A systematic review of the association between alcohol consumption, breast cancer recurrence, and a second primary breast cancer found that postmenopausal women should be especially careful with their alcohol intake. Cancer Therapy Advisor interviewed Anna Boltong, PhD, head of cancer information and support services at Cancer Council Victoria, and honorary senior research fellow of health sciences at the University of Melbourne in Victoria, Australia, about her group’s recent article in Cancer Treatment Reviews.1

Cancer Therapy Advisor (CTA): Does your research support alcohol abstinence for women who have had breast cancer, to prevent recurrence?

Dr Boltong: Any level of alcohol intake confers a greater risk of developing breast cancer and, therefore, any reductions women can make should be encouraged, especially when abstinence is not realistic or sustainable over the long term. The decision to abstain from alcohol should always be explored between the patient and her health care team. Our recent research shows that patients do not make the link between alcohol and cancer. Clinicians do not routinely raise the issue of alcohol with their patients.

CTA: Should postmenopausal women be especially careful with alcohol intake?

Dr Boltong: Yes. Our study showed that alcohol consumption increases the risk of breast cancer recurrence, particularly in postmenopausal women.

CTA: What role might genetics play?

Dr Boltong: Genetics play a major role in the development of breast cancer; having a strong family history of breast cancer is one of the strongest determinants of cancer development. It is estimated that around one-third of all cancers can be prevented through modifications to lifestyle. These include changes to diet and alcohol intake.

CTA: What studies are needed to determine if there is a clear(er) association between alcohol and development of a second primary breast cancer?

Dr Boltong: It is not until recent years that we have seen such large numbers of people having survived breast cancer for greater than 5 years (5-year survival from breast cancer is at an all-time high). This means that we now have greater opportunities to track people who have had cancer over a longer period.

Large studies should be designed to accurately monitor alcohol consumption both before and after a breast cancer diagnosis over the long term. Equally, participants in such studies should be followed up with over the long term to determine whether they develop another cancer. Studies specifically designed to test the association between alcohol consumption and subsequent cancer development should use specific and consistent methodologies to assess type and amount of alcohol consumed.