Wine and breast cancer risk with BRCA mutation

One of the more significant developments in the understanding of breast cancer risk factors was the discovery of two inheritable genetic mutations, BRCA1 and BRCA2, that dramatically increase the lifetime risk of breast cancer. These mutations are aberrant forms of a class of genes called “tumor suppressors” so when they don’t function normally, cancers are more likely to develop and spread. (Tests are available for these mutations and many women with BRCA are opting for prophylactic mastectomy and reconstruction.)

Since alcohol consumption is generally regarded as a risk factor for breast cancer, it is important to know how it might affect women with BRCA. Given all of the confusion about whether wine consumption increases or decreases risk, it becomes even more important to know what to recommend. Surely, the knowledge of a high risk of cancer and not being able to have a glass of wine with dinner seems like double punishment. Fortunately a recent study helps to provide some guidance.

The study, from a collaboration called the Hereditary Breast Cancer Clinical Study Group, analyzed matched pairs of breast cancer patients with and without each type of BRCA mutation, according to a range of lifestyle factors. It’s a powerful study because of the numbers of patients surveyed, nearly 2 thousand, and its broad reach from several countries, though most were from Canada and the U.S.

After statistical adjustments for other known factors, there was no increase in risk from moderate alcohol consumption. Some studies have actually found decreased odds of developing cancer among moderate drinkers with BRCA, but in this study the reduction was only seen in wine drinkers. The implication of this is that it is the wine that is responsible for lowering the risk seen in previous analyses where drinking could not be accurately subdivided by type of beverage. This meshes well with findings on breast cancer risk without the BRCA mutation.

Several compounds unique to red wine have impressive anti-cancer properties, specifically for breast cancer. Clinical trials using some of these compounds in conjunction with traditional therapy are underway. But if you or someone close to you has a strong family history of breast cancer, getting tested for the BRCA gene can save their life. The good news is that they can still share a glass of wine with you and not add to their worries.

Dennis J, Ghadirian P, Little J, Lubinski J, Gronwald J, Kim-Sing C, Foulkes W, Moller P, Lynch HT, Neuhausen SL, Domchek S, Armel S, Isaacs C, Tung N, Sweet K, Ainsworth P, Sun P, Krewski D, Narod S; the Hereditary Breast Cancer Clinical Study Group. Alcohol consumption and the risk of breast cancer among BRCA1 and BRCA2 mutation carriers. The Breast 2010;e-pub.

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