I'm high risk for breast cancer but I won't give up drinking

Times

16 hours ago

Bad news for women who, like me, drank most of a bottle of rosé in the dappled sun this weekend: that's our lot for the year. According to the World Health Organisation, women should be limiting themselves to six units a year, or they'll be increasing their breast cancer risk by up 27 per cent. The average British woman currently drinks 468 — six units is less than a bottle of wine, and less than half of the NHS's recommended cap of 14 units a week.
It's the latest piece of dietary health advice on a very long list of dietary health advice, often conflicting. Cut back on caffeine; drink green tea; don't drink cows' milk; oat milk causes a glucose spike; sliced white bread is the worst thing for you since sliced white bread; one glass of red wine a day is good for you; wine is killing you.
• Read more expert advice on healthy living, fitness and wellbeing
I'm 37, a mid-millennial. Unlike sober-curious Gen Z (who vape instead), I came of drinking age in the Noughties, when British drinking culture was the culture. My preferences were informed by ladettes matching the boys pint for pint and the cocktails they ordered on Sex and the City. I'm old enough to remember smoking in nightclubs in my teens — but now also old enough to be evangelical about wearing factor-50 sun cream every day, even in winter, even if I'm only seeing the sun through the windows and skylights at home. I don't smoke, get my steps in, avoid ultra processed foods, limit meat to once a week and buy organic. I've been dabbling with seed-cycling for hormone health; the science behind collagen supplements was the talking point of my friends' WhatsApp group this week. We're approaching our forties with a growing obsession around our health.
I'm also approaching my forties with a looming personal deadline that I'm trying not to turn into an obsession: my invisible switch from 'normal' to 'high' risk when it comes to breast cancer. It runs on both sides of my family. I didn't inherit the BRCA2 gene from my dad's side, which took his mother and one of his sisters (although actually before BRCA2 was discovered in 1995). There's a one in two chance of inheritance for each child: my sister does carry it, and was diagnosed with breast cancer at 32 (she's now 40, and cancer-free).
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But while the family history on my mum's side can't be traced to a specific gene mutation — at least not yet — mum's breast cancer, a slow-growing indolent cancer diagnosed a year after my sister's, and her mother's breast cancer at 48, which finally killed her after 16 years of treatment, recurrence, treatment, recurrence, and so on, were enough to get me a referral to a family history specialist last year. They established that I'll be at high risk between the ages of 40 and 60 (dropping back down to normal on the other side of that) so I will be getting annual mammograms through the NHS once I turn 40. I had the first, to provide the 'before' picture to the perhaps inevitable 'after', last year.
I read every new bit of advice about breast cancer as if it's for me. With my family history, the odds are that it will be at some point. But I've also seen the treatments, improving year on year. Diagnoses are faster; outcomes are better. Neither of my grandmothers survived cancer, but my parents and sister, all have. Between them, they have had chemotherapy, radiotherapy, two mastectomies, a lumpectomy, a prostatectomy and an oophorectomy. They have had a lot of brilliant doctors and nurses, and just as many dreadful hospital jacket potatoes.
I don't plan to quit drinking. I won't completely ignore this advice; I'll worry about it, try to cut back and feel guilty the next time I meet a friend to share a bottle. I already don't drink alone at home (after having spent the lockdowns having cocktails delivered by bicycle courier). But I'm not rigid about it, and might open a bottle of wine if I'm spending an afternoon cooking and listening to records. And when I'm plotting out a new writing project, I'm most likely to take my notebook to prop up a bar somewhere with a few glasses of red wine or a vodka martini.
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My drinking is still social, but without the antisocial side that I occasionally strayed into in my teens. The point of seeing friends is to see friends, but we're all the happier if we do that over a bottle of ice-cold rosé, sitting at a bistro table outside a local wine bar. A glass of wine at the end of the day is a ritual for many of my friends' parents, one that they are taking up as they have children of their own. This week, a friend was drinking non-alcoholic rosé while I drank alcoholic dry white; in a mixed group of friends, there's usually at least one zero-alcohol beer in each round. We're all cutting back, experimenting with our own versions of 'mindful drinking,' not least because the hangovers are so much worse as you get older. But we do all drink.
And six units a year isn't 'mindful drinking', it's teetotalism. I don't need alcohol to have fun, but by the time you eliminate alcohol, red meat, sugar, processed foods, sunshine and whatever the powers that be decide is unhealthy next month, you're left with a regimen, not a lifestyle. The world's blue zones, with the highest percentage of octagenarians in the world, aren't in dry countries, but in Greece, Italy and Japan. As well as a predisposition to breast cancer, my mum and I share a love of wine. Her Glaswegian mother barely drank, but she got breast cancer all the same. At least my way, I'll know how to take the edge off if I do too.