CAP TODAY Pathology/Laboratory Medicine/Laboratory Management
Editor: Deborah Sesok-Pizzini, MD, MBA, professor, Department of Clinical Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, and chief, Division of Transfusion Medicine, Children’s Hospital of Philadelphia.
Alcohol consumption relative to type of breast cancer risk in postmenopausal women
Alcohol consumption is a known risk factor for breast cancer, but it is not known which subtypes of breast cancer, if any, are more likely associated with alcohol consumption. The authors conducted a large study using the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial cohort to test for heterogeneity in alcohol-related risk by breast cancer subtypes defined by estrogen receptor (ER) and progesterone receptor (PR) status and histological type. They enrolled in the trial cohort 54,562 women aged 55 to 74 years who were recruited between 1993 and 2001. The authors calculated hazard ratios and 95 percent confidence intervals for breast cancer subtypes defined by histological type and ER/PR status using standard Cox models. They also used a novel two-stage Cox model to assess heterogeneity in risk for individual tumor characteristics while adjusting for others. The authors found that alcohol consumption was not associated with all breast cancer subtypes. In terms of histological type, stronger association was noted for lobular than for ductal cancers, although this was not statistically significant. However, the risk for women consuming seven or more drinks weekly among the mixed ductal/lobular group was significantly higher compared with the corresponding risk for those with ductal cancer. Positive associations were also observed with ER+/PR+ tumors. The authors concluded that breast cancer is linked to moderate alcohol consumption, which is consistent with a large number of previous studies. Additional larger studies are needed to corroborate the findings that different cancer subtypes have different risks related to alcohol consumption.
Falk RT, Maas P, Schairer C, et al. Alcohol and risk of breast cancer in postmenopausal women: an analysis of etiological heterogeneity by multiple tumor characteristics. Am J Epidemiol. 2014;180(7):705–717.
Correspondence: Roni T. Falk at falkr@mail.nih.gov