CTA: Do you believe these findings support development of public health recommendations specific for breast cancer survivors?

Dr Boltong: These findings support a change in public health recommendations for all people in an effort to prevent cancer, both in those who have had cancer as well as for people who have never had cancer. We do not encourage multiple sets of guidelines as the evidence does not support this, and this can become confusing for both patients and health professionals. Current public health recommendations in Australia are for a maximum of 2 standard drinks per day (20 g of alcohol). This study showed that alcohol consumption from levels as low as 6 g of alcohol per day modestly increases the risk of breast cancer recurrence.

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CTA: Only a couple of the studies identified the type of alcohol (such as beer and wine). Do you believe the type of alcohol consumed might result in different outcomes?

Dr Boltong: The most important thing to make consistent in future studies is how the amount of alcohol is assessed. The type of alcohol consumed may determine the total caloric contribution alcoholic beverages make to a person’s overall diet and could therefore have a variable contribution to becoming overweight or obese, which is a risk factor for cancer and cancer recurrence. All alcoholic beverages are seen as “empty calories,” and should be minimized to avoid the displacement of more nutritious foods and beverages from the diet.

CTA: What additional information may be of interest to our readers?

Dr Boltong: Models of survivorship care should be reviewed to accommodate protected time for medical oncologists to discuss lifestyle modification with their patients. Patients do not make the link between cancer and alcohol. Clinicians are well positioned to advise patients to adopt more healthful lifestyles to improve long term health outcomes.


  1. Simapivapan P, Boltong A, Hodge A. To what extent is alcohol consumption associated with breast cancer recurrence and second primary breast cancer?: a systematic review. Cancer Treat Rev. 2016 Sep 20. doi: 10.1016/j.ctrv.2016.09.010 [Epub ahead of print]