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To the Editor: The combined analysis of 6 cohort studies by Dr Smith-Warner and colleagues¹ provides evidence that alcohol consumption is associated with increased risk of breast cancer. Within a range between minimal and moderate consumption, the study demonstrates a dose-response relationship between alcohol intake and breast cancer risk. The intriguing finding is that women who consume a relatively large amount of alcohol do not show further increase in the risk of breast cancer. If this observation is true, it may indicate a potentially important biological mechanism underlying the association of alcohol with breast cancer risk.

Based on the features of the relationship between alcohol consumption and breast cancer risk (ie, a limited range of dose response and a modest increase in risk) as well as the recent development in the understanding of insulinlike growth factors (IGFs) in relation to breast cancer, we should have reason to speculate that moderate . . . [Full Text of this Article]