title: Pre- and postoperative alcohol consumption in breast cancer patients: impact on early events.
abstract: OBJECTIVE
  To investigate the association between pre- and postoperative alcohol consumption and risk for early breast cancer events, since the association between alcohol consumption and prognosis in breast cancer patients is unclear.
  
  
  METHODS
  Alcohol consumption was recorded for 934 primary breast cancer patients who underwent breast cancer surgery in Lund, Sweden, between 2002 and 2011 and were followed until December 31(st) 2012. Clinical data were obtained from medical records and population registries. Pre- and postoperative alcohol consumption was analyzed in relation to risk for early events.
  
  
  RESULTS
  Median follow-up time was 3.03 years and 100 breast cancer events, 65 distant metastases, and 76 deaths occurred. Compared to no consumption, any preoperative alcohol consumption was weakly associated with lower risk for early events, adjusted HR 0.69 (0.45-1.04), distant metastases, 0.60 (0.36-1.00) and death, 0.62 (0.38-1.01). In the 572 patients without axillary lymph node involvement, any alcohol consumption was not associated with risk for early events. However, in the 360 patients with axillary lymph node involvement, preoperative alcohol consumption was associated with lower risk for early events (adjusted HR 0.43 0.24-0.77; P interaction = 0.01).
  
  
  CONCLUSIONS
  Pre- and postoperative alcohol consumption was weakly associated with lower risk for early breast cancer events. The data does not support recommending that all breast cancer patients abstain from low to moderate alcohol consumption.
authors.affiliation: Department of Clinical Sciences, Division of Oncology and Pathology, Barngatan 2B, SE-22185 Lund, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Simonsson
authors.affiliation: Department of Clinical Sciences, Division of Oncology and Pathology, Barngatan 2B, SE-22185 Lund, Sweden.
authors.forename: Andrea
authors.initials: A
authors.lastname: Markkula
authors.affiliation: Department of Clinical Sciences, Division of Oncology and Pathology, Barngatan 2B, SE-22185 Lund, Sweden.
authors.forename: Pär-Ola
authors.initials: PO
authors.lastname: Bendahl
authors.affiliation: CREATE Health and Department of Immunotechnology, Lund University, Medicon Village, Building 406, Lund, Sweden.
authors.forename: Carsten
authors.initials: C
authors.lastname: Rose
authors.affiliation: Division of Surgery, Clinical Sciences, Lund, Lund University, Lund, Sweden ; Department of Surgery, Skåne University Hospital, Lund, Sweden.
authors.forename: Christian
authors.initials: C
authors.lastname: Ingvar
authors.affiliation: Department of Clinical Sciences, Division of Oncology and Pathology, Barngatan 2B, SE-22185 Lund, Sweden.
authors.forename: Helena
authors.initials: H
authors.lastname: Jernström
keywords: Alcohol consumption; Breast cancer; Death; Early breast cancer events; Early distant metastases