Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
J Natl Cancer Inst. 2010 Sep 22;102(18):1422-31. doi: 10.1093/jnci/djq316. Epub 2010 Aug 23.
Alcohol consumption is a well-established risk factor for breast cancer. This association is thought to be largely hormonally driven, so alcohol use may be more strongly associated with hormonally sensitive breast cancers. Few studies have evaluated how alcohol-related risk varies by breast cancer subtype.
We assessed the relationship between self-reported alcohol consumption and postmenopausal breast cancer risk among 87 724 women in the Women's Health Initiative Observational Study prospective cohort from 1993 through 1998. Multivariable adjusted Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). All statistical tests were two-sided.
A total of 2944 invasive breast cancer patients were diagnosed during follow-up through September 15, 2005. In multivariable adjusted analyses, alcohol consumption was positively related to risk of invasive breast cancer overall, invasive lobular carcinoma, and hormone receptor-positive tumors (all P(trend) ≤ .022). However, alcohol consumption was more strongly related to risk of certain types of invasive breast cancer compared with others. Compared with never drinkers, women who consumed seven or more alcoholic beverages per week had an almost twofold increased risk of hormone receptor-positive invasive lobular carcinoma (HR = 1.82; 95% CI = 1.18 to 2.81) but not a statistically significant increased risk of hormone receptor-positive invasive ductal carcinoma (HR = 1.14; 95% CI = 0.87 to 1.50; difference in HRs per drink per day among current drinkers = 1.15; 95% CI = 1.01 to 1.32, P = .042). The absolute rates of hormone receptor-positive lobular cancer among never drinkers and current drinkers were, 5.2 and 8.5 per 10 000 person-years, respectively, whereas for hormne receptor-positive ductal cancer they were 15.2 and 17.9 per 10 000 person-years, respectively.
Alcohol use may be more strongly associated with risk of hormone-sensitive breast cancers than hormone-insensitive subtypes, suggesting distinct etiologic pathways for these two breast cancer subtypes.
饮酒是乳腺癌的一个既定危险因素。这种关联在很大程度上被认为是与激素有关的，因此，酒精的使用可能与激素敏感型乳腺癌的关系更为密切。很少有研究评估酒精相关风险如何因乳腺癌亚型而异。
我们评估了 1993 年至 1998 年期间，87724 名参加妇女健康倡议观察研究前瞻性队列的女性自我报告的饮酒与绝经后乳腺癌风险之间的关系。多变量调整的 Cox 回归模型用于计算风险比（HR）和 95%置信区间（CI）。所有统计检验均为双侧。
在随访期间，截至 2005 年 9 月 15 日，共有 2944 名浸润性乳腺癌患者被诊断出。在多变量调整分析中，饮酒与浸润性乳腺癌总体、浸润性小叶癌和激素受体阳性肿瘤的风险呈正相关（所有 P(trend) ≤.022）。然而，与其他类型的浸润性乳腺癌相比，饮酒与某些类型的浸润性乳腺癌的关系更为密切。与从不饮酒者相比，每周饮用七杯或更多酒精饮料的女性患激素受体阳性浸润性小叶癌的风险几乎增加了两倍（HR = 1.82；95%CI = 1.18 至 2.81），但患激素受体阳性浸润性导管癌的风险无统计学意义增加（HR = 1.14；95%CI = 0.87 至 1.50；当前饮酒者中每日每杯饮料的 HR 差异 = 1.15；95%CI = 1.01 至 1.32，P =.042）。从不饮酒者和当前饮酒者中激素受体阳性小叶癌的绝对发生率分别为每 10000 人年 5.2 和 8.5 例，而激素受体阳性导管癌的发生率分别为每 10000 人年 15.2 和 17.9 例。
与激素不敏感亚型相比，酒精的使用可能与激素敏感型乳腺癌的风险更为密切相关，这表明这两种乳腺癌亚型有不同的发病机制。
