consuming alcohol increases the risk of developing the disease, and not just a little

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Every year in France, since 1994, the month of October is dedicated to breast cancer awareness, as part of the Pink October campaign. The opportunity, in particular, to emphasize screening. Remember that, if detected early, breast cancer is cured 9 times out of 10. But Pink October is also an opportunity to recall the importance of prevention and healthy lifestyle habits.

Among the many risk factors for breast cancer, there is one that is of particular concern: alcohol consumption. What are the biological mechanisms underlying the links between alcohol and breast cancer? What are the recommendations for prevention? Alcohol withdrawal? Here are some answers.

Leading cause of death among women in France

In France, breast cancer affects approximately one in eight women during their lifetimemaking it the most common cancer in women. It is also the one that causes the greatest number of cancer deaths in the female population: 14% of cancer deaths occurring in 2018 were due to breast cancer.

This cancer represents approximately 30% of cancers diagnosed in women in our country. In 2023, nearly 61,000 new cases were recorded, leading to 12,000 deaths.

Furthermore, a study by the National Cancer Institute (INCa) indicates that for the year 2015, among people aged 30 and over, nearly 28,000 new cases of cancer (11,700 among women and 16,200 among men) were attributable to alcohol consumption, i.e. 8% of new cases of cancer in all locations combined (7.5% and 8.5% of new cases of cancer in women and men respectively).

These statistics highlight the need for increased awareness and preventative measures.

Alcohol and cancer risk: a well-established link

Although still often underestimated or unknown, the carcinogenic nature of alcohol is now clearly demonstrated. Alcohol is the second leading preventable cause of cancer death, after tobacco. Since 1988, this substance has been classified as carcinogenic to humans by the International Agency for Research on Cancer (IARC).

This harmful effect of alcoholic beverages is due to ethanol, their main constituent. Once ingested, this molecule is in fact metabolized into compounds that can promote the development of cancer. This is for example the case of acetaldehyde, which can cause DNA damage which, if not repaired, can lead to cancer.

Cancer risk depends on the total amount of alcohol consumed, rather than the type of drink (wine, beer, aperitifs). Studies have shown that increased alcohol consumption increases the risk of breast cancer by 5% in premenopausal women and 9% in postmenopausal women for each unit of alcohol (about 10 g of ethanol) consumed per day.

However, this risk is often underestimated in France: only 58.4% of French people recognize that moderate alcohol consumption increases the risk of cancer.

Conversely, reducing alcohol consumption, or even abstaining, can significantly reduce the risk.

Alcohol and breast cancer

According to the INCa, in France, each year, 8,000 cases of breast cancer are attributable to alcohol consumption.

Research has highlighted several mechanisms by which alcohol promotes the development of breast cancer. Alcohol has the ability to elevate estrogen levels in the blood. However, these hormones play a central role in the development of certain types of breast cancer, in particular those described as “hormone-dependent”.

The risk of breast cancer begins to increase as soon as a person consumes alcohol, even in quantities less than one drink per day. In the United Kingdom, analysis of data collected during the Million Women Study, involving more than 28,000 women with breast cancer, suggests that every 10 grams of alcohol (i.e. one glass ) consumed per day is associated with a 12% increase in the risk of breast cancer.

Conversely, we see, among women who have stopped drinking, a gradual reduction in the risk of breast cancer, with a reduction of 20-30% after five years of abstinence.

And that’s not all: weaning also improves the response to anticancer treatments, reduces adverse effects, and reduces the risk of recurrence. And not just in the case of breast cancer.

Impact of alcohol withdrawal on cancer survival

In clinical practice, only 0.9% of cancer patients were informed about the possibility of getting help to reduce excessive alcohol consumption. This low level of consideration of alcohol consumption raises questions about the place of prevention in cancer therapy.

However, this question is not trivial. Indeed, cancer patients who stop consuming alcohol see their response to treatments improve, with an increase in survival rates of 15-25% in certain types of cancer, such as esophageal cancers. and head and neck.

Alcohol withdrawal is also associated with a reduction in treatment side effects, as well as a reduced risk of cancer recurrence, with a significant improvement in patients’ quality of life.

Weaning: what strategies?

Alcohol withdrawal is a complex process that requires appropriate professional care. Support from addiction specialists is essential to overcome the challenges of withdrawal. Alcohol withdrawal can cause different symptoms such as tremors, sleep problems, nausea, anxiety. These symptoms may be exacerbated in breast cancer patients due to the stress of the disease. These withdrawal challenges vary from person to person.

Regular consultations make it possible to monitor progress, adjust treatments and prevent relapses. Finally, psychosocial support, including therapies and discussion groups, strengthens motivation and improves the patient’s environment, thus increasing the chances of success. Different associations are involved in this goal, such as the League Against Cancer and the Europa Donna France association.

We can never repeat it enough: alcohol is a significant risk factor for breast cancer, and one that is too little known. Promoting alcohol withdrawal could play a crucial role not only in reducing the incidence of this cancer, but also in improving survival.

Recommendations for limiting alcohol consumption and cessation strategies should be widely disseminated and integrated into cancer prevention and treatment programs.

Finally, let’s reiterate the guidelines for alcohol consumption recommended in France: do not consume more than ten standard drinks per week; do not consume more than two glasses per day; have days without consumption in a week: “for your health, alcohol is a maximum of two drinks per day and not every day”.

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