Did you know alcohol is a carcinogen? If not, you’re far from alone.
For years, the national dialog around alcohol use has centered around wine’s purported heart health benefits, thanks to muddied public health and media messaging and industry lobbying. A study in the journal Cancer Epidemiology, Biomarkers & Prevention found that more than half of adults don’t know about the link between drinking and cancer. Some even believed that alcohol reduced cancer risk.
But the reality is that alcohol consumption and cancer risk are linked, and alcohol consumption is a leading modifiable risk factor for breast cancer in the U.S. And with American women drinking more heavily today, this is an especially timely topic.
The association between alcohol and breast cancer was described in two landmark reports published in 1987 in the New England Journal of Medicine, which found that even modest drinking was associated with an increased risk of breast cancer. It was preliminary work—results were based on the approximately 17 epidemiological studies on alcohol and breast cancer available at the time—but was notable nonetheless.
Today, the most up-to-date research describes a more complex association between alcohol and breast cancer risk—complex in that a woman’s unique biology, comorbidities, family history, and other factors all play a role in her personal risk. Thanks to research, we now know that alcohol use can cause a small—but real—increase in breast cancer risk. On an individual level, this should be weighed against a woman’s overall risk, considering other breast cancer risk factors that may apply.
Here’s what else you need to know.
First, a few facts about alcohol and breast cancer:
Scientists are still studying the role drinking plays in breast cancer development, but several theories have emerged. Researchers have observed that drinking causes a rise in estrogen receptor–positive breast cancer—the most common form of breast cancer—possibly because it causes a rise in circulating estrogen.
Alcohol, a significant source of empty calories, may also increase breast cancer risk by contributing to overweight and obesity. Excess body fat can influence risk in several ways, including increasing levels of estrogen, insulin, and other factors that encourage cell growth.
In addition, drinking harms DNA, which directs cell function and growth. Alcohol is broken down into acetaldehyde, which damages DNA and prevents the body from repairing it. Once DNA is damaged, a cell can start to grow out of control and create a malignant tumor. Drinking can also harm DNA by causing oxidative stress in cells.
Alcohol may also affect the body’s ability to absorb certain nutrients. For example, drinking can lead to poor absorption of folate, and low levels of this vitamin are thought to play a role in the risk of some cancers, including breast.
It’s important to note that alcohol’s effects can vary from person to person because of factors related to an individual’s biological makeup. These factors should be considered in conjunction with a person’s other breast cancer risk factors to get an accurate picture of how alcohol play a role. Assessing risk is therefore complicated and compounds the controversy around how much is too much.
The relationship between drinking and breast cancer is especially concerning because, in recent years, drinking rates have surged among women.
According to a study published in JAMA Network Open, women surveyed reported a 41 percent rise in excessive/binge drinking episodes—defined as consumption of 4 or more drinks in a few hours—during the earlier part of the pandemic. But rates had been rising even before then, with women experiencing a 58 percent increase in heavy drinking and an 84 percent increase in alcohol-use disorder from 2001 to 2013.
Young women (ages 18-25) are at even higher risk biologically since rapid proliferation and incomplete differentiation of breast cells between menarche (first period) and first full-term pregnancy heightens vulnerability to alcohol’s carcinogenic effects—and because alcohol use is particularly common in this group. Unfortunately, few young women are aware that alcohol use increases breast cancer risk.
Part of the reason so many people aren’t aware of the alcohol and breast cancer connection is because misconceptions about drink’s effects on health have persisted for years. Examples include:
Myth: Having one drink a day is healthy.
Fact: This belief likely stems from alcohol’s purported positive effects on cardiovascular health. Experts suspect this may have created a “health halo” that led the public to overgeneralize alcohol’s health benefits to other diseases. In reality, the theory that drinking is good for the heart was never well established and no research to date has ever demonstrated cause and effect. And now, recent research suggests that moderate drinking does not protect the heart and, in fact, may increase a person’s risk of cardiovascular disease.
Myth: Red wine helps prevent cancer.
Fact: Some older data suggested that the high concentration of antioxidants in red wine, such as resveratrol, could lower cancer risk. While resveratrol may have some anti-cancerous properties, it’s not found exclusively in red wine. Non-carcinogenic sources include blueberries and grapes.
Myth: Breast cancer risk varies by the type of alcohol consumed.
Fact: There is no “safer” type of alcohol. Any drink that contains ethanol (alcohol)—wine, beer, liquor—increases breast cancer risk. This is true regardless of the product’s quality and price.
The current dietary guidelines recommend that adults of legal drinking age not drink or drink in moderation (one or fewer drinks in a day for women, two or fewer drinks for men). If you do drink, talk to your doctor about whether eliminating or limiting alcohol is best for your breast and overall health. In addition to doing a comprehensive breast cancer risk assessment, they can consider other health conditions you may have, whether you have a strong family history of cardiovascular disease or any other cancer, and more to help you make an informed decision.
Knowledge is power and understanding how alcohol consumption can influence your breast cancer risk is important to guide if and how you modify your intake.
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