Several meta-analyses and major reviews of epidemiologic data confirm a moderate, but statistically significant, association between moderate to heavy alcohol intake and subsequent risk of developing breast cancer [77, 98].
There is evidence of a dose-response relationship, e.g., as little as one to two drinks per day can increase risk. One combined analysis of data from 53 studies around the world estimated that the RR for breast cancer increased 7% for each additional 10 g of alcohol consumed daily .
The association between alcohol intake and greater breast cancer risk has been observed regardless of the type of alcohol consumed, and alcohol intake has been shown to be associated with a higher risk for both premenopausal and postmenopausal breast cancer .
Alcohol consumption may be particularly deleterious for individuals with suboptimal intake of some nutrients such as folate, beta-carotene, lutein/zeaxanthin, and vitamin C .
Alcohol intake could increase risk of breast cancer through several mechanisms.
Observational and clinical trial data show that premenopausal women, and postmenopausal women taking oral or transdermal hormone replacement therapy, have higher concentrations of circulating estrogens if they drink alcohol, compared with abstainers [52, 100, 101].
Animal data suggest that alcohol could act as a cocarcinogen by stimulating conversion of inactive to active metabolites that can bind to or damage DNA, by inhibiting carcinogen detoxification, or by impairing liver clearance of carcinogens .
Alcohol, and its metabolite acetaldehyde could also inhibit repair of carcinogen-induced DNA damage.
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