Have a question about women’s health or menopause? Dr. Patricia Yarberry Allen may have the answer. Click here to send in your question to be posted on WVFC.


Question
: For years now I have been told that having a glass or two of red wine a day is good for my health. Last week I read that all alcohol, including wine, can increase my chances of getting breast cancer.

I am 52 and postmenopausal. My mother had breast cancer in her 40s and died from the disease. I have done everything my doctor has told me to do to prevent or find breast cancer early. What does the new study about alcohol mean for me?

Dr. Pat: Women absorb and metabolize alcohol differently from men, so even if a man and a woman drink the same amount of alcohol, the woman’s blood alcohol content will be higher. New studies show that these differences — and the consequences — are far more important than we ever knew, and we are beginning to understand the effects of alcohol consumed at relatively lower consumptions over time.

The study you are referring to was conducted by researchers at Kaiser Permanente Medical Care Program in Oakland, Calif. Researchers tracked the drinking habits of 70,033 women who had shared information about their alcohol consumption during health examinations between 1978 and 1985. By 2004, 2,829 of the participants had been diagnosed with breast cancer.

The study found that women who had one or two drinks a day increased their risk of breast cancer by 10 percent compared to women who had less than one drink a day. Women who had more than three drinks a day increased their risk by 30 percent. It does not matter whether you drink beer, wine or liquor.

One of the explanations for the relationship between alcohol and breast cancer seems to be related to estrogen. Research is demonstrating that alcohol increases the levels of estrogen in the blood of postmenopausal women. Estrogen is associated with higher levels of breast cancer.

“A 30 percent increased risk is not trivial. To put it into context, it is not much different from the increased risk associated with women taking estrogenic hormones. Incidentally, in previous research completed at Kaiser Permanente, we have found that smoking a pack of cigarettes or more per day is related to a similar (30 percent) increased risk of breast cancer,” Kaiser Permanente researcher Dr. Arthur Klatsky said in a statement.

While breast cancer rates vary between populations, and only a small proportion of women are heavy drinkers, Klatsky added that a 30 percent increase in the relative risk from heavy drinking might translate into approximately an extra 5 percent of all women developing breast cancer.

I have had many questions about alcohol use and health in women lately. My patients often say, “I have two glasses of red wine with dinner. It is good for my heart and it relaxes me. Now, you are telling me that this is dangerous, too?”

Alcohol does offer some heart protection benefits, but the truth is, we don’t know how much alcohol is safe for each woman, so we should consider this new information in conjunction with family history and other factors. You do have a significant family history of premenopausal breast cancer in a close relative. If you want to continue to lower your risk of breast cancer, the best advice I can give you is to look at alcohol as a special treat, not a daily vitamin. Enjoy a glass of wine on special occasions, but limit it to two or three times a week.

Stay tuned as members of WVFC’s Medical Advisory Board continue to write about alcohol consumption and women over 40. Information is just that: information. What we do with it can change our lives.

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  • Deborah January 12, 2009 at 11:01 am

    I am 50-years-old. Would stopping alcohol consumption now decrease the risk I’ve already exposed myself to by drinking the past 15 years? Is there a way to “erase” past exposure to alcohol?

    Reply
  • Deborah January 12, 2009 at 11:00 am

    I am 50-years-old. Would stopping alcohol consumption now decrease the risk I’ve already exposed myself to by drinking the past 15 years? Is there a way to “erase” past exposure to alcohol?

    Reply
  • Carolyn Hahn November 29, 2007 at 9:35 pm

    Thanks, Cori.
    I am going to lift weights (for bone density), use the (hideously boring) stairmaster (aerobics), take a lot of walks, and…
    continue to to drink what the Wall Street Journal once called “refrigerator white” (the bottle you keep in the door of the fridge). PS: Jacques Pepin said he and his wife drink two bottles of wine a day at dinner! And they look forward to it all day!
    Alkies. Anyway, I know it would be better if I (Ms Osteopenia) drank One Glass of Wine Max Per Day but…oh well! Not there yet.

    Reply
  • Cori H November 28, 2007 at 11:35 pm

    Dr. Pat,
    I appreciate this discussion a lot!
    Thanks also to Dr. Murrell. I was looking for those references on the folate/alcohol question and you provided them all in one place.
    Thanks to Dr. Pat for allowing the dissenting views to stay up here. I know of other blogs where unpopular views get removed.
    My thoughts:
    1. It’s well-known that alcohol depletes B Vitamins. So these findings seem perfectly logical to me.
    2. Those of us who like to drink are going to drink.
    3. We might as well educate ourselves and try to replenish nutrients we know we’re losing when we have our vices!
    So, personally, I’m going to continue eating my green vegetables, taking my B-complex containing 800mcg of folic acid daily and drink moderately (most of the time 😉

    Reply
  • Mitchell Gaynor, M.D. October 23, 2007 at 5:53 pm

    While studies have suggested being deficient in folic acid may increase the risk of breast cancer further, I do not believe that taking a folate supplement would reduce the risk of a woman who drinks alcohol regularly back to normal any more than stopping smoking reduces the risk of lung cancer to the degree of having never started cigarette smoking.
    While the data is not conclusive, a recent summary of 63 published studies involving different populations in several countries showed that 65 percent of the studies reported that alcohol was associated with an increased risk of breast cancer.
    I agree with Dr. Allen that alcohol consumption should be kept to about a 4 oz. of red wine per day maximum. Given that heavy alcohol consumption is associated with colon cancer, head and neck cancers as well as liver cancer, this recommendation is reasonable for men as well.
    I believe a 4- to 6-ounce glass of red wine three to four times per week is reasonable for those individuals who wish to drink, given the current data.

    Reply
  • Jeff Murrell October 9, 2007 at 12:39 am

    Dr. Pat,
    Thank you for responding to your concerns regarding my post. I agree that, “each woman should follow the medical advice of a doctor familiar with her personal and family medical history.”
    My comment was simply a review of the current literature available on this topic. Dr. Patrick Borgen makes a comment that I would agree with, “It is simply not possible to control each and every variable in a way that might lead to such black and white conclusions”. If you believe this to be true, the alcohol studies would also fall under this same criticism.
    I have taken the data available in the scientific literature and tried to present it in a balanced way. Most studies (not all) indicate there is an increased risk of breast cancer with increased alcohol consumption. I noted this as my first point. Most studies (not all) indicate that folic acid may reduce the excess risk of breast cancer associated with alcohol consumption. This is the current state of the scientific literature on the topic.
    If women drink, I would prefer them to know that adequate folic acid levels may reduce the excess risk of breast cancer associated with alcohol consumption.
    Sincerely,
    Jeff

    Reply
  • Dr. Pat Allen October 6, 2007 at 1:35 pm

    Thank you for your question, Ylise. The study looked at the connection between alcohol and newly diagnosed cases of breast cancer. It found that women who had one to two alcoholic drinks per day increased their risk of breast cancer by 10 percent, compared to women who drank less than one drink per day.
    It would be best to discuss the findings with your oncologist to determine what this might portend for breast cancer survivors.

    Reply
  • ylise October 5, 2007 at 3:27 pm

    As a woman who has experienced breast cancer, I am confused by this data. My oncologist tells me that it is fine to have a glass (or two) of wine with dinner. Does your research include an increased risk for recurrence of breast cancer or only newly diagnosed cases?

    Reply
  • Dr. Pat Allen October 3, 2007 at 10:35 pm

    I disagree so strongly with this comment. I consulted several oncologists in New York who specialize in breast cancer, and not one reported telling their patients that they could drink if they took folic acid – not one doctor out of the five I consulted.
    In fact, Dr. Patrick Borgen, director of the Brooklyn Breast Cancer Project at the Maimonides Cancer Center, said in response, “If I produced wine in the Napa Valley I would cite the same studies, but in our hearts we know that these studies are treacherous. It is simply not possible to control each and every variable in a way that might lead to such black and white conclusions.”
    As I responded to the original question, each woman should follow the medical advice of a doctor familiar with her personal and family medical history. In my opinion, women should be wary of promises of a quick solution that will counteract the effects of alcohol consumption. The research is simply not solid enough to support making these suggestions.

    Reply
  • Jeff Murrell October 3, 2007 at 12:44 am

    Dr. Pat
    Thank you for your thoughtful post. As a Ph.D. scientist and Napa Valley winemaker devoted to the cause of ending breast cancer, this issue hits very close to home. We have thoroughly researched the scientific literature and found the following results:
    1) There is consistent scientific evidence that alcohol intake may increase the risk of breast cancer.
    2) There is consistent scientific information from around the world indicating that adequate levels of folate (folic acid) may reduce the excess risk of breast cancer associated with alcohol consumption.
    We are hopeful that future articles will enlighten people about folate’s ability to reduce the increased risk of breast cancer associated with alcohol consumption.
    Click here to visit our site for more information
    Sincerely,
    Dr. Jeff Murrell
    American Roots Winery

    Reply