If you are one of the many women who take hormone replacement therapy (HRT) to manage menopausal symptoms, pause before you reach for an alcoholic beverage. A report published in Annals of Internal Medicine suggests that the combination of HRT and alcohol substantially boosts breast cancer risk in postmenopausal women.

Measuring alcohol use

For this analysis, Harvard researchers repeatedly polled more than 44,000 postmenopausal women as to how much alcohol they usually consumed and whether they currently or had previously used HRT. (One drink was defined as 12 oz of beer, 4 oz of wine, or 1½ oz of distilled spirits.) The researchers kept track of the women for 16 years and noted those who developed breast cancer during that time.

A combination of factors

Both the use of hormone replacement therapy for longer than 5 years and intake of about one drink per day boosted the risk of breast cancer. The combination of these two factors, though, further compounded the risk. Comparing women who drank at least one alcoholic beverage per day, those who used HRT for more than 5 years were nearly twice as likely than non-HRT users to develop breast cancer.

How alcohol hurts

Scientists have know for some time that women who drink more than one alcoholic beverage a day are more likely than non-drinkers to develop breast cancer. It's not yet clear why, but it's possible that a steady supply of alcohol interferes with DNA repair within cells or with the liver's ability to rid the body of carcinogens. Of even more concern, though, may be its effect on estrogen levels - several studies have shown that steady alcohol intake raises a woman's estrogen level, which is an issue for hormone-dependent cancers like breast cancer.

Advice to women

The authors of this study say that a woman's lifetime risk of developing breast cancer - estimated to be about 4% - doubles to about 8% with the concurrent use of HRT and more than one alcoholic beverage per day. They acknowledge, though, that light to moderate alcohol intake appears to reduce the risk of heart disease, leaving women (and their healthcare providers) to decide individually if a daily drink represents a health benefit or a health liability. As always, no one is advising women who customarily do not drink to add alcohol to their diets for health reasons.

Source

Use of postmenopausal hormones, alcohol, and risk for invasive breast cancer.
W. Chen, G. Colditz, B. Rosner,  et al., Ann Int Med, 2002, vol. 137, pp. 798--804

Links

• Hormone Replacement Therapy (HRT) - Now What to Do?
• Should You Drink to Your Health?
• Breast Cancer - Partial or Complete Breast Removal?
• Good Health Habits Cut Cancer Risk
• To quickly access additional accurate information on this and other nutrition-related topics, visit Tufts University's Nutrition Navigator