Alcohol Consumption and Survival after a Breast Cancer Diagnosis: A Literature-Based Meta-analysis and Collaborative Analysis of Data for 29,239 Cases

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  • Alaa M G Ali
  • Marjanka K Schmidt
  • Manjeet K Bolla
  • Qin Wang
  • M Gago-Dominguez
  • J Esteban Castelao
  • Angel Carracedo
  • Victor Muñoz Garzón
  • Henrik Flyger
  • Jenny Chang-Claude
  • Alina Vrieling
  • Anja Rudolph
  • Petra Seibold
  • Heli Nevanlinna
  • Taru A Muranen
  • Kirsimari Aaltonen
  • Carl Blomqvist
  • Keitaro Matsuo
  • Hidemi Ito
  • Hiroji Iwata
  • Akiyo Horio
  • Esther M John
  • Mark Sherman
  • Jolanta Lissowska
  • Jonine Figueroa
  • Montserrat Garcia-Closas
  • Hoda Anton-Culver
  • Mitul Shah
  • John L Hopper
  • Antonia Trichopoulou
  • Bas Bueno-de-Mesquita
  • Vittorio Krogh
  • Elisabete Weiderpass
  • Anne Andersson
  • Françoise Clavel-Chapelon
  • Laure Dossus
  • Guy Fagherazzi
  • Petra H Peeters
  • Anja Olsen
  • Gordon C Wishart
  • Douglas F Easton
  • Signe Borgquist
  • Kim Overvad
  • Aurelio Barricarte
  • Carlos A González
  • María-José Sánchez
  • Pilar Amiano
  • Elio Riboli
  • Tim Key
  • Paul D Pharoah

BACKGROUND: Evidence for an association of alcohol consumption with prognosis after a diagnosis of breast cancer has been inconsistent. We have reviewed and summarized the published evidence and evaluated the association using individual patient data from multiple case cohorts.

METHODS: A MEDLINE search to identify studies published up to January 2013 was performed. We combined published estimates of survival time for "moderate drinkers" versus nondrinkers. An analysis of individual participant data using Cox regression was carried out using data from 11 case cohorts.

RESULTS: We identified 11 published studies suitable for inclusion in the meta-analysis. Moderate postdiagnosis alcohol consumption was not associated with overall survival [HR, 0.95; 95% confidence interval (CI), 0.85-1.05], but there was some evidence of better survival associated with prediagnosis consumption (HR, 0.80; 95% CI, 0.73-0.88). Individual data on alcohol consumption for 29,239 cases with 4,839 deaths were available from the 11 case cohorts, all of which had data on estrogen receptor (ER) status. For women with ER-positive disease, there was little evidence that pre- or postdiagnosis alcohol consumption is associated with breast cancer-specific mortality, with some evidence of a negative association with all-cause mortality. On the basis of a single study, moderate postdiagnosis alcohol intake was associated with a small reduction in breast cancer-specific mortality for women with ER-negative disease. There was no association with prediagnosis intake for women with ER-negative disease.

CONCLUSION: There was little evidence that pre- or post-diagnosis alcohol consumption is associated with breast cancer-specific mortality for women with ER-positive disease. There was weak evidence that moderate post-diagnosis alcohol intake is associated with a small reduction in breast cancer-specific mortality in ER-negative disease.

IMPACT: Considering the totality of the evidence, moderate postdiagnosis alcohol consumption is unlikely to have a major adverse effect on the survival of women with breast cancer.

TidsskriftCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Udgave nummer6
Sider (fra-til)934-945
Antal sider12
StatusUdgivet - jun. 2014

ID: 138776355