Alcohol Consumption Before and After Breast Cancer Diagnosis: Associations With Survival From Breast Cancer, Cardiovascular Disease, and Other Causes

被引:49
|
作者
Newcomb, Polly A. [1 ,2 ]
Kampman, Ellen [3 ]
Trentham-Dietz, Amy [2 ]
Egan, Kathleen M. [4 ]
Titus, Linda J. [5 ]
Baron, John A. [6 ]
Hampton, John M. [2 ]
Passarelli, Michael N. [1 ]
Willett, Walter C. [7 ,8 ]
机构
[1] Fred Hutchinson Canc Res Ctr, Seattle, WA 98109 USA
[2] Univ Wisconsin, Paul P Carbone Comprehens Canc Ctr, Madison, WI USA
[3] Wageningen Univ, NL-6700 AP Wageningen, Netherlands
[4] H Lee Moffitt Canc Ctr & Res Inst, Tampa, FL USA
[5] Norris Cotton Canc Ctr, Lebanon, NH USA
[6] Univ N Carolina, Lineberger Comprehens Canc Ctr, Chapel Hill, NC 27599 USA
[7] Harvard Univ, Sch Med, Boston, MA USA
[8] Brigham & Womens Hosp, Boston, MA 02115 USA
关键词
FOOD FREQUENCY QUESTIONNAIRE; PROGESTERONE-RECEPTOR STATUS; HORMONE REPLACEMENT THERAPY; NATIONAL DEATH INDEX; WOMENS HEALTH; RISK-FACTORS; POSTMENOPAUSAL WOMEN; MAMMOGRAPHIC DENSITY; PROGNOSTIC-FACTORS; PHYSICAL-ACTIVITY;
D O I
10.1200/JCO.2012.46.5765
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose Alcohol intake is associated with increased risk of breast cancer. In contrast, the relation between alcohol consumption and breast cancer survival is less clear. Patients and Methods We assessed pre- and postdiagnostic alcohol intake in a cohort of 22,890 women with incident invasive breast cancer who were residents of Wisconsin, Massachusetts, or New Hampshire and diagnosed from 198 to 200 at ages 20 to 79 years. All women reported on prediagnostic intake; a subsample of 4,881 reported on postdiagnostic intake. Results During a median follow-up of 11.3 years from diagnosis, 7,780 deaths occurred, including 3,484 resulting from breast cancer. Hazard ratios (HR) and 95% CIs were estimated. Based on a quadratic analysis, moderate alcohol consumption before diagnosis was modestly associated with disease-specific survival (compared with nondrinkers, HR = 0.93 [95% CI, 0.85 to 1.02], 0.85 [95% CI, 0.75 to 0.95], 0.88 [95% CI, 0.75 to 1.02], and 0.89 [95% CI, 0.77 to 1.04] for two or more, three to six, seven to nine, and >= 10 drinks/wk, respectively). Alcohol consumption after diagnosis was not associated with disease-specific survival (compared with nondrinkers, HR = 0.88 [95% CI, 0.61 to 1.27], 0.80 [95% CI, 0.49 to 1.32], 1.01 [95% CI, 0.55 to 1.87], and 0.83 [95% CI, 0.45 to 1.54] for two or more, three to six, seven to nine, and >= 10 drinks/wk, respectively). Results did not vary by beverage type. Women consuming moderate levels of alcohol, either before or after diagnosis, experienced better cardiovascular and overall survival than nondrinkers. Conclusion Overall alcohol consumption before diagnosis was not associated with disease-specific survival, but we found a suggestion favoring moderate consumption. There was no evidence for an association with postdiagnosis alcohol intake and breast cancer survival. This study, however, does provide support for a benefit of limited alcohol intake for cardiovascular and overall survival in women with breast cancer. (c) 2013 by American Society of Clinical Oncology
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页码:1939 / +
页数:10
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