Research table: Alcohol and breast cancer survival

This summary table contains detailed information about research studies. Summary tables are a useful way to look at the science behind many breast cancer guidelines and recommendations. However, to get the most out of the tables, it’s important to understand some key concepts. Learn how to read a research table.

Introduction: Some findings suggest women who drink alcohol after a breast cancer diagnosis have a higher risk of breast cancer recurrence (a return of breast cancer) and breast cancer mortality (death from breast cancer) than those who don’t drink alcohol.

Other studies show no difference in breast cancer recurrence or breast cancer mortality between those who drink alcohol.

One reason for these mixed findings may be that drinking in moderation has some health benefits. It may lower the risks of heart disease, high blood pressure and overall mortality (death from any cause) [1-2].

Excessive alcohol drinking has no health benefits, only health risks.

Learn more about alcohol and breast cancer survival.

Learn about alcohol and breast cancer risk.

Learn about the strengths and weaknesses of different types of studies.

Study selection criteria: Prospective cohort studies with at least 1,000 participants, pooled analyses and meta-analyses.

All studies measured alcohol intake after breast cancer diagnosis.  

Table note: Relative risk above 1 indicates increased risk. Relative risk below 1 indicates decreased risk.  

Study	Study Population (number of participants)	Follow-up (years)	Women Treated for Breast Cancer Who Drank Moderate Amounts of Alcohol versus Those Who Did Not Drink Alcohol, RR (95% CI)
			Breast Cancer Recurrence	Breast Cancer Mortality
Prospective cohort studies
Women’s Health Initiative Observational Study [3]	7,835	8		0.88 (0.41-1.87)
Collaborative Women’s Longevity Study [4]	4,881	11		0.80 (0.49-1.32)
WHEL Study [5]	3,088	7	0.91 (0.71-1.18)
Women’s Health Study [6]	2,830	25		1.24 (0.80-1.91)*
Pathways Study [7]	2,763	11	1.06 (0.81-1.39)	1.08 (0.78-1.50)
LACE Study [8]	1,897	7	1.35 (1.00-1.83)	1.51 (1.00-2.29)
Breast Cancer Family Registry – New York [9]	1,116	9		0.96 (0.49-1.89)
Pooled and meta-analyses
After Breast Cancer Pooling Project [10-11]	9,329	10	1.08 (0.89-1.30)†,‡	1.05 (0.84-1.32)
Gou et al. [12]	12 studies		1.17 (0.80-1.73)	1.08 (0.94-1.25)

* Among women who had estrogen receptor-positive breast cancers, those who drank more than 1 alcoholic drink per day had an increased risk of breast cancer mortality compared to women who drank less than 1 drink per month, 1.37 (1.18-1.59).

† Among women who were diagnosed with breast cancer after menopause, those who drank 4 or more alcoholic drinks a week had an increased risk of breast cancer recurrence compared to those who did not drink alcohol, 1.19 (1.01-1.40).

‡ Among women who had estrogen receptor-positive breast cancers, those who drank 7 or more alcoholic drinks a week had an increased risk of late breast cancer recurrence (5 or more years after diagnosis) compared to non-drinkers, 1.28 (1.01-1.62).

References

1. Fuchs CS, Stampfer MJ, Colditz GA, et al. Alcohol consumption and mortality among women. N Engl J Med. 332(19):1245-50, 1995.
2. Forman JP, Stampfer MJ, Curhan GC. Diet and lifestyle risk factors associated with incident hypertension in women. JAMA. 302(4):401-11, 2009.
3. Lowry SJ, Kapphahn K, Chlebowski R, Li CI. Alcohol use and breast cancer survival among participants in the Women’s Health Initiative. Cancer Epidemiol Biomarkers Prev. 25(8):1268-73, 2016.
4. Newcomb PA, Kampman E, Trentham-Dietz A, et al. Alcohol consumption before and after breast cancer diagnosis: associations with survival from breast cancer, cardiovascular disease, and other causes. J Clin Oncol. 31(16):1939-46, 2013.
5. Flatt SW, Thomson CA, Gold EB, et al. Low to moderate alcohol intake is not associated with increased mortality after breast cancer. Cancer Epidemiol Biomarkers Prev. 19(3):681-8, 2010.
6. Mostofsky E, Lee IM, Buring JE, Mukamal KJ. Impact of alcohol consumption on breast cancer incidence and mortality: the Women’s Health Study. J Womens Health (Larchmt). 2024 Feb 28 [Online ahead of print].
7. Kwan ML, Valice E, Ergas IJ, et al. Alcohol consumption and prognosis and survival in breast cancer survivors: The Pathways Study. Cancer. 129(24):3938-3951, 2023.
8. Kwan ML, Kushi LH, Weltzien E, et al. Alcohol consumption and breast cancer recurrence and survival among women with early-stage breast cancer: the life after cancer epidemiology study. J Clin Oncol. 28(29):4410-6, 2010.
9. Zeinomar N, Thai A, Cloud AJ, McDonald JA, Liao Y, Terry MB. Alcohol consumption and breast cancer-specific and all-cause mortality in women diagnosed with breast cancer at the New York site of the Breast Cancer Family Registry. PLoS One. 12(12):e0189118, 2017.
10. Kwan ML, Chen WY, Flatt SW, et al. Postdiagnosis alcohol consumption and breast cancer prognosis in the after breast cancer pooling project. Cancer Epidemiol Biomarkers Prev. 22(1):32-41, 2013.
11. Nechuta S, Chen WY, Cai H, et al. A pooled analysis of post-diagnosis lifestyle factors in association with late estrogen-receptor-positive breast cancer prognosis. Int J Cancer. 138(9):2088-97, 2016.
12. Gou YJ, Xie DX, Yang KH, et al. Alcohol consumption and breast cancer survival: a meta- analysis of cohort studies. Asian Pac J Cancer Prev. 14(8):4785-90, 2013.

Updated 05/22/24