Alcohol and postmenopausal breast cancer risk defined by estrogen and progesterone receptor status: A prospective cohort study

Reiko Suzuki, Weimin Ye, Tove Rylander-Rudqvist, Shigehira Saji, Graham A. Colditz, Alicja Wolk

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109 Scopus citations


Background: Alcohol intake has been reported to be positively associated with an increased risk of postmenopausal breast cancer; however, the association with the estrogen receptor (ER) and progesterone receptor (PR) status of the breast tumors remains unclear. Methods: Self-reported data on alcohol consumption were collected in 1987 and 1997 from 51847 postmenopausal women in the population-based Swedish Mammography Cohort. Through June 30, 2004, 1188 invasive breast cancer case patients with known ER and PR status were identified during an average 8.3-year follow-up. We used Cox proportional hazards models to estimate multivariable relative risks (RRs) of breast cancer, adjusting for age; family history of breast cancer; body mass index; height; parity; age at menarche, first birth, and menopause; education level; use of postmenopausal hormones; and diet. Heterogeneity among groups was evaluated using the Wald test. All statistical tests were two-sided. Results: Alcohol consumption was associated with an increased risk for the development of ER-positive (+) tumors, irrespective of PR status (highest intake [≥10 g of alcohol per day] versus nondrinkers, multivariable RR = 1.35, 95% confidence interval [CI] = 1.02 to 1.80; Ptrend<.049 for ER+PR+ tumors; and RR = 2.36, 95% CI + 1.56 to 3.56; Ptrend<.001 for ER+PR- tumors). The absolute rate of ER+ breast cancer (standardized to the age distribution of person-years experienced by all study participants using 5-year age categories) was 232 per 100000 person-years among women in the highest category of alcohol intake, and 158 per 100000 person-years among nondrinkers. No association was observed between alcohol intake and the risk of developing ER- tumors. Furthermore, we observed a statistically significant interaction between alcohol intake and the use of postmenopausal hormones on the risk for ER+PR+ tumors (Pinteraction = .039). Conclusion: The observed association between risk of developing postmenopausal ER+ breast cancer and alcohol drinking, especially among those women who use postmenopausal hormones, may be important, because the majority of breast tumors among postmenopausal women overexpress ER.

Original languageEnglish
Pages (from-to)1601-1608
Number of pages8
JournalJournal of the National Cancer Institute
Issue number21
StatePublished - Nov 2 2005


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