Research table: Alcohol and breast cancer risk

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: Many studies show having 1-2 drinks (or more) of alcohol per day is linked to an increased risk of breast cancer.

A meta-analysis that combined the results of 98 studies found women who drank alcohol were 11% more likely than non-drinkers to get breast cancer [1].

Learn more about alcohol and breast cancer risk.

Find a summary of research studies on alcohol and breast cancer survival.

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

See how this risk factor compares with other risk factors for breast cancer.

* Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date.  

Study selection criteria: Prospective cohort studies with at least 1,500 breast cancer cases, meta-analyses and pooled analyses.

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)	Relative Risk of Breast Cancer in Women who Drank Alcohol Compared to Women who Did Not RR (95% CI)
			1-2 drinks/day†	2-4 drinks/day†
Prospective cohort studies
Million Women Study [2]	1,280,296 (28,380 cases)	7	1.13 (1.10-1.16)	1.29 (1.23-1.35)‡
Nurses’ Health Study [3]	105,986 (7,690 cases)	28	1.22 (1.13-1.32)	1.20 (1.07-1.35)
NIH-AARP Diet and Health Study [4]	184,418 (5,461 cases)	7	1.13 (1.02-1.25)	1.23 (1.08-1.41)
EPIC [5]	274,688 (4,285 cases)	6	1.07 (0.96-1.19)	1.13 (1.01-1.25)
Multiethnic Cohort Study [6]	85,089 (3,885 cases)	12	1.12 (0.95-1.32)	1.53 (1.32-1.77)
Women’s Health Study [7]	39,811 (2,830 cases)	25	1.35 (1.19-1.53)§
Kaiser Permanente [8]	70,033 (2,829 cases)	16	1.2 (1.1-14)	1.4 (1.1-1.7)
Women’s Health Initiative Observational Study [9]	87,724 (2,944 cases)	7-12	1.27 (1.05-1.53)	1.24 (1.00-1.55)
45 and Up Study (Australia) [10]	121,770 (2,160 cases)	5	1.15 (1.00-1.34)	1.17 (0.97-1.42)
Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial [11]	54,562 (1,905 cases)	9	1.35 (1.12-1.64)||
Iowa Women’s Health Study [12]	34,393 (1,875 cases)	14	Significant increase
Nurses’ Health Study II [13]	44,187 (1,722 cases)	13	1.33 (1.12-1.58)
California Teachers Study [14]	103,460 (1,742 cases)	4-5	0.91 (0.71-1.16)	1.32 (1.06-1.63)
Pooled and meta-analyses
Collaborative Group on Hormonal Factors in Breast Cancer [15]	153,582 (58,515 cases)		1.13 (1.08-1.19)	1.21 (1.14-1.28)
Pooling Project of Prospective Studies of Diet and Cancer [16]	1,089,273 (37,191 cases)	6-18	1.19 (1.14-1.25)	1.32 (1.23-1.41)
Smith-Warner et al. [17]	322,647 (4,335 cases)		1.16 (0.98-1.38)	1.41 (1.18-1.69)
Bagnardi et al. [18]	115 studies		1.04 (1.01-1.07)
	95 studies			1.23 (1.19-1.28)
Choi et al. [19]	15 studies		1.13 (1.11-1.15)

† In the U.S., there’s an average of 13 grams (g) of alcohol in a bottle or can of beer, 11 g in a glass of wine and 15 g in a shot of whiskey. Relative risk categories are based on the number of drinks, or the number of drinks estimated by the amount of alcohol in a glass of wine.

‡ Categorized as 15 or more drinks per week.

§ Categorized as more than 1 drink per week versus less than 1 drink per month.

|| Categorized as 7 or more drinks per week.

References

1. Key J, Hodgson S, Omar RZ, et al. Meta-analysis of studies of alcohol and breast cancer with consideration of the methodological issues. Cancer Causes Control. 17(6):759-70, 2006.
2. Allen NE, Beral V, Casabonne D, et al. for the Million Women Study Collaborators. Moderate alcohol intake and cancer incidence in women. J Natl Cancer Inst. 101(5):296-305, 2009.
3. Chen WY, Rosner B, Hankinson SE, Colditz GA, Willett WC. Moderate alcohol consumption during adult life, drinking patterns, and breast cancer risk. JAMA. 306(17):1884-90, 2011.
4. Lew JQ, Freedman ND, Leitzmann MF, et al. Alcohol and risk of breast cancer by histologic type and hormone receptor status in postmenopausal women: the NIH-AARP Diet and Health Study. Am J Epidemiol. 170(3):308-17, 2009.
5. Tjønneland A, Christensen J, Olsen A, et al. Alcohol intake and breast cancer risk: the European Prospective Investigation into Cancer and Nutrition (EPIC). Cancer Causes Control. 18(4):361-73, 2007.
6. Park SY, Kolonel LN, Lim U, White KK, Henderson BE, Wilkens LR. Alcohol consumption and breast cancer risk among women from five ethnic groups with light to moderate intakes: the Multiethnic Cohort Study. Int J Cancer. 134(6):1504-10, 2014.
7. 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].
8. Li Y, Baer D, Friedman GD, Udaltsova N, Shim V, Klatsky AL. Wine, liquor, beer and risk of breast cancer in a large population. Eur J Cancer. 45(5):843-50, 2009.
9. Li CI, Chlebowski RT, Freiberg M, et al. Alcohol consumption and risk of postmenopausal breast cancer by subtype: the women’s health initiative observational study. J Natl Cancer Inst. 102(18):1422-31, 2010.
10. Sarich P, Canfell K, Egger S, et al. Alcohol consumption, drinking patterns and cancer incidence in an Australian cohort of 226,162 participants aged 45 years and over. Br J Cancer. 124(2):513-523, 2021.
11. Falk RT, Maas P, Schairer C, et al. Alcohol and risk of breast cancer in postmenopausal women: an analysis of etiological heterogeneity by multiple tumor characteristics. Am J Epidemiol. 180(7):705-17, 2014.
12. Sellers TA, Vierkant RA, Cerhan JR, Gapstur SM, Vachon CM, Olson JE, Pankratz VS, Kushi LH, Folsom AR. Interaction of dietary folate intake, alcohol, and risk of hormone receptor-defined breast cancer in a prospective study of postmenopausal women. Cancer Epidemiol Biomarkers Prev. 11(10 Pt 1):1104-7, 2002.
13. Chen WY, Colditz GA, Rosner B, Hankinson SE, Hunter DJ, Manson JE, Stampfer MJ, Willett WC, Speizer FE. Use of postmenopausal hormones, alcohol, and risk for invasive breast cancer. Ann Intern Med. 137(10):798-804, 2002.
14. Horn-Ross PL, Canchola AJ, West DW, Stewart SL, Bernstein L, Deapen D, Pinder R, Ross RK, Anton-Culver H, Peel D, Ziogas A, Reynolds P, Wright W. Patterns of alcohol consumption and breast cancer risk in the California Teachers Study cohort. Cancer Epidemiol Biomarkers Prev. 13(3):405-11, 2004.
15. Collaborative Group on Hormonal Factors in Breast Cancer. Alcohol, tobacco and breast cancer—collaborative reanalysis of individual data from 53 epidemiological studies, including 58,515 women with breast cancer and 95,067 women without the disease. Br J Cancer. 87(11):1234-45, 2002.
16. Jung S, Wang M, Anderson K, et al. Alcohol consumption and breast cancer risk by estrogen receptor status: in a pooled analysis of 20 studies. Int J Epidemiol. 45(3):916-28, 2016.
17. Smith-Warner SA, Spiegelman D, Yaun SS, et al. Alcohol and breast cancer in women: a pooled analysis of cohort studies. JAMA. 279(7):535-540. 1998. 
18. Bagnardi V, Rota M, Botteri E, et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis. Br J Cancer. 112(3):580-93, 2015.
19. Choi YJ, Myung SK, Lee JH. Light alcohol drinking and risk of cancer: a meta-analysis of cohort studies. Cancer Res Treat. 50(2):474-487, 2018.

Updated 06/05/24