November 2012 Ask the Expert: Diet and Nutrition After Breast Cancer
Suzanne Dixon, MPH, MS, RD, is a registered dietitian, epidemiologist, author and speaker. She is an internationally recognized expert in nutrition, chronic disease prevention, cancer epidemiology and health and wellness.http://www.lbbc.org/Learning-From-Others/Ask-the-Expert/2012-11-Nutrition-and-Diet
Question: What are the effects of alcohol on triple-negative breast cancer survivorship?
Ms. Dixon: Several large observational studies show an association between drinking alcohol and increased risk of breast cancer and breast cancer recurrence. Alcohol is most strongly linked with increased risk of estrogen receptor-positive breast cancer. This connection is not surprising, because health experts note that when a woman drinks alcohol, the level of estrogen circulating in her body increases.
There haven’t been enough studies to know with certainty whether or not alcohol increases risk of triple-negative breast cancer recurrence. However, it is a good idea to limit alcohol consumption anyway, because alcohol itself is known to becarcinogenic, or cancer-causing.
Studies suggest, at least for ER-positive breast cancer, that risk of recurrence increases when a woman has more than one or two drinks per week. This is far below the standard health recommendation that women consume no more than one drink per day.
Also, keep in mind that one drink may be smaller than most people realize. A single drink is five ounces of wine, 12 ounces of beer or 1½ ounces of hard liquor. A typical large glass of wine often contains eight or even 10 ounces. This would be two servings.
If you have a history of breast cancer and truly enjoy a glass of wine or a cocktail, I suggest that alcohol be saved for special occasions or enjoyed once per week with a nice dinner. If completely avoiding alcohol is not difficult for you, then you should avoid it.
I believe it’s important to consider all of the things you can do to take care of yourself. For example, even for women who are overweight or obese, the combination of five or more servings of vegetables and fruit per day and 30 minutes per day of moderately vigorous exercise has been shown to reduce the risk of recurrence by nearly 50 percent.
Despite this, many women are strongly advised not to consume alcohol but are never told the importance of healthy eating and regular exercise. This focuses only on the negative—“don’t drink”—but fails to empower women with the positive things they can do to reduce risk, such as eat well and exercise regularly.
All women with a history of breast cancer, but especially ER-positive breast cancer, should limit alcohol intake or eliminate it altogether. However, it would be a mistake to focus only on one thing, such as alcohol. If all of the other healthy lifestyle choices are in place—a good diet, regular physical activity, avoiding tobacco, getting adequate sleep, managing stress,and so forth—an occasional alcoholic beverage is unlikely to have measurable impact on risk of recurrence. Just remember that “occasional” means special occasions, not every day.
