More needs to be understood about exactly how, on a biomolecular level, alcohol ups cancer risk, Drs. Brooks and Zakhari argue, to “allow women to make better informed decisions about the risks and benefits of alcohol consumption in the context of their overall health and at different stages of their life.”   

But others urge clinicians to caution breast cancer survivors and women at elevated risk of developing breast cancer away from drinking regularly, even moderately.

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The oft-cited literature suggesting cardiovascular benefits for moderate drinkers has itself come under scrutiny, as well, critics point out – for example, for inadequately distinguishing never-drinkers from long-term abstainers like recovering alcoholics, which could cloud the health benefits of abstention, and inconsistent definitions in the research literature, of what constitutes “moderate” drinking.

Young women who consume alcohol regularly “even in small doses” may have an increased risk of breast cancer, Helmut K. Seitz, MD, PhD, told The Advisor Blog. Dr. Seitz is a distinguished professor of internal medicine for Gastroenterology and Alcohol Research at the University of Heidelberg.

“We know now there is no threshold with respect to alcohol dosage and breast cancer,” he explained.

Women who are not at increased risk of breast cancer should limit alcohol consumption to less than 1 glass or serving a day, Dr. Seitz and coauthors recently concluded, based on a meta-analysis of data from published studies published in the journal Alcohol and Alcoholism.

“It is very clear that women diagnosed with breast cancer should be advised not to drink alcohol regularly and may limit their alcohol intake to certain occasions,” Dr. Seitz said.

Current evidence makes it “wise to suggest that women who have other risk factors for breast cancer such as a positive family history or benign breast lesions” not drink alcohol on a regular basis, he said, and that “women in general should limit their alcohol consumption.”

Some cardiologists already suggest patients drink moderately to prevent coronary heart disease and myocardial infarction, Dr. Seitz notes — “an extremely risky recommendation,” he said.

“Not everybody benefits from small amounts of alcohol,” he emphasized. “More than 60 different diseases are associated with alcohol consumption, even at a moderate dose.”’

Evidence for a cardiovascular benefit associated with moderate alcohol consumption is actually limited to specific patient populations, like the elderly, Dr. Seitz added.

“It is difficult to understand (how) somebody who has no risk factors for coronary heart disease, such as a 30-year-old healthy person, may benefit from chronic alcohol drinking,” he said. “On the other hand, these young women who are consuming alcohol regularly, even in small doses, may have an increased risk for breast cancer.”