
Other experts, including the following, also provide guidelines for exercise, nutrition and health:
- The Academy of Nutrition and Dietetics
- The United States Office of Disease Prevention and Health Promotion
- The American Institute for Cancer Research
- What is my breast cancer risk?
- What are some ways I can lower that risk?
- Is it ok to drink one or two alcoholic beverages per week?
- Is there anything else I can do to lower my risk for breast cancer?
The following are studies focused on nutrition and cancer prevention.
- NCT04125914: HEALTH4Families: Optimizing a Weight Management and Health Behavior Intervention for BRCA+ and Families. This trial studies how well weight management and health behavior intervention lower the risk of cancer in patients with hereditary breast and ovarian cancer mutations or mutations.
- Energetics and Lifestyle in Inherited Syndromes (ELLIE’s Study). ELLIE’s Project is designed to look at factors, such as weight, Body Mass Index, metabolism, dietary habits and activity levels that may affect cancer risk in people with inherited mutations linked to cancer.
- NCT05094466: Parent and Family Obesity Intervention in Reducing Obesity Risk in Racial Ethnic Minority Families. This compares the effects of parent/caregiver-focused programs to family-focused programs in reducing obesity risk in racial ethnic minority families.
- NCT04374747: Fruit and Vegetable Intervention in Lactating Women to Reduce Breast Cancer Risk. This trial is for nursing mothers. This study will look to see if eating at least 8 to 10 daily servings of fruits and vegetables reduces breast cancer biomarkers.
- NCT03448003: Comprehensive Lifestyle Change To Prevent Breast Cancer. This trial looks at how well lifestyle changes work to prevent breast cancer. Premenopausal women 18 years and older with intact breast and ovaries are eligible.
- NCT03779867: Acute Exercise Intervention in Reducing Breast Cancer Risk in Healthy Participants (ACE). This trial at the Fred Hutchinson Cancer Research Center in Seattle studies how well acute exercise in healthy participants reduces the risk of breast cancer in healthy participants.
- NCT03550885: Diet Modulation of Bacterial Sulfur and Bile Acid Metabolism and Colorectal Cancer Risk. This study investigates colorectal cancer risk in African Americans who consume high amounts of taurine and saturated fat (e.g., animal-based diets) compared with those who consume low amounts of taurine and saturated fat (e.g., plant-based diets).
- NCT04192071: Virtual Human Delivered Nutrition Module for Colorectal Cancer Prevention. This study will develop and test an interactive nutrition module for use with colorectal cancer screening to learn which messages and graphics promote understanding of cancer risk and promote screening.
You can find a registered dietician in your area using the search tool from the Academy of Nutrition and Dietetics.
Who covered this study?
African American women not immune to alcohol-breast cancer link This article rates 4.5 out of 5 stars
Alcohol is associated with higher risk of breast cancer in African-American women This article rates 3.5 out of 5 stars
The link between alcohol and breast cancer Is stronger This article rates 1.5 out of 5 stars
Nature World News
Alcohol linked to increased cases of breast cancer in African-American women This article rates 1.0 out of 5 stars