Breast cancer, alcohol, and phosphate toxicity.

Alcohol consumption is associated with an increased risk of breast cancer, even at low alcohol intake levels, but public awareness of the breast cancer risk associated with alcohol intake is low. Furthermore, the causative mechanisms underlying alcohol's association with breast cancer are unknown. The present theoretical paper uses a modified grounded theory method to review the research literature and propose that alcohol's association with breast cancer is mediated by phosphate toxicity, the accumulation of excess inorganic phosphate in body tissue. Serum levels of inorganic phosphate are regulated through a network of hormones released from the bone, kidneys, parathyroid glands, and intestines. Alcohol burdens renal function, which may disturb the regulation of inorganic phosphate, impair phosphate excretion, and increase phosphate toxicity. In addition to causing cellular dehydration, alcohol is an etiologic factor in nontraumatic rhabdomyolysis, which ruptures cell membranes and releases inorganic phosphate into the serum, leading to hyperphosphatemia. Phosphate toxicity is also associated with tumorigenesis, as high levels of inorganic phosphate within the tumor microenvironment activate cell signaling pathways and promote cancer cell growth. Furthermore, phosphate toxicity potentially links cancer and kidney disease in onco-nephrology. Insights into the mediating role of phosphate toxicity may lead to future research and interventions that raise public health awareness of breast cancer risk and alcohol consumption.

[1]  B. Stordal Breastfeeding reduces the risk of breast cancer: A call for action in high‐income countries with low rates of breastfeeding , 2022, Cancer medicine.

[2]  Zhimei Lv,et al.  Chronic Kidney Disease and Cancer: Inter-Relationships and Mechanisms , 2022, Frontiers in Cell and Developmental Biology.

[3]  P. Prajapati,et al.  Hand sanitizers as a preventive measure in COVID-19 pandemic, its characteristics, and harmful effects: a review , 2022, Journal of the Egyptian Public Health Association.

[4]  E. Rakha,et al.  Specific cell differentiation in breast cancer: a basis for histological classification , 2021, Journal of Clinical Pathology.

[5]  I. Soerjomataram,et al.  Global burden of cancer in 2020 attributable to alcohol consumption: a population-based study , 2021, The Lancet. Oncology.

[6]  P. Contu,et al.  Alcohol Consumption Is a Modifiable Risk Factor for Breast Cancer: Are Women Aware of This Relationship? , 2021, Alcohol and alcoholism.

[7]  A. Sjölander,et al.  Mammographic microcalcifications and risk of breast cancer , 2021, British Journal of Cancer.

[8]  A. Stinghen,et al.  Uremic Toxins: An Alarming Danger Concerning the Cardiovascular System , 2021, Frontiers in Physiology.

[9]  H. Rondon-Berrios,et al.  Hypophosphatemia in cancer patients , 2021, Clinical kidney journal.

[10]  J. Hirst,et al.  Regulation of ATP hydrolysis by the ε subunit, ζ subunit and Mg-ADP in the ATP synthase of Paracoccus denitrificans , 2020, Biochimica et biophysica acta. Bioenergetics.

[11]  C. Porta,et al.  The basics of onco-nephrology in the renal clinic , 2020, Journal of Nephrology.

[12]  Ronald B. Brown Phosphate and Oxysterols May Mediate an Inverse Relationship Between Atherosclerosis and Cancer , 2020, EMJ Oncology.

[13]  Aaron White Gender Differences in the Epidemiology of Alcohol Use and Related Harms in the United States , 2020, Alcohol research : current reviews.

[14]  R. Saskin,et al.  Assessment of Secondary Sarcomas Among Patients With Cancer of the Abdomen or Pelvis Who Received Combinations of Surgery, Radiation, and Chemotherapy vs Surgery Alone , 2020, JAMA network open.

[15]  J. Tucker,et al.  Changes in Adult Alcohol Use and Consequences During the COVID-19 Pandemic in the US , 2020, JAMA network open.

[16]  E. Combet,et al.  Klotho, Aging, and the Failing Kidney , 2020, Frontiers in Endocrinology.

[17]  M. Perazella,et al.  Onconephrology: The intersections between the kidney and cancer , 2020, CA: a cancer journal for clinicians.

[18]  E. Lerma,et al.  Rhabdomyolysis. , 2020, Disease-a-month : DM.

[19]  Ronald B. Brown Breakthrough Knowledge Synthesis in the Age of Google , 2020, Philosophies.

[20]  R. Elias,et al.  25-vitamin D reduces inflammation in uremic environment , 2020, Scientific Reports.

[21]  W. Klein,et al.  Alcohol and Cancer Risk: Clinical and Research Implications. , 2019, JAMA.

[22]  Amanda L. Garrett,et al.  Modeling the Use of Mixed Methods–Grounded Theory: Developing Scales for a New Measurement Model , 2019, Journal of Mixed Methods Research.

[23]  F. Rumjanek,et al.  H+-dependent inorganic phosphate transporter in breast cancer cells: Possible functions in the tumor microenvironment. , 2019, Biochimica et biophysica acta. Molecular basis of disease.

[24]  G. Capasso,et al.  Summary of the International Conference on Onco-Nephrology: an emerging field in medicine. , 2019, Kidney international.

[25]  F. Cordera,et al.  Is Breast Cancer Associated with Primary Hyperparathyroidism? , 2019, American Journal of Otolaryngology and Head and Neck Surgery.

[26]  Melanie Birks,et al.  Grounded theory research: A design framework for novice researchers , 2019, SAGE open medicine.

[27]  R. Unwin,et al.  Physiological regulation of phosphate by vitamin D, parathyroid hormone (PTH) and phosphate (Pi) , 2018, Pflügers Archiv - European Journal of Physiology.

[28]  D. Trump Calcitriol and cancer therapy: A missed opportunity , 2018, Bone reports.

[29]  Arjun Gupta,et al.  Tumor Lysis Syndrome. , 2018, JAMA oncology.

[30]  M. Razzaque,et al.  Phosphate toxicity and tumorigenesis. , 2018, Biochimica et biophysica acta. Reviews on cancer.

[31]  F. Rumjanek,et al.  Characterization of inorganic phosphate transport in the triple-negative breast cancer cell line, MDA-MB-231 , 2018, PloS one.

[32]  Foad Alzoughool,et al.  Vitamin D and Breast Cancer: Latest Evidence and Future Steps , 2017, Breast cancer : basic and clinical research.

[33]  R. García-Becerra,et al.  Chronic moderate ethanol intake differentially regulates vitamin D hydroxylases gene expression in kidneys and xenografted breast cancer cells in female mice , 2017, The Journal of Steroid Biochemistry and Molecular Biology.

[34]  Jason V. Evans,et al.  Interstitial Inorganic Phosphate as a Tumor Microenvironment Marker for Tumor Progression , 2017, Scientific Reports.

[35]  S. Sivakumar Mineral status of female breast cancer patients in Tamil Nadu , 2016 .

[36]  A. Hodge,et al.  To what extent is alcohol consumption associated with breast cancer recurrence and second primary breast cancer?: A systematic review. , 2016, Cancer treatment reviews.

[37]  P. Mitchell,et al.  Chronic kidney disease and the risk of cancer: an individual patient data meta-analysis of 32,057 participants from six prospective studies , 2016, BMC Cancer.

[38]  J. Varon,et al.  Beyond muscle destruction: a systematic review of rhabdomyolysis for clinical practice , 2016, Critical Care.

[39]  K. Pathak,et al.  Hypercalcemia in metastatic breast cancer unrelated to skeletal metastasis , 2016, Canadian Medical Association Journal.

[40]  Kelly E McKinnon,et al.  Inorganic phosphate induces cancer cell mediated angiogenesis dependent on forkhead box protein C2 (FOXC2) regulated osteopontin expression , 2015, Molecular carcinogenesis.

[41]  Naihua Duan,et al.  Purposeful Sampling for Qualitative Data Collection and Analysis in Mixed Method Implementation Research , 2015, Administration and Policy in Mental Health and Mental Health Services Research.

[42]  G. Bazoukis,et al.  Nontraumatic rhabdomyolysis with short-term alcohol intoxication – a case report , 2015, Clinical case reports.

[43]  D. Santoro,et al.  Nephro-oncology: a link in evolution , 2015, Renal failure.

[44]  M. Razzaque,et al.  Dysregulation of phosphate metabolism and conditions associated with phosphate toxicity. , 2015, BoneKEy reports.

[45]  C. la Vecchia,et al.  Alcohol consumption and site-specific cancer risk: a comprehensive dose–response meta-analysis , 2014, British Journal of Cancer.

[46]  R. Wanders,et al.  Rhabdomyolysis: a review of the literature , 1993, Clinical Neurology and Neurosurgery.

[47]  S. Larsson,et al.  Alcohol consumption and risk of atrial fibrillation: a prospective study and dose-response meta-analysis. , 2014, Journal of the American College of Cardiology.

[48]  I. Romieu,et al.  Female breast cancer and alcohol consumption: a review of the literature. , 2014, American journal of preventive medicine.

[49]  L. Holmberg,et al.  Inorganic phosphate and the risk of cancer in the Swedish AMORIS study , 2013, BMC Cancer.

[50]  Elfi Furtmueller,et al.  Using grounded theory as a method for rigorously reviewing literature , 2013, Eur. J. Inf. Syst..

[51]  Mn Ibclc Sue Hermann Rn,et al.  Breast Cancer Diagnosis While Breastfeeding: When Two Worlds Collide , 2012 .

[52]  M. Razzaque,et al.  Can features of phosphate toxicity appear in normophosphatemia? , 2012, Journal of Bone and Mineral Metabolism.

[53]  P. Torres,et al.  Three feedback loops precisely regulating serum phosphate concentration. , 2011, Kidney international.

[54]  P. Diemunsch,et al.  Paraneoplastic polymyositis associated with breast cancer: a therapeutic emergency , 2011, Breast Cancer Research and Treatment.

[55]  S. Kuo,et al.  SLC34A2 as a novel marker for diagnosis and targeted therapy of breast cancer. , 2010, Anticancer research.

[56]  Pixu Liu,et al.  Targeting the phosphoinositide 3-kinase pathway in cancer , 2009, Nature Reviews Drug Discovery.

[57]  M. Perazella,et al.  Renal vulnerability to drug toxicity. , 2009, Clinical journal of the American Society of Nephrology : CJASN.

[58]  David M Sabatini,et al.  Defining the role of mTOR in cancer. , 2007, Cancer cell.

[59]  J. Chudek,et al.  Phosphatemia is related to chromosomal aberrations of parathyroid glands in patients with hyperparathyroidism. , 2007, Journal of nephrology.

[60]  M. Tsutsumi,et al.  Effect of chronic dietary ethanol in the promotion of N‐nitrosomethylbenzylamine‐induced esophageal carcinogenesis in rats , 2006, Journal of gastroenterology and hepatology.

[61]  S. Fukushima,et al.  Dose‐dependence of promotion of 2‐amino‐3,8‐dimethylimidazo[4,5‐f]quinoxaline‐induced rat hepatocarcinogenesis by ethanol: Evidence for a threshold , 2005, Cancer science.

[62]  R. Stevens,et al.  In utero alcohol exposure increases mammary tumorigenesis in rats , 2004, British Journal of Cancer.

[63]  J. Park,et al.  Human in-vivo 31P MR Spectroscopy of Benign and Malignant Breast Tumors , 2001, Korean journal of radiology.

[64]  J. Gill,et al.  The effects of moderate alcohol consumption on female hormone levels and reproductive function. , 2000, Alcohol and alcoholism.

[65]  N. Shikata,et al.  Long-term ethanol consumption in ICR mice causes mammary tumor in females and liver fibrosis in males. , 2000, Alcoholism, clinical and experimental research.

[66]  C. Kovacs,et al.  Hyperprolactinemia caused by lactation and pituitary adenomas is associated with altered serum calcium, phosphate, parathyroid hormone (PTH), and PTH-related peptide levels. , 1995, The Journal of clinical endocrinology and metabolism.

[67]  R. Rajasekharan,et al.  Lipid peroxidation and ethanol-related tumor promotion in Fischer-344 rats treated with tobacco-specific nitrosamines. , 1994, Alcohol and alcoholism.

[68]  H. Schuller,et al.  Transplacental induction of pancreas tumors in hamsters by ethanol and the tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone. , 1993, Cancer research.

[69]  A. Harris,et al.  Phosphomonoester is associated with proliferation in human breast cancer: a 31P MRS study. , 1993, British Journal of Cancer.

[70]  L. Anderson,et al.  Enhancement of tumorigenesis by N-nitrosodiethylamine, N-nitrosopyrrolidine and N6-(methylnitroso)-adenosine by ethanol. , 1993, Cancer letters.

[71]  K. Yamagiwa,et al.  Effect of Alcohol Ingestion on Carcinogenesis by Synthetic Estrogen and Progestin in the Rat Liver , 1991, Japanese journal of cancer research : Gann.

[72]  J. Stack,et al.  In vivo phosphorus-31 magnetic resonance spectroscopy of normal and pathological breast tissues. , 1991, The British journal of radiology.

[73]  Y. Hiasa,et al.  Effect of ethanol on hepatocarcinogenesis initiated in rats with 3′‐methyl‐4‐dimethylaminoazobenzene in the absence of liver injuries , 1989, International journal of cancer.

[74]  H. Iishi,et al.  Promotion by ethanol of gastric carcinogenesis induced by N-methyl-N'-nitro-N-nitrosoguanidine in Wistar rats. , 1989, British Journal of Cancer.

[75]  T. Ng,et al.  Therapeutic response of breast carcinoma monitored by 31P MRS in situ , 1989, Magnetic resonance in medicine.

[76]  M. Moerland,et al.  Human breast cancer in vivo: H-1 and P-31 MR spectroscopy at 1.5 T. , 1988, Radiology.

[77]  S. J. Jassbi,et al.  A histopathological image dataset for grading breast invasive ductal carcinomas , 2020 .

[78]  Ahmedin Jemal,et al.  Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States , 2018, CA: a cancer journal for clinicians.

[79]  P. Jatlow,et al.  Inhalation of Alcohol Vapor: Measurement and Implications , 2017, Alcoholism, clinical and experimental research.

[80]  P. Pacher,et al.  Alcohol Misuse and Kidney Injury: Epidemiological Evidence and Potential Mechanisms , 2017, Alcohol research : current reviews.

[81]  R. Bansal,et al.  Alcoholic Binge and Nontraumatic Rhabdomyolysis : A Case Report , 2017 .

[82]  P. Mitchell,et al.  Reduced estimated GFR and cancer mortality. , 2014, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[83]  K. Mystakidou,et al.  Measurement of blood phosphorus: a quick and inexpensive method for detection of the existence of cancer in the body. Too good to be true, or forgotten knowledge of the past? , 2014, Medical hypotheses.

[84]  Mei-hua Zhang Rhabdomyolosis and its pathogenesis. , 2012, World journal of emergency medicine.

[85]  I.,et al.  PHOSPHORUS METABOLISM OF NEOPLASTIC TISSUES ( MAMMARY CARCINOMA , LYMPHOMA , LYMPHOSARCOMA ) AS INDICATED BY RADIOACTIVE PHOSPHORUS ' , 2010 .

[86]  Kdoqi Disclaimer K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. , 2002, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[87]  Murray Epstein Alcohol’s Impact on Kidney Function , 1997, Alcohol health and research world.

[88]  D. Porter,et al.  Phosphorus-31 metabolism of human breast--an in vivo magnetic resonance spectroscopic study at 1.5 Tesla. , 1994, The British journal of radiology.

[89]  K. Mitsumori,et al.  Enhancing effect of ethanol on esophageal tumor development in rats by initiation of diethylnitrosamine. , 1993, Carcinogenesis.

[90]  V. Nachiappan,et al.  Ethanol-mediated promotion of oral carcinogenesis in hamsters: association with lipid peroxidation. , 1993, Nutrition and cancer.

[91]  R. Watson,et al.  Modulation of cancer growth by vitamin E and alcohol. , 1993, Alcohol and alcoholism.

[92]  K. Singletary,et al.  Ethanol consumption and DMBA-induced mammary carcinogenesis in rats. , 1991, Nutrition and cancer.

[93]  D. N. Ward,et al.  Phosphorus incorporation into nucleic acids and proteins of liver nuclei of normal and azo dye-fed rats. , 1955, Cancer research.

[94]  Iarc Monograhs,et al.  3. Studies of Cancer in Experimental Animals , 2008 .