TY - JOUR

T1 - Alcohol Consumption and Survival after a Breast Cancer Diagnosis

T2 - A Literature-Based Meta-analysis and Collaborative Analysis of Data for 29,239 Cases

AU - Ali, Alaa M G

AU - Schmidt, Marjanka K

AU - Bolla, Manjeet K

AU - Wang, Qin

AU - Gago-Dominguez, M

AU - Castelao, J Esteban

AU - Carracedo, Angel

AU - Garzón, Victor Muñoz

AU - Bojesen, Stig E

AU - Nordestgaard, Børge G

AU - Flyger, Henrik

AU - Chang-Claude, Jenny

AU - Vrieling, Alina

AU - Rudolph, Anja

AU - Seibold, Petra

AU - Nevanlinna, Heli

AU - Muranen, Taru A

AU - Aaltonen, Kirsimari

AU - Blomqvist, Carl

AU - Matsuo, Keitaro

AU - Ito, Hidemi

AU - Iwata, Hiroji

AU - Horio, Akiyo

AU - John, Esther M

AU - Sherman, Mark

AU - Lissowska, Jolanta

AU - Figueroa, Jonine

AU - Garcia-Closas, Montserrat

AU - Anton-Culver, Hoda

AU - Shah, Mitul

AU - Hopper, John L

AU - Trichopoulou, Antonia

AU - Bueno-de-Mesquita, Bas

AU - Krogh, Vittorio

AU - Weiderpass, Elisabete

AU - Andersson, Anne

AU - Clavel-Chapelon, Françoise

AU - Dossus, Laure

AU - Fagherazzi, Guy

AU - Peeters, Petra H

AU - Olsen, Anja

AU - Wishart, Gordon C

AU - Easton, Douglas F

AU - Borgquist, Signe

AU - Overvad, Kim

AU - Barricarte, Aurelio

AU - González, Carlos A

AU - Sánchez, María-José

AU - Amiano, Pilar

AU - Riboli, Elio

AU - Key, Tim

AU - Pharoah, Paul D

N1 - ©2014 American Association for Cancer Research.

PY - 2014/6

Y1 - 2014/6

N2 - BACKGROUND: Evidence for an association of alcohol consumption with prognosis after a diagnosis of breast cancer has been inconsistent. We have reviewed and summarized the published evidence and evaluated the association using individual patient data from multiple case cohorts.METHODS: A MEDLINE search to identify studies published up to January 2013 was performed. We combined published estimates of survival time for "moderate drinkers" versus nondrinkers. An analysis of individual participant data using Cox regression was carried out using data from 11 case cohorts.RESULTS: We identified 11 published studies suitable for inclusion in the meta-analysis. Moderate postdiagnosis alcohol consumption was not associated with overall survival [HR, 0.95; 95% confidence interval (CI), 0.85-1.05], but there was some evidence of better survival associated with prediagnosis consumption (HR, 0.80; 95% CI, 0.73-0.88). Individual data on alcohol consumption for 29,239 cases with 4,839 deaths were available from the 11 case cohorts, all of which had data on estrogen receptor (ER) status. For women with ER-positive disease, there was little evidence that pre- or postdiagnosis alcohol consumption is associated with breast cancer-specific mortality, with some evidence of a negative association with all-cause mortality. On the basis of a single study, moderate postdiagnosis alcohol intake was associated with a small reduction in breast cancer-specific mortality for women with ER-negative disease. There was no association with prediagnosis intake for women with ER-negative disease.CONCLUSION: There was little evidence that pre- or post-diagnosis alcohol consumption is associated with breast cancer-specific mortality for women with ER-positive disease. There was weak evidence that moderate post-diagnosis alcohol intake is associated with a small reduction in breast cancer-specific mortality in ER-negative disease.IMPACT: Considering the totality of the evidence, moderate postdiagnosis alcohol consumption is unlikely to have a major adverse effect on the survival of women with breast cancer.

AB - BACKGROUND: Evidence for an association of alcohol consumption with prognosis after a diagnosis of breast cancer has been inconsistent. We have reviewed and summarized the published evidence and evaluated the association using individual patient data from multiple case cohorts.METHODS: A MEDLINE search to identify studies published up to January 2013 was performed. We combined published estimates of survival time for "moderate drinkers" versus nondrinkers. An analysis of individual participant data using Cox regression was carried out using data from 11 case cohorts.RESULTS: We identified 11 published studies suitable for inclusion in the meta-analysis. Moderate postdiagnosis alcohol consumption was not associated with overall survival [HR, 0.95; 95% confidence interval (CI), 0.85-1.05], but there was some evidence of better survival associated with prediagnosis consumption (HR, 0.80; 95% CI, 0.73-0.88). Individual data on alcohol consumption for 29,239 cases with 4,839 deaths were available from the 11 case cohorts, all of which had data on estrogen receptor (ER) status. For women with ER-positive disease, there was little evidence that pre- or postdiagnosis alcohol consumption is associated with breast cancer-specific mortality, with some evidence of a negative association with all-cause mortality. On the basis of a single study, moderate postdiagnosis alcohol intake was associated with a small reduction in breast cancer-specific mortality for women with ER-negative disease. There was no association with prediagnosis intake for women with ER-negative disease.CONCLUSION: There was little evidence that pre- or post-diagnosis alcohol consumption is associated with breast cancer-specific mortality for women with ER-positive disease. There was weak evidence that moderate post-diagnosis alcohol intake is associated with a small reduction in breast cancer-specific mortality in ER-negative disease.IMPACT: Considering the totality of the evidence, moderate postdiagnosis alcohol consumption is unlikely to have a major adverse effect on the survival of women with breast cancer.

U2 - 10.1158/1055-9965.EPI-13-0901

DO - 10.1158/1055-9965.EPI-13-0901

M3 - Journal article

C2 - 24636975

VL - 23

SP - 934

EP - 945

JO - Cancer Epidemiology, Biomarkers & Prevention

JF - Cancer Epidemiology, Biomarkers & Prevention

SN - 1055-9965

IS - 6

ER -