Postdiagnosis alcohol consumption and breast cancer prognosis in the after breast cancer pooling project.
Postdiagnosis alcohol consumption and breast cancer prognosis in the after breast cancer pooling project.
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DOI：
10.1158/1055-9965.epi-12-1022
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发表时间：
2013-01
期刊：
影响因子：
--
通讯作者：
Caan BJ
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文献类型：
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作者：
Kwan ML;Chen WY;Flatt SW;Weltzien EK;Nechuta SJ;Poole EM;Holmes MD;Patterson RE;Shu XO;Pierce JP;Caan BJ
饮酒是乳腺癌发病的一个既定危险因素。然而，其在乳腺癌预后中的作用仍不清楚。我们在乳腺癌后合并项目中对9,329名乳腺癌患者进行了一项诊断后饮酒与复发和死亡率的调查。从1990年至2006年，来自三个前瞻性美国队列的女性被诊断患有AJCC I-III期乳腺肿瘤。在进入队列时（平均诊断后2.1年），使用食物频率问卷评估酒精摄入量。使用延迟进入考克斯比例风险模型估计风险比（HR）和95%置信区间（CI），并对已知预后因素进行调整。经过平均10.3年的随访，1,646例复发和1,543例死亡。5，422名女性（58%）被认为是饮酒者（酒精≥0.36 g/天，≥0.25杯/周），中位数为5.3 g/天。总体而言，与不饮酒相比，规律饮酒（≥6.0 g/d）与复发风险无关（6-<12 g/d的HR =1.03; 95% CI：0.86，1.24; 12-<24 g/d的HR =1.12; 95% CI：0.93，1.34; ≥24 g/d的HR =1.04; 95% CI：0.84，1.31）。然而，风险因绝经状态而显著不同（相互作用p <0.05）。经常饮酒（≥6.0 g/天）的绝经后女性复发风险增加（HR=1.19; 95% CI：1.01，1.40）。酒精摄入与死亡率无关。定期饮酒与乳腺癌复发和总死亡率无关，但复发风险仅在绝经后妇女中升高。酒精摄入和复发之间的关联可能取决于乳腺癌诊断时的绝经状态。
Alcohol consumption is an established risk factor for incident breast cancer. However, its role in breast cancer prognosis remains unclear. We conducted an investigation of post-diagnosis alcohol consumption with recurrence and mortality among 9,329 breast cancer patients in the After Breast Cancer Pooling Project. Women were diagnosed from 1990-2006 with AJCC Stage I-III breast tumors from three prospective U.S. cohorts. Alcohol intake was assessed at cohort entry (mean 2.1 years post-diagnosis) using a food frequency questionnaire. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using delayed entry Cox proportional hazards models with adjustment for known prognostic factors. After a mean follow-up of 10.3 years, 1,646 recurrences and 1,543 deaths were ascertained. 5,422 women (58%) were considered drinkers (≥0.36 g/day of alcohol, ≥0.25 drinks/week) with a median of 5.3 g/day. Overall, compared with non-drinking, regular alcohol intake (≥6.0 g/day) was not associated with risk of recurrence (HR for 6-<12 g/day=1.03; 95% CI: 0.86, 1.24; HR for 12-<24 g/day=1.12; 95% CI: 0.93, 1.34; HR for ≥24 g/day=1.04; 95% CI: 0.84, 1.31). However, risk varied significantly by menopausal status (p for interaction<0.05). Postmenopausal women who regularly consumed alcohol (≥6.0 g/day) had increased risk of recurrence (HR=1.19; 95% CI: 1.01, 1.40). Alcohol intake was not associated with mortality. Regular alcohol consumption was not associated with breast cancer recurrence and total mortality overall, yet recurrence risk was only elevated in postmenopausal women. The association between alcohol intake and recurrence may depend on menopausal status at breast cancer diagnosis.