Ask the Doctors - Can alcohol affect risk of breast cancer recurrence?

Dr. Robert Ashley, MD

Dear Doctor: I read your recent response to a question about alcohol consumption and its correlation to breast cancer. But what about the risk once you've been diagnosed? I was recently diagnosed with breast cancer and have completed radiation. I am on medication and have a very positive prognosis. I enjoy a glass of wine occasionally and am wondering if I should continue doing this. You talked about two units of alcohol every three or four days as being acceptable. What exactly are two units, and would this be OK for someone in my situation?

Dear Reader: For those who missed my previous column, let me repeat: The relationship between alcohol consumption and breast cancer has been studied multiple times, and there does appear to be a link. Studies have shown that this link is dose-responsive, meaning the more you drink, the greater the risk of developing breast cancer. The correlation between breast cancer and heavy or binge drinking is the most definite.

In the prior article, I also referred to a positive benefit of alcohol for women, in that research has found that having one drink (two units of alcohol) every three to four days was linked to a significant decrease -- 17 percent -- in death during the course of one study.

As for whether there is an association between alcohol consumption and cancer recurrence or a new cancer after a breast cancer diagnosis, that has been studied as well. A 2016 article in the journal Cancer Treatment Reviews analyzed results from 16 studies to assess breast cancer risk and alcohol consumption in women who had previously been diagnosed with breast cancer. Eleven of the studies looked at recurrence of the original breast cancer, and five studies looked at another new breast cancer developing. The women in the studies were followed for five to 18 years.

Some studies showed no correlation, but the results of the combined studies did show a small connection between alcohol intake and a recurrence of breast cancer. The correlation was found even among those who drank one unit of wine every day -- that's half a standard glass, to answer your question about units of wine. Alcohol also had a greater effect upon women after menopause and women who were obese. However, the five studies that looked at new breast cancers did not show an effect from alcohol.

It is difficult to make an overarching conclusion from this data, but there does appear to be some correlation between alcohol and an increased risk of breast cancer recurrence. However, this correlation was not seen in women who drank alcohol less frequently then one drink every other day. So in regard to breast cancer, it's likely safe to have a glass of wine (two units of alcohol) every three days, as this amount doesn't seem to be linked to an increased risk of new or recurrent breast cancer.

But please make sure to continue your regular follow-ups of evaluations with mammograms.

Make an appointment with UCLA Breast Health to receive personalized, multidisciplinary breast health care in a compassionate and supportive environment.

Robert Ashley, MD, is an internist and assistant professor of medicine at the University of California, Los Angeles.

Ask the Doctors is a syndicated column first published by UExpress syndicate.