酒精与乳癌

酒精与乳癌（英语：alcohol and breast cancer）之间的关系很明确：饮用酒精饮料，包括葡萄酒、啤酒、或是烈酒（蒸馏酒），是罹患乳癌以及其他某些癌症的危险因素。^[1]^[2]^[3]全世界每年因为饮酒而导致超过100,000例的乳癌病例发生。^[3]

乳房切除术后切下的大型乳癌样本（本例为侵袭性乳腺管癌（英语：Ductal carcinoma））。

世界卫生组织（WHO）所属的国际癌症研究机构宣布，有足够的科学证据把酒精饮料归类为导致女性罹患患乳癌的一类致癌物。^[2]一类致癌物所包含的是有明确的科学证据证明其为致癌的物质，例如吸食烟草（吸烟）。

一位女人每天平均喝两单位的酒精，罹患乳癌的风险比平均每天只喝一单位的女人高出8%。^[4]即使是少量饮酒 - 每周一到三个单位 - 也会提高罹患乳癌的风险。^[3]

重度饮酒者与不饮酒者，以及轻度饮酒者相比，会更容易因为乳癌而死亡。^[3]^[5]此外, 饮酒数量越多的女人, 越有可能在乳癌初始治愈之后，再度复发。^[5]

风险发生机制

酒精增加乳癌风险的机制尚未被充分了解，可能是：

雌激素和雄激素的水准升高^[6]
乳腺对致癌物质的易感性受到增强 ^[6]
乳腺DNA损伤扩大^[6]
乳癌细胞具有更强的转移潜力^[6]

上述风险的强度可能取决于酒精的摄取量。^[6]

其他饮食因素（如叶酸缺乏症）、生活习惯（包括使用激素替代疗法）、或是生物学特性（如肿瘤细胞中的激素受体的表达），也可能增加酒精对乳癌产生风险的易感性。^[6]

饮酒妇女所产下的女儿

研究显示，母亲在怀孕期间饮酒，可能会影响其女儿罹患乳癌的可能性。“对于怀孕的女性来说，即使适度饮酒，也可能透过减少褪黑激素或是其他机制，而导致循环雌二醇的水准升高。这可能会影响女儿发育中的乳腺组织，而导致他们终生罹患乳癌的风险遭到提升。”^[7]

轻度和适度饮酒

轻度饮酒是每周喝一到三个单位的酒，适度饮酒是每天喝一单位左右。轻度和适度饮酒都与有较高罹患乳癌的风险有关联。^[3]^[8]然而，少量饮酒与大量饮酒相比，增加乳癌的风险较小。

复发

饮酒或不饮酒并不能完全决定治疗后乳癌是否会复发。^[5]然而，女人摄取酒精越多，癌症复发的可能性就越大。^[5]

对男性而言

在男性身上比较少发现乳癌，每100,000名男性的发病率不到一例。^[9]针对人口把过度饮酒当作危险因素来做研究，所得的结果混杂。有项研究显示，每日饮酒10克，可能会让风险增加16%。^[10]其他的研究则没显示有任何影响，但在这些研究之中只有少数是酗酒者。^[11]

流行病学

全世界每年大约有144,000妇女被诊断出罹患乳癌，而原因是饮酒所导致。^[3]每年约有38,000 名妇女死于由酒精诱发的乳癌。^[3]这些人约有80%是重度或中度饮酒者。^[3]

参见

参考文献

^ Hayes, J.; Richardson, A.; Frampton, C. Population attributable risks for modifiable lifestyle factors and breast cancer in New Zealand women. Internal Medicine Journal. November 2013, 43 (11): 1198–1204. ISSN 1445-5994. PMID 23910051. S2CID 23237732. doi:10.1111/imj.12256.
^ ^2.0 ^2.1 Alcohol consumption and ethyl carbamate International Agency for Research on Cancer Working Group on the Evaluation of Carcinogenic Risks to Humans (2007: Lyon, France) ISBN 9789283212966
^ ^3.0 ^3.1 ^3.2 ^3.3 ^3.4 ^3.5 ^3.6 ^3.7 Shield, Kevin D.; Soerjomataram, Isabelle; Rehm, Jürgen. Alcohol Use and Breast Cancer: A Critical Review. Alcoholism, Clinical and Experimental Research. June 2016, 40 (6): 1166–1181. ISSN 1530-0277. PMID 27130687. doi:10.1111/acer.13071.
^ Non-Technical Summary 互联网档案馆的存档，存档日期2006-07-24. Committee on Carcinogenicity of Chemicals in Food Consumer Products and the Environment (COC)
^ ^5.0 ^5.1 ^5.2 ^5.3 Gou, YJ; Xie, DX; Yang, KH; Liu, YL; Zhang, JH; Li, B; He, XD. Alcohol Consumption and Breast Cancer Survival: A Meta-analysis of Cohort Studies.. Asian Pacific Journal of Cancer Prevention. 2013, 14 (8): 4785–90. PMID 24083744. doi:10.7314/APJCP.2013.14.8.4785  . Although our meta-analysis showed alcohol drinking was not associated with increased breast cancer mortality and recurrence, there seemed to be a dose-response relationship of alcohol consumption with breast cancer mortality and recurrence and alcohol consumption of >20 g/d was associated with increased breast cancer mortality.
^ ^6.0 ^6.1 ^6.2 ^6.3 ^6.4 ^6.5 Singletary KW, Gapstur SM. Alcohol and breast cancer: review of epidemiologic and experimental evidence and potential mechanisms. JAMA. 2001, 286 (17): 2143–51. PMID 11694156. doi:10.1001/jama.286.17.2143.
^ Stevens RG, Hilakivi-Clarke L. Alcohol exposure in utero and breast cancer risk later in life. Alcohol and Alcoholism. 2001, 36 (3): 276–7. PMID 11373268. doi:10.1093/alcalc/36.3.276  .
^ Zhang SM, Lee IM, Manson JE, Cook NR, Willett WC, Buring JE. Alcohol consumption and breast cancer risk in the Women's Health Study. Am J Epidemiol. March 2007, 165 (6): 667–76. PMID 17204515. doi:10.1093/aje/kwk054  .
^ Male Breast Cancer. [2021-12-24]. （原始内容存档于2021-12-20）.
^ Guénel, P.; Cyr, D.; Sabroe, S.; Lynge, E.; Merletti, F.; Ahrens, W.; Baumgardt-Elms, C.; Ménégoz, F.; Olsson, H.; Paulsen, S.; Simonato, L.; Wingren, G. Alcohol drinking may increase risk of breast cancer in men: a European population-based case-control study. Cancer Causes & Control. Aug 2004, 15 (6): 571–580. ISSN 0957-5243. PMID 15280636. S2CID 23750821. doi:10.1023/B:CACO.0000036154.18162.43.
^ Brinton, A.; Richesson, A.; Gierach, L.; Lacey Jr, R.; Park, Y.; Hollenbeck, R.; Schatzkin, A. Prospective evaluation of risk factors for male breast cancer. Journal of the National Cancer Institute. Oct 2008, 100 (20): 1477–1481. ISSN 0027-8874. PMC 2720728  . PMID 18840816. doi:10.1093/jnci/djn329.

外部链接

UK: Committee on Carcinogenicity of Chemicals in Food, Consumer Products Consumption of alcoholic beverages and risk of breast cancer
UK: Committee on Carcinogenicity of Chemicals in Food, Consumer Products Evidence for association between consumption of alcoholic beverages and breast cancer

[1] Hayes, J.; Richardson, A.; Frampton, C. Population attributable risks for modifiable lifestyle factors and breast cancer in New Zealand women. Internal Medicine Journal. November 2013, 43 (11): 1198–1204. ISSN 1445-5994. PMID 23910051. S2CID 23237732. doi:10.1111/imj.12256.

[IARC-2] 2.0 ^2.1 Alcohol consumption and ethyl carbamate International Agency for Research on Cancer Working Group on the Evaluation of Carcinogenic Risks to Humans (2007: Lyon, France) ISBN 9789283212966

[:0-3] 3.0 ^3.1 ^3.2 ^3.3 ^3.4 ^3.5 ^3.6 ^3.7 Shield, Kevin D.; Soerjomataram, Isabelle; Rehm, Jürgen. Alcohol Use and Breast Cancer: A Critical Review. Alcoholism, Clinical and Experimental Research. June 2016, 40 (6): 1166–1181. ISSN 1530-0277. PMID 27130687. doi:10.1111/acer.13071.

[COC-4] Non-Technical Summary 互联网档案馆的存档，存档日期2006-07-24. Committee on Carcinogenicity of Chemicals in Food Consumer Products and the Environment (COC)

[:1-5] 5.0 ^5.1 ^5.2 ^5.3 Gou, YJ; Xie, DX; Yang, KH; Liu, YL; Zhang, JH; Li, B; He, XD. Alcohol Consumption and Breast Cancer Survival: A Meta-analysis of Cohort Studies.. Asian Pacific Journal of Cancer Prevention. 2013, 14 (8): 4785–90. PMID 24083744. doi:10.7314/APJCP.2013.14.8.4785  . Although our meta-analysis showed alcohol drinking was not associated with increased breast cancer mortality and recurrence, there seemed to be a dose-response relationship of alcohol consumption with breast cancer mortality and recurrence and alcohol consumption of >20 g/d was associated with increased breast cancer mortality.

[pmid11694156-6] 6.0 ^6.1 ^6.2 ^6.3 ^6.4 ^6.5 Singletary KW, Gapstur SM. Alcohol and breast cancer: review of epidemiologic and experimental evidence and potential mechanisms. JAMA. 2001, 286 (17): 2143–51. PMID 11694156. doi:10.1001/jama.286.17.2143.

[7] Stevens RG, Hilakivi-Clarke L. Alcohol exposure in utero and breast cancer risk later in life. Alcohol and Alcoholism. 2001, 36 (3): 276–7. PMID 11373268. doi:10.1093/alcalc/36.3.276  .

[8] Zhang SM, Lee IM, Manson JE, Cook NR, Willett WC, Buring JE. Alcohol consumption and breast cancer risk in the Women's Health Study. Am J Epidemiol. March 2007, 165 (6): 667–76. PMID 17204515. doi:10.1093/aje/kwk054  .

[9] Male Breast Cancer. [2021-12-24]. （原始内容存档于2021-12-20）.

[10] Guénel, P.; Cyr, D.; Sabroe, S.; Lynge, E.; Merletti, F.; Ahrens, W.; Baumgardt-Elms, C.; Ménégoz, F.; Olsson, H.; Paulsen, S.; Simonato, L.; Wingren, G. Alcohol drinking may increase risk of breast cancer in men: a European population-based case-control study. Cancer Causes & Control. Aug 2004, 15 (6): 571–580. ISSN 0957-5243. PMID 15280636. S2CID 23750821. doi:10.1023/B:CACO.0000036154.18162.43.

[11] Brinton, A.; Richesson, A.; Gierach, L.; Lacey Jr, R.; Park, Y.; Hollenbeck, R.; Schatzkin, A. Prospective evaluation of risk factors for male breast cancer. Journal of the National Cancer Institute. Oct 2008, 100 (20): 1477–1481. ISSN 0027-8874. PMC 2720728  . PMID 18840816. doi:10.1093/jnci/djn329.

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