Lowry Sarah J, Kapphahn Kris, Chlebowski Rowan, Li Christopher I
Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Med/Quantitative Sciences Unit, Stanford University School of Medicine, Palo Alto, California.
Cancer Epidemiol Biomarkers Prev. 2016 Aug;25(8):1268-73. doi: 10.1158/1055-9965.EPI-16-0151. Epub 2016 May 19.
Alcohol increases the risk of breast cancer even at moderate levels of intake. However, the relationship between alcohol consumption and mortality among breast cancer patients is less clear.
This study included women from the Women's Health Initiative observational study and randomized trial diagnosed with breast cancer (n = 7,835). Cox proportional hazards regression was used to estimate adjusted HRs and 95% confidence intervals (CI) for overall and breast cancer-specific (BCS) mortality associated with drinking alcohol before or after a breast cancer diagnosis. We also assessed whether changes in drinking habits after diagnosis are related to mortality.
Women who were consuming alcohol prior to their breast cancer diagnosis had a nonstatistically significant 24% (95% CI, 0.56-1.04) reduced risk of BCS mortality and a 26% (95% CI, 0.61-0.89) reduced risk of all-cause mortality. Some variation was observed by estrogen receptor (ER) status as alcohol consumption was associated with a 49% (95% CI, 0.31-0.83) reduced risk of BCS mortality among ER(-) patients with no change in risk observed among ER(+) patients (HR = 0.97; 95% CI, 0.31-1.54), though the difference between these risks was not statistically significant (P for interaction = 0.39). Postdiagnosis alcohol consumption, and change in consumption patterns after diagnosis, did not appear to be associated with all-cause or BCS mortality.
In this large study, consumption of alcohol before or after breast cancer diagnosis did not increase risks of overall or cause-specific mortality.
Coupled with existing evidence, alcohol consumption is unlikely to have a substantial impact on mortality among breast cancer patients. Cancer Epidemiol Biomarkers Prev; 25(8); 1268-73. ©2016 AACR.
即使是适度饮酒，酒精也会增加患乳腺癌的风险。然而，饮酒与乳腺癌患者死亡率之间的关系尚不清楚。
本研究纳入了来自女性健康倡议观察性研究和随机试验中被诊断为乳腺癌的女性（n = 7,835）。采用Cox比例风险回归来估计与乳腺癌诊断前后饮酒相关的总体和乳腺癌特异性（BCS）死亡率的调整后HR及95%置信区间（CI）。我们还评估了诊断后饮酒习惯的变化是否与死亡率相关。
在乳腺癌诊断前饮酒的女性，其BCS死亡率风险降低24%（95% CI，0.56 - 1.04），差异无统计学意义，全因死亡率风险降低26%（95% CI，0.61 - 0.89）。根据雌激素受体（ER）状态观察到一些差异，饮酒与ER（-）患者BCS死亡率风险降低49%（95% CI，0.31 - 0.83）相关，而ER（+）患者风险无变化（HR = 0.97；95% CI，0.31 - 1.54），尽管这些风险之间的差异无统计学意义（交互作用P = 0.39）。诊断后饮酒以及诊断后饮酒模式的变化似乎与全因或BCS死亡率无关。
在这项大型研究中，乳腺癌诊断前后饮酒均未增加总体或病因特异性死亡率风险。
结合现有证据，饮酒不太可能对乳腺癌患者的死亡率产生实质性影响。《癌症流行病学与生物标志物预防》；25(8)；1268 - 73。©2016美国癌症研究协会。
