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All TopicsForum: DCIS (Ductal Carcinoma In Situ) → Topic: Drinking wine after bilateral mastectomy

Topic: Drinking wine after bilateral mastectomy

Forum: DCIS (Ductal Carcinoma In Situ) — Just diagnosed, in treatment, or finished treatment for DCIS.

Posted on: May 13, 2010 01:28PM

pamcycle wrote:

What are the risks associated with breast cancer reoccurance and drinking a glass of wine or two if you have a bilateral mastectomy?

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Posts 1 - 25 (25 total)

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May 13, 2010 01:32PM Lilah wrote:

Well if you are taking narcotics (like Vicodin) for pain -- you are not supposed to drink wine.  As far as whether alcohol contributes to the risk of BC reoccurence, there are studies that seem to say that moderate consumption is OK.  Other studies recommend against drinking entirely.  Which leads me to conclude they don't really know and we should all live by Julia Childs edict: all things in moderation :)

Dx 6/2/2009, IDC, Stage IIa, Grade 3, 1/17 nodes, ER-/PR-, HER2+
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May 13, 2010 02:26PM IronJawedBCAngel wrote:

There is a risk associated with use of alcohol, but I will point out, my mom is an alcoholic and abused alcohol and smoked cigarettes for many years, and has never had cancer of any kind. I never smoked, rarely drank as I was afraid of becoming like her, led a very healthy lifestyle, and I am the one who is diagnosed.  I may have had breast cancer, but I refuse to allow it to control my life.  Quality of life is important to me, so I no longer deprive myself of everything.  I enjoy a few glasses when I want, not everyday, but that is more out of financial and weight concerns.  There needs to be balance.  Wine may not be the best for my breast cancer, but red wine is good for my heart.  I just do not let breast cancer define me.  Enjoy life!

DCIS, 2005, lumpectomy, 32 rads, tamoxifen

Dx 4/15/2005, DCIS, <1cm, Stage 0, Grade 3, 0/0 nodes, ER+/PR+, HER2-
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May 13, 2010 02:51PM carol1949 wrote:

Many sources say the reservatrol in red wine is actually good for fighting bc.  Certainly, you don't want to drink any alcohol is you are on narcotics!

Dx 4/4/2008, IDC, 6cm+, Stage IIIb, ER+, HER2-
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May 13, 2010 06:02PM Beesie wrote:

Alcohol consumption is at most a weak contributory factor in breast cancer recurrence.  If I recall correctly, the most recent study indicated that moderate alcohol consumption increased recurrence risk by about 30%.  After a bilateral mastectomy for DCIS, your risk of recurrence is in the range of 1% - 2%; this means that alcohol consumption might put your risk into the range of 1.3% - 2.6%.   

More importantly (to me, anyway), is the fact that alcohol consumption has been shown to have no impact on mortality.  This is because alcohol actually has health benefits.  Here is a video of Professor Michele Holmes, from Harvard, discussing the most recent study.  Her conclusion is that given the expected long term survival of women with early stage BC, the benefits from moderate alcohol consumption, in terms of heart health, balance out the negatives with regard to increased BC recurrence risk.  http://www.ecancermedicalscience.com/tv/video-by-category.asp?play=364&cid=5&scid=0&q

Dx 9/15/05, DCIS-MI, 6cm+ Gr3 DCIS w/IDC microinvasion, Stage I, 0/3 nodes, ER+/PR- “No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke

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May 14, 2010 09:09PM kittycat wrote:

I love to drink wine.  I had DCIS and a BMX and had a recurrence 8 months later.  Now, I don't drink wine nightly, but will have 1-2 glasses about 3 times per week.  I have the BRCA1 gene and I'm triple negative, so I'm sure that was the contributing factor to my cancer coming back.  Some of the healthiest people i know are the ones who got bc, so there's no telling...

2 time survivor of triple negative BC, postiive for BRCA1 gene mutation! 9 surgeries, 5 months of chemo and 6 weeks of radiation.

Dx 6/17/2009, DCIS, <1cm, Stage 0, Grade 2, 0/0 nodes, ER-/PR-, HER2-Dx 4/30/2010, IDC, <1cm, Stage I, Grade 3, 0/10 nodes, ER-/PR-, HER2-Surgery 08/12/2009 Mastectomy (Both); Reconstruction: Tissue expander placement (Both)Surgery 12/15/2009 Reconstruction: Breast implants (permanent) (Both)Surgery 05/04/2010 Lumpectomy (Right); Lymph Node Removal: Axillary Lymph Node Dissection (Right)Chemotherapy 06/16/2010 Adriamycin, Cytoxan, TaxolRadiation Therapy 11/15/2010 ExternalSurgery 07/20/2011 Prophylactic Ovary Removal (Both)Surgery 08/30/2011 Reconstruction: Breast implants (permanent) (Right)Surgery 05/15/2012 Reconstruction: Breast implants (permanent) (Right)
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May 14, 2010 10:56PM ktn wrote:

pamcycle~ I remember asking my breast surgeon when I met him if I could still drink wine and he said absolutely! I had 2 tumours and lymph nodes involved. I have said on these boards before that I will drink in moderation and enjoy myself. If alcohol was a huge cause, all female alcoholics would have BC!!!! On the home page of BCO I googled this question and found alcohol can increase getting BC but all the data isn't in about recurrence. Enjoy an occasional drink and live your life!
Dx 6/18/2008, ILC, 5cm, Stage IIIa, Grade 2, 9/24 nodes, ER+/PR+, HER2-
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May 14, 2010 11:13PM CrunchyPoodleMama wrote:

I have to chime in because this has been weighing heavily on me.

In November, I had a lumpectomy to remove a large area of DCIS... 8cm long area removed but still had DCIS in two margins. For various reasons, I delayed re-excision until just this week.

In those less-than-six-months, the tiny DCIS cells that remained had started replicating and growing again. 

Now, I had completely changed my lifestyle to be anti-cancer after diagnosis... I stopped consuming aspartame, sugar, and other cancer no-no's, started supplementing with iodine and vitamin D3 etc.

The ONLY two things I did that weren't anti-cancer were: 1) I continued to be stressed out all the time, and 2) I started drinking 2-3 glasses of red wine PER NIGHT. (And those were FULL glasses -- if a serving is 3 ounces, I shudder to think how many servings per night and per week I was drinking!!)

I do think moderation is probably okay (a serving or two once in a long while), but I feel like I personally can't afford to take any chances after this little "experiment." It probably makes a difference that I am ER+ and I know that (for me) 2-3 glasses a night is enough to affect my estrogen levels.

Of course it's not a definite thing... as ktn said, why don't all female alcoholics have bc then? But, not all smokers get lung cancer, but that's a chance I'm not willing to take either.

Julia ~ Dear friends, do what you can to help your body fight/prevent cancer. 1. Supplement with iodine and vitamin D. 2. STOP taking hormonal birth control/HRT. 3. Eat organic real food, not chemical or fake food.

Dx 11/13/2009, DCIS, 4cm, Stage 0, Grade 2, 0/0 nodes, ER+/PR+
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May 15, 2010 02:24AM kittycat wrote:

Ha!  I had DCIS and had a recurrence after having a BMX.  Now it's IDC with some DCIS.  My former BS told me I could wait a while before making decisions, possibly years.  Well, I'm glad I acted quickly, but I still got it again!

2 time survivor of triple negative BC, postiive for BRCA1 gene mutation! 9 surgeries, 5 months of chemo and 6 weeks of radiation.

Dx 6/17/2009, DCIS, <1cm, Stage 0, Grade 2, 0/0 nodes, ER-/PR-, HER2-Dx 4/30/2010, IDC, <1cm, Stage I, Grade 3, 0/10 nodes, ER-/PR-, HER2-Surgery 08/12/2009 Mastectomy (Both); Reconstruction: Tissue expander placement (Both)Surgery 12/15/2009 Reconstruction: Breast implants (permanent) (Both)Surgery 05/04/2010 Lumpectomy (Right); Lymph Node Removal: Axillary Lymph Node Dissection (Right)Chemotherapy 06/16/2010 Adriamycin, Cytoxan, TaxolRadiation Therapy 11/15/2010 ExternalSurgery 07/20/2011 Prophylactic Ovary Removal (Both)Surgery 08/30/2011 Reconstruction: Breast implants (permanent) (Right)Surgery 05/15/2012 Reconstruction: Breast implants (permanent) (Right)
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May 15, 2010 06:58AM mom3band1g wrote:

crunchypoodle- did you test for iodine deficiency?  I have been very interested in the link between iodine def and cancer.  I got some sea salt with iodine from the Dekalb Farmers Market because we eat almost 0 salt and I would bet big money my whole family is low.  I want to test for the deficiency though.  Have to remember to call my Dr....

lumpectomy 2/10/10 bi-lat mx 3/25/10 rads completed 7/10!

Dx 1/19/2010, DCIS, 6cm+, Stage 0, Grade 3, ER+/PR+
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May 15, 2010 10:52AM Beesie wrote:

AH!!!!!   I hate the scare tactics on alcohol!  Let's get the facts straight rather than shout out scare tactics.

Yes, studies have shown that alcohol consumption may increase BC risk by up to 30%.  This means that alcohol is considered to be a low risk factor for breast cancer.  There's no argument about that. The 30% increase in risk is exactly the number that I used in my previous post.  What it means is that someone who had a mastectomy for DCIS, who has a 1% - 2% risk of recurrence, may increase their risk of recurrence to 1.3% - 2.6% if they consume moderate amounts of alcohol.  Recurrence risk is spread over many years - some recurrences don't happen for 10 years or even longer, but most recurrences will happen within the first five years after an initial diagnosis.  So this means that for those of us who had mastectomies for DCIS, consuming alcohol may increase our recurrence risk by approx. 0.1% per year.  Wow!!!  That's sure going to keep me from enjoying a glass of wine.  Uh, no!!

What about those who had a lumpectomy?  If someone has a post-treatment (surgery, possibly radiation, possibly Tamoxifen) recurrence risk of 6%, a 30% increase means that moderate consumption of alcohol will increase this recurrence risk to 7.8%.  Again, this risk is spread over many years, but most of the risk will occur within the first five years.  So in this example, for each of these first 5 years, recurrence risk may be increased by 0.35%.  Whether this is enough of a risk increase to eliminate alcohol consumption from your lifestyle is a personal decision. 

To put the BC risk from alcohol consumption into perspective, take a look at this risk chart from the Komen Foundation:  http://ww5.komen.org/BreastCancer/BreastCancerRiskFactorsTable.html  Most of our BC risk is driven by factors that we can't control.  We freak out about alcohol because it is one of the few risk factors that we can control, but the fact is that it is a low risk factor and the amount that most of us will be able to impact our overall risk by reducing/eliminating alcohol consumption is very small.

Something else to keep in mind is that the leading cause of death of women in North America is heart disease.  Cancer - all cancers combined, including lung cancer which kills more women than breast cancer - is second.  Moderate alcohol consumption has been shown to help reduce the risk of heart disease (note however that heavy alcohol consumption has the oppositve effect).  This is why study after study has shown that while moderate alcohol consumption may lead to a slightly higher risk of BC or BC recurrence, there is no impact on mortality.  This is because today, thankfully most women survive breast cancer and go on to live long lives.  But as we age, heart disease becomes a much greater concern.  So in making our choices, we need to consider all our health risks - and when it comes to alcohol consumption, there is a bit of a "balancing act" (to use the words of Dr. Holmes).

Yes, there are thousands of articles that talk about BC risk and alcohol consumption. It's a favorite topic of journalists reporting on health news. Many of those articles just regurgitate the same info from the same study, but even at that, it's a fact that there have been quite a few studies that have shown a link between alcohol and BC.  But rather that read newspaper writers' interpretations of BC and alcohol studies, I find more credibility in the opinions of doctors who specialize in breast cancer and who look at all of the studies and draw overall conclusions: 

  • From Dr. Susan Love:  "If wine makes your dinners more pleasurable, you don't have to abandon it altogether. However, you may want to forgo the second glass. Four or five glasses a week shouldn't have a measurable effect on your risk of recurrence.   Another thing to consider: Recent research indicates that alcohol appears to only increase breast cancer risk in women who have low folate levels. Folate is a B vitamin that is found in a variety of foods; it is also added to many vitamin and mineral supplements. In its synthetic form it is referred to as folic acid. So if you are someone who enjoys a glass of wine with dinner, you may want to consider taking a folate supplement or a multivitamin that includes folate. "  http://www.dslrf.org/breastcancer/content.asp?CATID=60&L2=1&L3=6&L4=0&PID=&cid=596&sid=132
  • From Dr. Michele Holmes (who specializes in lifestyle factors and BC - see the video link in my above post): "Kwan et al showed what we've always suspected: There's an increase in recurrence and breast cancer death associated with alcohol, mostly in postmenopausal women, and the impact may be worse in obese women. They did not find an increase total deaths, which pulls together some of the previous literature. Our message about alcohol to women with breast cancer may have to be as nuanced as our message to women who don't have breast cancer. Yes, alcohol may indeed increase the risk for recurrence and death from breast cancer. However, with the very high survival rates of women with early-stage breast cancer, many patients live long enough to get heart disease. Alcohol may not increase risk for total death because it is preventing women of dying from heart disease."   http://www.hemonctoday.com/article.aspx?rid=51335

I'm not suggesting that heavy alcohol consumption is good for us - there have been dozens of studies that have shown that it's not.  I'm not advocating that those who don't consume alcohol now start drinking - of course not.  I'm not saying that those who choose to eliminate alcohol from their diets are making a bad choice - not at all.  I'm also not suggesting that there is no link between breast cancer risk and alcohol - alcohol does slightly increase BC risk.  But I'm fed up with all the scare tactics that lead women with BC to believe that they can never enjoy a drink again.  We need to have perspective and look at alcohol in the context of the total picture of our BC risk, our overall health and our lifestyle/enjoyment of life.  And in that context, for those of us who enjoy an occasional glass of wine with dinner, the science suggests that there is nothing wrong with that and for most of us, the negative health impact will be minimal, if there is any impact at all.

Dx 9/15/05, DCIS-MI, 6cm+ Gr3 DCIS w/IDC microinvasion, Stage I, 0/3 nodes, ER+/PR- “No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke

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May 15, 2010 11:41AM mom3band1g wrote:

daisy6 - Will do.

lumpectomy 2/10/10 bi-lat mx 3/25/10 rads completed 7/10!

Dx 1/19/2010, DCIS, 6cm+, Stage 0, Grade 3, ER+/PR+
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May 15, 2010 12:46PM Beesie wrote:

Daisy, I did the math on the 30% recurrence risk.  Women can decide for themselves if this is a  minimal increase in risk, based on their on risk level and their own risk tolerance.  For me, having had a mastectomy, a 0.1% increase in risk per year is minimal.  If you think that's too much of an increase in risk for you, then make your own choice.  I'm not trying to make this decision for other women - like you, I'm trying to present the facts so that they can make the decision for themselves.  For me, that means presenting what I believe to be credible sources of data, including the conclusions of respected specialists who have reviewed all the research.  Yes, there are over 600,000 articles on the internet that women can search through themselves, but how many are written by experts who understand this issue, have read all the research studies and know how to analyse a piece of research? How many are thorough reviews of the research, rather than topline summaries? How do you figure out what is a good article vs. one that is only presenting a part of the study (the part that is most likely to get headlines, rather than the "ifs" and "buts" that go along with most every research study).   Dr. Holmes is Professor at Dana-Farber/Harvard and Brigham and Young.  Her specific area of study is how diet/lifestyle factors affect survival for those diagnosed with breast cancer and prostate cancer. Your dietian may have attended ASCO; Dr. Holmes presented at ASCO.  To me, she's a credible source.

Or how about Dr. Jeffrey Peppercorn, who is a researcher/breast cancer specialist from Duke?  Here's his analysis on the most recent study that showed the 30% increase in risk:  "...The new results could be consistent with counseling breast cancer patients that "one glass of wine may be okay, but keep it at that," Peppercorn said, though he cautioned against overinterpreting the observational data. Peppercorn additionally warned about the barely significant overall hazard ratios and the limitations of self-reporting alcohol intake."

What's important to note is that we are not disagreeing on the research or the results.  We are actually quoting the exact same study.  What we are disagreeing on is the interpretation and implications of this study and for this I am relying on the opinions of experts.  By the way, it's not me who says that a 30% increase in risk is considered "low risk".  Komen say that.  And here's how the American Cancer Society talk about alcohol and breast cancer risk:  "Compared with non-drinkers, women who consume 1 alcoholic drink a day have a very small increase in risk. "  ACS :: What Are the Risk Factors for Breast Cancer?   And from the Annals of Surgery/NCI:  "Risk factors that have received a great deal of publicity (hormone use, alcohol consumption, obesity, nulliparity) present a relatively modest relative risk for breast cancer (<2). ....the documented effect of alcohol consumption on the incidence of breast cancer appears to be modest. Numerous studies have reported that consumption of one drink per day or less (approximately 12 g alcohol) does not significantly affect the risk of breast cancer.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1514477/  So my comment about alcohol being a "low risk factor" is based on the medical/scientific standpoint assessment of risk; it's not my opinion.

I agree completely that everyone can and should make their own decision about whether or not to consume alcohol and I encourage everyone to read up on the BC & Alcohol studies.  It's important to not rely on the opinions of laypersons - including myself.  My only advice is to be careful in your choice of information sources - all articles on Google are not equal.  Read the respected medical journals if you can, read the original reports on the studies or the interpretations from experts in the field.  Then make a decision that's right for you, for your health and for your lifestyle.

By the way, I find that one of the best things I do to reduce my blood pressure is relaxing with a glass of wine!  Since there are those who believe that stress may lead to breast cancer, and since stress has certainly be proven to cause a multitude of other health problems, I consider that to be one of the good things that I do for my health! Wink

Dx 9/15/05, DCIS-MI, 6cm+ Gr3 DCIS w/IDC microinvasion, Stage I, 0/3 nodes, ER+/PR- “No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke

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May 15, 2010 12:51PM CrunchyPoodleMama wrote:

Beesie, what you've said is correct, and no one is saying you must NEVER NEVER NEVER have even one sip of wine.

I just wanted to offer my story as a cautionary tale. I didn't drink a sip of wine for several months after my dx. Then one day I realized an occasional glass of wine wouldn't hurt and would probably be good for my health. So I enjoyed it and boy was it delicious!

The next week, I saw someone on facebook post that she reeeeally could use a nice glass of wine. I thought, "Mmm, that sounds good," and went and poured myself one. No problem, right?

The next night, I treated myself to another... it was becoming part of a lovely evening ritual (and helped combat my insomnia to boot). A get-together with girlfriends, well of course wine was a must!

Before I knew it, I was having two glasses of wine a night... nearly EVERY night... occasionally three.  I still thought of myself as an occasional or possibly moderate drinker.

Well, I'm here to tell you that that qualifies as HEAVY drinking according to the alcohol/bc studies. One glass of wine alone might be 2-3 servings. It's an easy trap to fall into.

A half-glass (i.e. a serving) of red wine once a week is dandy. No one here is saying not to do that.

But if you pour yourself a wine glass full to the brim and have that EVERY night with dinner, as silly as it seems, that is getting dangerously close to what's considered "heavy drinking" according to the breast cancer/alcohol studies. That's simply factual, not scare tactic.

Julia ~ Dear friends, do what you can to help your body fight/prevent cancer. 1. Supplement with iodine and vitamin D. 2. STOP taking hormonal birth control/HRT. 3. Eat organic real food, not chemical or fake food.

Dx 11/13/2009, DCIS, 4cm, Stage 0, Grade 2, 0/0 nodes, ER+/PR+
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May 15, 2010 02:06PM Beesie wrote:

In all my posts on this topic I've stressed that I am referring to "moderate" consumption.

Given what the BC & Alcohol studies actually show, and given the questions about how many of these studies are done (self reporting is a big issue; when self-reporting, do women underestimate the amount of wine that they drink? Quite possibly, don't you think?) I think it's wrong to scare women into thinking that alcohol consumption is bad.  A question such as the one that started this thread stems from those types of scare tactics, whether in the press or on this board.  Honestly, should someone who had a bilateral mastectomy for non-invasive breast cancer really be worried about whether drinking a glass or two of wine will increase her BC recurrence risk?  I understand why the question was asked - I'm not criticizing that at all - but to me the answer should be pretty simple:  If you've had a bilateral mastectomy for DCIS, your risk is so low that any possible minor increase in risk from alcohol consumption isn't something that you should be worried about, if you want to enjoy the occasional glass of wine. The stress of worrying about it will be worse for you than the occasional glass of wine. For the question asked, that's the simple and factual answer.  And many did answer that way.  Unfortunately it wasn't left at that and instead a discussion was started about how alcohol has a high impact on recurrence risk.  This is factually incorrect; alcohol has a low impact on recurrence risk.  And given the question that was asked to start this thread, this subsequent discussion seems to serve no purpose but to counter the earlier responses and create fear and questioning about whether any alcohol is okay.     

Most studies on BC and alcohol consider a glass of wine to be 5oz.  None of the studies (to my knowledge) have shown any increase in risk for those who consume up to 3 glasses of wine a week.  Most of the studies have shown that consuming 4-6 glasses of wine a week may increase BC risk anywhere from 10% - 30% (but with no increase in overall mortality).  Those are the facts.  Everyone can decide from there what they choose to do about that. 

There are many women who make an educated decision about alcohol consumption and choose to consume moderately. I am one of those women.  I think it's shameful the way that so many (in the press, some doctors, some women here) try to make us feel guilty or bad or stressed about our choice.  The facts - about moderate alcohol consumption - simply don't support that. 

Dx 9/15/05, DCIS-MI, 6cm+ Gr3 DCIS w/IDC microinvasion, Stage I, 0/3 nodes, ER+/PR- “No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke

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May 15, 2010 07:48PM IronJawedBCAngel wrote:

I am not my breast cancer.  The information posted on any of these boards is just the opinion, sometimes supported by research, that any one of us chooses to embrace, and make our decisions accordingly.  The risk I am willing to take, may be more than what another individual wishes to accept.  I don't think Beesie is trying to force her opinion down any ones throat, but I do think she is trying to put the risk into perspective.  The psychologist that works at my cancer center once commented that he did not want any woman thinking their cancer came back because of that one ice cream cone or those two glasses of wine. There has got to be balance and quality of life, or our doctors have not been successful in sending us off into survivorship.  I am not a doctor, but I don't think some glasses of wine were directly responsible for a woman's grade 2 DCIS cells multiplying in the months between the first and second excision.  They may have contributed, but the cancer cells were doing exactly what makes them cancer cells by definition.  There was abnormal rate of growth of the cells, and that is what cancer cells do.  I didn't see anything about tamoxifen or an AI being taken after the first excision, before the second, which is what would keep the estrogen from feeding that cancer cell.  None of us have absolute control over what happens, with our cancers or any other aspect of our life.  We gather our information and make the best decision for ourselves.  I have a slightly different perspective than someone who is just beginning this journey.  I am just asking that you all have good primary care doctors that oversee your health care beyond your breast cancer.  As my psychologist said, he has seen far too many women so focused on not dying of cancer, that they forget to live.  Some get so focused on the breast cancer, they do not see the heart attack, stroke, or other important health issue coming to run them down.

For those of you who choose not to have a drink, that is great!  However, do you also go without hair color, cosmetics, facial products, non- organic meat and vegatables, etc. etc?  There are carcinegens in all of those things.  For myself, I refuse to live in a bubble and let breast cancer win.  I do take a folic acid supplement as the benefits of folic acid are documented.  In all aspects of my breast cancer, I have embraced the philosophy that I prepare for the worst, but hope for the best.  As I stated before, my mom is an alcoholic and smoker, no cancer ever.  My good friend Dorothy, a 56 year breast cancer survivor, does not drink, but is a typical southern girl, loves fried chicken, catfish, foods loaded in fats and sugars, she is overweight, and yet, 56 years later, still here defying everyone that would have predicted her chance of survival. Before breast cancer, I went without so many things I would have enjoyed, but I was afraid of being fat, becoming an alcoholic like my mom, having too much fun. Getting breast cancer taught me that life is simply too short to not cash in some fun tickets.  I  now regret not partying more in my youth, and stopping to smell the roses.  Growing old is a privilege.  We are all going to die someday, and we simply lack much control over when that will be.  I had a hard lesson on that two years ago when my best friend's son died at the age of 21 in a parachuting accident.  Enjoy life, live it with passion!  Do not let the cancer win by having it control every aspect of your life.  Read the research, educate yourself, and make the best choice for you, but please do not live your life in fear.

DCIS, 2005, lumpectomy, 32 rads, tamoxifen

Dx 4/15/2005, DCIS, <1cm, Stage 0, Grade 3, 0/0 nodes, ER+/PR+, HER2-
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May 16, 2010 06:05PM, edited May 16, 2010 06:07PM by Beesie

Everyone can - and should  - make their own decision about this.  Daisy, both you and I have presented different points of view and supporting documentations.  I'm happy to leave it at that.

With regard to how a 30% increase in recurrence risk can equate to a 0.1% increase in risk per year, here's how the math works on that. What's necessary is to convert the relative increase (30%) into an absolute increase.  Here's how that's done:

  • It is generally agreed that for those who have a mastectomy for DCIS, recurrence risk falls in the range of 1% - 2%.  This has been confirmed by many studies.  Note that this is lifetime recurrence risk (i.e. this risk is spread out over all the years of the rest of your life).
  • 30% of 1% is 0.3%; 0.3% is the absolute risk increase.  This means that a 30% increase of a base risk of 1% equals 1.3%.
  • 30% of 2% is 0.6%; 0.6% is the absolute risk increase.  This means that a 30% increase of a base risk of 2% equals 2.6%.
  • Therefore, for those who choose to consume alcohol moderately, their lifetime recurrence risk after a mastectomy for DCIS may increase from a range of 1% - 2% to a range of 1.3% - 2.6%. 
  • As I explained in one of my earlier posts, while a recurrence can occur at any time, even 10 or 20 years later, most recurrences happen within the first 5 years.  This also means that most of the risk increase from consuming alcohol will affect us during those first 5 years.  So let's assume that 80% of recurrences happen within the first 5 years.  That means that the amount of risk increase that will impact us over these first 5 years will range from 0.24% to 0.48% (80% of the 0.3% and 0.6% absolute risk increases).  To determine the annual increase in risk, divide these numbers by 5.  This means that the annual risk increase for those who have a mastectomy for DCIS and who choose to consume alcohol moderately is in the range of 0.05% to 0.1% (I've rounded the numbers up).

Edited for typos only.

Dx 9/15/05, DCIS-MI, 6cm+ Gr3 DCIS w/IDC microinvasion, Stage I, 0/3 nodes, ER+/PR- “No power so effectually robs the mind of all its powers of acting and reasoning as fear.” Edmund Burke

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May 16, 2010 06:22PM lizzymack1 wrote:

You know, the trials and tribulations of this disease are so awful, some liquor can only help!   We only live once.   They don't know **S** about what causes bc and they don't know what exacerbates it.    Ignore all the nonsense and do what you please.    If anyone can, with some certainty, point out what they did that caused them to get bc, then don't do THAT again!   Did anyone see "Little Miss Sunshine?"   Remember the grandfather?  Like it or not, bc is going to effect our life expectancy so enjoy while you are here.

I have not even been operated on yet and the other night I had a beer and felt like I was getting an odd sensation in my  breast and I don't really give a _____!   The statistics say that if you don't have kids it is a risk and it seems to me 90% of women w/bc have kids?  Believe me, if they knew more than we do they would not be playing "pin the tail on the cause" quite so much!

Have fun, girls, because like JennSmith58 said her mom did all that stuff and has no dx and Jenn lived the clean life and she gets the dx.....there is no rhyme or reason....just enjoy yourselves.

Abraham Lincoln: It is not the years in your life that count---it's the life in your years>>>> Recon trilogy!: BMX w/imm recon 6/10=TE infected (failed); MF graft attempt 10/11=L necrotic (failed): 7/12 DIEP FLAP **VERY successful**

Dx 4/16/2010, IDC, 2cm, Stage IIb, Grade 2, 2/18 nodes, ER+/PR+, HER2-
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May 16, 2010 08:39PM Diane509 wrote:

how did you even find out you had a recurrence?  I had DCIS in 1 breast, had them both removed and did immediate reconstruction with lat flap procedure.  was under the impression after the pathology came back negative for invasive cancer and the node was negative that would be it.... no more mammography etc.... how did you discover 8 months later of a recurrence?

Dx 2/17/2010, DCIS, 1cm, Stage 0, Grade 2, ER+/PR+
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May 17, 2010 06:04AM mom3band1g wrote:

diane509- don't you see your bs for follow-up care?  I will see my bs every 6m for the next 5 yrs and then once a year for  life.  You should also be doing self-exams. 

lumpectomy 2/10/10 bi-lat mx 3/25/10 rads completed 7/10!

Dx 1/19/2010, DCIS, 6cm+, Stage 0, Grade 3, ER+/PR+
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May 17, 2010 09:45AM, edited May 17, 2010 09:46AM by lizzymack1

Daisy-

I can appreciate what you are saying, however, they know NOTHING about what is causing cancer so avoiding certain things is the equivalent of shadow boxing.   We don't know who/what the ghosts are or what the problem is.   All alcohols do not have the same properties etc.. so I just find it to be a bunch of :malarkey.   Again, this is a byproduct of "we-don't-know-what-the-hell-is-going-on-let's-pin-the-tail-on-the-cause!" 

To each their own but before you stress out over a few drinks or whatever remember if liquor was the devil 95% of the population would have bc.  I still quote Axel Rose from Guns N' Roses and their profound lyrics of "they blame it on the cigarette but I can't see, tell me who you are going to believe."  Enough said!

Liz

Abraham Lincoln: It is not the years in your life that count---it's the life in your years>>>> Recon trilogy!: BMX w/imm recon 6/10=TE infected (failed); MF graft attempt 10/11=L necrotic (failed): 7/12 DIEP FLAP **VERY successful**

Dx 4/16/2010, IDC, 2cm, Stage IIb, Grade 2, 2/18 nodes, ER+/PR+, HER2-
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May 17, 2010 10:30AM Bren-2007 wrote:

I've been following this thread with interest ... but declined to post until now.

Cause ... Liz .. I just love Guns N' Roses.  woohoo!

hugs,

Bren

PS ... I don't drink at all, but it has nothing to do with cancer.  I was alcohol-free for 28 years when I got breast cancer.  I think getting b/c is a crapshoot.  And speaking of shooting craps ... love the game as well.

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May 17, 2010 02:41PM JAT wrote:

I come from a long line of drinkers. While I enjoyed alcohol in my twenties, by my 30s I was strictly a "social drinker" and after I had my daughter I just about gave up alcohol.  For the past 20 years, I did a lot of the "right things"-  walked 5 miles daily, ate organic, gave up butter and most fats,etc.  I have 6 older siblings and two parents still alive in their late 80s-- At 43, I was the first(and for their sakes, I hope the last)  in my family to get cancer-- and I was the one who was always teased for "looking" so fit. But I also live in a world in which people put pesticides on their lawns (and my generation, women in their 40s, have all been exposed to pesticides since our childhood-- who ever regulated DEET when we were kids or the pesticides sprayed from airplanes?), the FDA and EPA refuse to properly regulate our air and water (my filter system is good but cannot remove pharmaceuticals or weed killer).  Every time I see my oncologist, I ask, what did I do wrong? should I eat more broccoli? will not eating tumeric daily  bring back my cancer? what I want is to regain control of my life, but it's gone forever  Her area of research is on diet and exercise and their relationship to breast cancer-- but she  just shakes her head when I ask, "do I need to give up sugar completely?" (My God, what is left for me to enjoy?). I will not give up chocolate and I finally enjoy butter (ironically, my cholesterol is always perfect now that I restored fats to my diet).  So like so many of you have said, we have to just live our lives-- probably we'll always worry (I know I do), but we can't blame ourselves for causing our cancer. As my doctors all concur, "it's just bad luck."    - -- Julie.

Dx 5/9/2008, DCIS, Stage 0, Grade 3, 0/5 nodes, ER+/PR+
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May 17, 2010 03:49PM nancy2721 wrote:

Hi everyone,

I'm really glad I found this thread- of all things I've gone through since this dx this single topic has been weighing on my mind. I'm sure both views are accurate and sincere in their deliveries..but I think we all need to make our own decisions and support each other in theirs. I feel breast cancer is taking enough from me.- it is NOT making me give up my 1-2 glasses of pinot noir at night. I have no other vices- and if my nightly glass or two is going to bring me happiness, relaxation and a little peace among all of this chaos- I'm going for it- without guilt. So many different opinions- even among my team of docs, nurses, techs etc that I have decided it is up to my heart and spirit to decide. Cheers.

Dx 1/7/2010, IDC, <1cm, Stage I, Grade 1, 0/2 nodes, ER+/PR+, HER2-
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May 17, 2010 04:11PM Diane509 wrote:

I can't recall what the BS told me.. I think she said to recuperate and then we would have a follow up appointment sometime.  I was just curious how they found IBC on someone after a bi-lateral mastectomy ... I guess there is no guarantee all the tissue is removed but I feel like I had it.. now it's gone.... and I was told no more mammography after this.... I guess I have more questions for the docs!

Dx 2/17/2010, DCIS, 1cm, Stage 0, Grade 2, ER+/PR+
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May 17, 2010 06:12PM JAT wrote:

Diane-- You're at the early stage of the process, and if you're doing reconstruction, that can be drawn out over several months. Your surgeon should put you on a cycle of exams-- one every 6 months, and you should be followed by an oncologist, every 6 months. At Georgetown, they don't do mammograms or MRIs for bilateral patients-- just a breast exam, feel your arm and neck nodes, etc.-- but 4x/year by 2 sets of experienced hands is comforting. My oncologist also does blood work once a year, plus I have my GP do a physical yearly with blood work. There is no guarantee this will catch a recurrence before it's invasive, but it offers some peace of mind. Ask your surgeon and oncologist what their standard of care/follow-up is (on the west coast many drs. order MRIs). I know some women on this site get ultrasounds but I was told this isn't approved for screeing after a bilateral, only for targeted exams (I've had several for specific spots I thought were lumps-- usually just scar tissue or stitches that refuse to dissolve even after a  1 1/2 yrs. after my implant exchange!). I hope this helps.--Julie

Dx 5/9/2008, DCIS, Stage 0, Grade 3, 0/5 nodes, ER+/PR+