Illness Researcher

Alcohol

AvoidCaution

19 studies · 2 recommendations

Last updated: February 25, 2026

Alcohol – Breast Cancer

Avoid9 studies

Alcohol consumption consistently increases breast cancer risk across all tumor subtypes

Nine studies spanning over 680,000 women — including four case-control studies and five prospective cohorts — demonstrate a clear dose-response relationship between alcohol intake and breast cancer risk. Case-control data show odds ratios of 2.68 to 3.76 for alcohol consumers versus non-drinkers. The EPIC cohort (334,850 women, 11,576 cases) found each 10 g/day increase in alcohol raised breast cancer hazard by 4.2% (95% CI: 2.7–5.8%), with significant trends across ER+/PR+, ER−/PR−, and HER2− subtypes. The Nurses' Health Study II (91,005 women) linked even pre-first-pregnancy drinking to elevated risk (RR = 1.11 per 10 g/day). Women consuming two or more drinks daily face significantly higher odds. Drinking before first full-term pregnancy amplifies the association. Limiting alcohol as part of a healthy lifestyle score reduced postmenopausal breast cancer risk by up to 26%.

Evidence

Adherence to cancer prevention recommendations and risk of breast cancer in situ in the United Kingdom Biobank

Authors: Karavasiloglou, Nena, Kühn, Tilman, Pestoni, Giulia, Rohrmann, Sabine

Published: November 15, 2022

In a UK Biobank cohort study, a lifestyle score incorporating alcohol limitation (among other WCRF/AICR recommendations) was inversely associated with breast cancer in situ risk among participants not reporting dietary changes in the past 5 years (HR per unit increase = 0.92, 95% CI = 0.85–0.99). In the overall cohort, the association was not statistically significant (HR = 0.96, 95% CI = 0.91–1.03). Among those reporting dietary changes due to illness, no association was observed (HR = 1.04, 95% CI = 0.94–1.15). The findings suggest breast cancer in situ shares a similar risk factor profile with invasive breast cancer.

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Adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research Recommendations and Breast Cancer in the SUN Project

Authors: Barrios Rodríguez, Rocío, Jiménez Moleón, José Juan

Published: July 13, 2020

Among 10,930 women in the SUN prospective cohort, alcohol intake was scored as one component of an 8-item WCRF/AICR cancer prevention compliance index. Women with overall scores >5 versus ≤3 points had a multivariable-adjusted hazard ratio of 0.27 (95% CI: 0.08-0.93) for post-menopausal breast cancer. A non-significant inverse association was observed for overall breast cancer. The results suggest the protective association was attributable to the combined effects of dietary and lifestyle components including alcohol limitation.

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Lifestyle factors and breast cancer in a Moroccan population case-control study of the center Mohammed VI for cancer treatment

Authors: Abdelatif, Benider, Driss, Radallah, Ezzahra, Imad Fatima, Houda, Drissi, Karima, Bendahhou

Published: September 26, 2019

In this case-control study conducted at the Mohammed VI Centre for cancer treatment in Casablanca, alcohol consumption was positively associated with breast cancer risk with an odds ratio of 3.76, indicating that women who consumed alcohol had nearly four times the odds of developing breast cancer compared to non-drinkers. This positions alcohol as one of the strongest modifiable behavioral risk factors identified in the study, second only to family history of breast cancer (OR=5.73).

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Healthy lifestyle and risk of breast cancer among postmenopausal women in the European Prospective Investigation into Cancer and Nutrition cohort study

Authors: Andersson, Anne, Ardanaz, Eva, Baglietto, Laura, Buckland, Genevieve, Bueno-de-Mesquita, H. B(As), Chajes, Veronique, Dahm, Christina C., Dartois, Laureen, de Batlle, Jordi, Dossus, Laure, Ericson, Ulrika,, Ferrari, Pietro, Freisling, Heinz, Gunter, Marc, Key, Tim J., Krogh, Vittorio, Lagiou, Pagona, Lund University., Lund University., Lund University., May, Anne, McKenzie, Fiona, Navarro, Carmen, Overvad, Kim, Panico, Salvatore, Peeters, Petra H., Riboli, Elio, Rinaldi, Sabina, Romieu, Isabelle, Rosso, Stefano, Sanchez, Maria-Jose, Sund, Malin, Travis, Ruth C., Trichopoulos, Dimitrios, Trichopoulou, Antonia, Tumino, Rosario, Vergnaud, Anne-Claire, Weiderpass, Elisabete, Wirfält, Elisabet,

Published: November 16, 2014

In the EPIC cohort of 242,918 postmenopausal women followed for a median of 10.9 years, 7,756 incident breast cancer cases were identified. Alcohol consumption was one of five HLIS components scored 0-4 (higher = healthier). Women in the highest HLIS category versus the second category had a 26% lower breast cancer risk (adjusted HR = 0.74; 95% CI: 0.66-0.83). Each point increase in the combined HLIS reduced breast cancer risk by 3%. The protective association held for both hormone receptor double positive (HR = 0.81, 95% CI: 0.67-0.98) and double negative subtypes (HR = 0.60, 95% CI: 0.40-0.90).

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Alcohol intake and breast cancer in the European prospective investigation into cancer and nutrition

Authors: Amiano, Pilar, Ardanaz, Eva, Baglietto, Laura, Biessy, Carine, Boeing, Heiner, Borgquist, Signe,, Bueno-de-Mesquita, H. B(as), Chajes, Veronique, Chirlaque, Maria-Dolores, Clavel-Chapelon, Francoise, de Batlle, Jordi, Dossus, Laure, Duell, Eric J., Ferrari, Pietro, Hallmans, Goran, Johansson, Ingegerd, Kaaks, Rudolf, Key, Timothy J., Khaw, Kay-Tee, Lagiou, Pagona, Lukanova, Annekatrin, Lund University., Lund University., Lund University., Lund, Eiliv, Murphy, Neil, Nilsson, Lena Maria, Olsen, Anja, Overvad, Kim, Palli, Domenico, Panico, Salvatore, Peeters, Petra H., Quiros Garcia, Jose Ramon, Riboli, Elio, Romieu, Isabelle, Sanchez, Maria-Jose, Scoccianti, Chiara, Sieri, Sabina, Skeie, Guri, Tjonneland, Anne, Travis, Ruth C., Trichopoulos, Dimitrios, Trichopoulou, Antonia, Tumino, Rosario, van Gils, Carla H., Vineis, Paolo, Wareham, Nick, Wark, Petra A., Weiderpass, Elisabete, Wirfält, Elisabet,

Published: November 3, 2014

In this large European prospective cohort of 334,850 women followed for an average of 11 years (3,670,439 person-years), 11,576 incident breast cancer cases were diagnosed. Each 10 g/day increase in alcohol intake raised breast cancer hazard ratio by 4.2% (95% CI: 2.7–5.8%). Compared to the reference group consuming 0–5 g/day, intake of >5–15 g/day was associated with a 5.9% increase in breast cancer risk (95% CI: 1–11%). Significant increasing trends were observed across all tumor subtypes including ER+/PR+, ER−/PR−, HER2−, and ER−/PR−/HER2− tumors. Women who started drinking prior to their first full-term pregnancy had a stronger association with breast cancer risk than those who started afterwards.

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Alcohol Intake Between Menarche and First Pregnancy: A Prospective Study of Breast Cancer Risk

Authors: Berkey, Catherine S., Chen, Wendy Y., Colditz, Graham A., Collins, Laura C., Connolly, James L., Liu, Ying, Rosner, Bernard, Schnitt, Stuart J., Tamimi, Rulla M., Willett, Walter C.

Published: March 10, 2014

A prospective cohort study of 91,005 parous women in the Nurses' Health Study II followed from 1989 through June 30, 2009, identified 1,609 breast cancer cases. Alcohol consumption between menarche and first pregnancy was associated with increased breast cancer risk (RR = 1.11 per 10 g/day intake; 95% CI = 1.00 to 1.23), adjusted for drinking after first pregnancy. Post-first-pregnancy alcohol showed a similar association (RR = 1.09 per 10 g/day; 95% CI = 0.96 to 1.23). The association between pre-first-pregnancy drinking and breast neoplasia appeared stronger with longer menarche-to-first-pregnancy intervals.

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OBESIDAD Y CANCER DE MAMA

Authors: Arceo Guzmán, Mario Enrique, De La Cruz Vargas, Jhony Alberto, Héctor Lorenzo, Ocaña Servín

Published: November 1, 2010

Case-control study of 168 Mexican women (84 cases, 84 controls) in Acapulco and Toluca. Bivariate analysis revealed alcohol consumption was associated with increased breast cancer risk with OR 2.68 (95% CI 1.43–5.02), indicating nearly a 2.7-fold higher odds of breast cancer among alcohol consumers compared to non-consumers.

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Menopausal hormone therapy and other breast cancer risk factors in relation to the risk of different histological subtypes of breast cancer: a case-control study

Authors: A Tjonneland, C Magnusson, C Magnusson, C Magnusson, C Schairer, C Stahlberg, Cecilia Magnusson, CI Li, CI Li, CI Li, CI Li, CI Li, CL Chen, CM Magnusson, Collaborative Group on Hormonal Factors in Breast Cancer, E Banks, E Weiderpass, E Weiderpass, Emma Lindström, F Levi, G Heimer, G Ursin, G Ursin, GL Anderson, H Stalsberg, I Persson, J Manjer, J Wohlfahrt, JR Daling, K Hemminki, K Takahashi, Lena U Rosenberg, LM Newcomer, LM Newcomer, M Ewertz, MC Pike, NS Goldstein, PA Newcomb, Paul W Dickman, Per Hall, PP Rosen, S Ahmed, SA Lee, Sara Wedrén, SM Gapstur, V Beral, Y Chen

Published: January 1, 2006

In this population-based case-control study comparing 2,289 breast cancer cases (1,888 ductal, 308 lobular, 93 tubular) with 3,065 age-frequency matched controls among Swedish women aged 50-74 years diagnosed between 1993-1995, recent alcohol consumption exceeding 10 g/day was associated with a significantly increased risk of tubular breast cancer with an odds ratio of 3.1 (95% CI 1.4-6.8). The association with ductal and lobular subtypes at this consumption level did not reach statistical significance, suggesting alcohol may differentially affect breast cancer risk by histological subtype.

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Risk factors for breast cancer in a population with high incidence rates.

Authors: Barlow, Janice, Belli, Flavia, Chew, Terri, Clarke, Christina, Erdmann, Christine A, Farren, Georgianna, Gould, Mary, Lee, Marion, Moghadassi, Michelle, Peskin-Mentzer, Roni, Quesenberry, Charles P, Souders-Mason, Virginia, Spence, Linda, Suzuki, Marisa, Wrensch, Margaret

Published: January 1, 2003

In this case-control study of 285 breast cancer cases and 286 controls in Marin County, California, women who on average consumed two or more alcoholic drinks per day had statistically significantly higher odds of breast cancer compared to controls in multivariate analyses. Additionally, beginning drinking after age 21 was associated with increased risk. The study specifically identified alcohol consumption as a modifiable risk factor in this population with high breast cancer incidence and mortality rates, suggesting that reducing alcohol intake could lower breast cancer risk.

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Caution10 studies

Limiting alcohol intake reduces breast cancer risk in a dose-dependent manner

Across 10 studies encompassing over 500,000 participants—including 6 cohort studies, 2 RCTs, and a case-control study—alcohol consumption consistently increases breast cancer risk. A UK cohort found a 27% higher risk per 10 units/week (HR 1.27, 95% CI 1.03–1.58) with no safe threshold. Norwegian cohorts showed each healthy lifestyle point (including lower alcohol) reduced postmenopausal breast cancer risk by 3% (HR 0.97, 95% CI 0.96–0.98). Among Swedish women with alcoholism, breast cancer incidence rose 15% above the general population. A UK Biobank analysis of 288,802 participants linked each point of adherence to cancer prevention guidelines—including alcohol restriction—to a 10% breast cancer risk reduction (HR 0.90, 95% CI 0.87–0.94). European data confirmed women consuming ≥30 g/day had 27% higher overall mortality. RCTs targeting alcohol reduction in breast cancer survivors showed feasibility with measurable improvements in body weight and lifestyle markers.

Evidence

Abbreviated Score to Assess Adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations and Risk of Cancer in the UK Biobank

Authors: Celis-Morales C, Ho FK, Malcomson FC, Mathers JC, Parra-Soto S, Sharp L

Published: January 9, 2024

A prospective cohort of 288,802 UK Biobank participants (mean age 56.2 years), cancer-free at baseline, was followed for a median of 8.2 years (IQR 7.4–8.9). An abbreviated adherence score incorporating body weight, physical activity, fruit/vegetable/fiber intake, red and processed meat limitation, and alcohol restriction was calculated (range 0–5 points). Each 1-point increment in the score was associated with a 10% reduction in breast cancer risk (HR 0.90; 95% CI 0.87–0.94). During follow-up, 23,448 participants were diagnosed with cancer overall. Multivariable Cox proportional hazards models adjusted for confounders confirmed the inverse association.

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A healthy lifestyle index and cancer: Using a multifactor lifestyle exposure to estimate cancer incidence and survival among Norwegian women

Authors: Chen, Sairah Lai Fa

Published: August 17, 2023

In the Norwegian Women and Cancer Study prospective cohort of approximately 170,000 women, alcohol intake was one of five HLI components. A higher HLI score — reflecting lower alcohol intake alongside better diet, physical activity, non-smoking, and healthy BMI — was associated with lower postmenopausal breast cancer risk. Cox proportional hazard models demonstrated that greater positive changes in HLI score over time were associated with lower risk of lifestyle-related cancers combined, regardless of baseline HLI score.

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Combined Lifestyle Behaviors and the Incidence of Common Cancer Types in the Norwegian Women and Cancer Study (NOWAC)

Authors: Borch, Kristin Benjaminsen, Braaten, Tonje Bjørndal, Chen, Sairah Lai Fa, Ferrari, Pietro, Nøst, Therese Haugdahl, Sandanger, Torkjel M

Published: January 1, 2021

In the NOWAC prospective cohort study of 96,869 women, alcohol consumption was scored from 0 to 4 points as part of the Healthy Lifestyle Index. Each one-point HLI increment was associated with a 3% reduction in postmenopausal breast cancer risk (HR 0.97, 95% CI: 0.96–0.98). The composite score, where lower alcohol intake earned higher points, demonstrated a significant inverse relationship with breast cancer incidence across the follow-up period from baseline (1996-2004).

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Alcohol consumption and risk of common cancers: evidence from a cohort of adults from the United Kingdom

Authors: Betts, Georgina, Grainge, Matthew J., Opazo-Breton, Magdalena, Ratschen, Elena

Published: September 11, 2017

In a UK population-representative cohort of 8,670 adults followed from 1984/85 through 2009 using cancer registry linkage, typical weekly alcohol consumption showed a statistically significant linear association with breast cancer in women. The hazard ratio was 1.27 per 10 units/week (95% CI 1.03–1.58), adjusted for cigarette smoking and other covariates. The linear fit indicated no safe threshold—each incremental increase in weekly units corresponded to proportionally higher breast cancer risk. Cox regression modeling with detailed alcohol diary data strengthened the exposure assessment compared to simpler intake measures.

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Lifetime alcohol use and overall and cause-specific mortality in the European Prospective Investigation into Cancer and nutrition (EPIC) study

Authors: Agnoli, Claudia, Arriola, Larraitz, Barricarte, Aurelio, Benetou, Vasiliki, Beulens, Joline Wj, Boeing, Heiner, Bradbury, Kathryn E, Brennan, Paul, Dartois, Laureen, Dossus, Laure, Duell, Eric J, Fagherazzi, Guy, Ferrari, Pietro, Gunter, Marc, Johansson, Mattias, Kaaks, Rudolf, Khaw, Kay-Tee, Kragh Andersen, Per, Li, Kuanrong, Licaj, Idlir, Lund University., Lund University., Molina-Montes, Esther, Muller, David C, Norat, Teresa, Nunes, Luciana, Olsen, Anja, Overvad, Kim, Palli, Domenico, Peeters, Petra, Riboli, Elio, Romieu, Isabelle, Sacerdote, Carlotta, Sanchez, Carmen Navarro, Tjønneland, Anne, Trichopoulos, Dimitrios, Trichopoulou, Antonia, Tumino, Rosario, Wallström, Peter,, Wareham, Nick, Weiderpass, Elisabete

Published: January 1, 2014

Among 380,395 European participants followed for 12.6 years, female breast cancer was included in the 2,053 alcohol-related cancer deaths recorded. Women consuming ≥30 g/day of alcohol had an overall mortality HR of 1.27 (95% CI 1.13–1.43) compared to moderate drinkers (0.1–4.9 g/day). In competing risks analyses, ARC mortality in women was of similar magnitude to CVD/CHD mortality, indicating alcohol-related cancers including breast cancer represent a substantial proportion of alcohol-attributable deaths in women. The 10-year risk of overall death for women aged 60 drinking >30 g/day was 5% for never-smokers and 7% for current smokers.

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Breast cancer risk reduction:is it feasible to initiate a randomised controlled trial of a lifestyle intervention programme (ActWell) within a national breast screening programme?

Authors: AH Eliassen, Alison Kirk, Alistair Thompson, Annie S Anderson, AS Anderson, AS Anderson, B Fisher, C Emslie, CL Craig, DG Evans, E Broadbent, EO Fourkala, Graham Brennan, Hilary Dobson, IK Larsen, J Ahn, J Ritchie, Jacqueline Sugden, K Hunt, L Roe, LM Morimoto, M Macleod, Maureen Macleod, Nanette Mutrie, R Schwarzer, RL Prentice, Ronan E O’Carroll, S Caswell, S Michie, S Michie, SA Eccles, Sally Wyke, Shaun Treweek, SU Dombrowski, T Byers, TA Hastert

Published: January 1, 2014

The ActWell RCT (n=80 recruited, 65 completed) included alcohol reduction as one of three intervention targets alongside body weight and physical activity. The programme was delivered over 3 months in two NHS Scottish Breast Screening Programme sites. Participants had a mean age of 58 ± 5.6 years and mean BMI of 29.2 ± 7.0 kg/m², with 44% reporting a family history of breast cancer. The overall intervention produced significant between-group differences for body weight (-2.04 kg, 95% CI: -3.24 to -0.85 kg), BMI, waist circumference, physical activity, and sitting time. Retention was 81% and 70% would recommend the programme.

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Healthy lifestyle and risk of breast cancer for indigenous and non-indigenous women in New Zealand: a case control study.

Authors: Ellison-Loschmann, Lis, Firestone, Ridvan, Jeffreys, Mona, McKenzie, Fiona, Pearce, Neil, Romieu, Isabelle

Published: January 1, 2014

In a New Zealand case-control study with 1093 breast cancer cases and 2118 matched controls, lower alcohol consumption was included in an eleven-factor healthy lifestyle index. Postmenopausal Māori women scoring in the top HLIS tertile had significantly lower breast cancer odds (OR 0.47, 95% CI 0.23-0.94) compared to the bottom tertile. The study covered breast cancer cases registered from 2005-2007, with controls matched by ethnicity and 5-year age bands.

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Alcohol Intake and Mortality among Women with Invasive Breast Cancer

Authors: Bergkvist, L, Harris, Holly Ruth, Wolk, A

Published: January 1, 2012

In a prospective cohort of 3,146 women diagnosed with invasive breast cancer in the Swedish Mammography Cohort followed from 1987 to 2008, 385 breast cancer-specific deaths and 860 total deaths occurred. Women consuming ≥10 g/day of alcohol (approximately 0.75–1 drinks) had an adjusted hazard ratio for breast cancer-specific death of 1.36 (95% CI 0.82–2.26; p_trend = 0.47) compared with non-drinkers, indicating no statistically significant association. Those consuming 3.4–9.9 g/day had a 33% lower risk of death from non-breast cancer causes (HR 0.67, 95% CI 0.50–0.90; p_trend = 0.04). Alcohol consumption was assessed via food frequency questionnaire, and Cox proportional hazard models adjusted for confounders were used.

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Study protocol to investigate the effect of a lifestyle intervention on body weight, psychological health status and risk factors associated with disease recurrence in women recovering from breast cancer treatment

Authors: A Campbell, A McTiernan, A McTiernan, A Silvestri, A Visser, AB Kornblith, AC Utter, AH Wu, AJ Daley, Amanda Daley, AN Dentino, AS Fairey, AT Beck, B Dugue, B Rockhill, B Zumoff, BL Andersen, BL Gruber, BL Stauffer, BM Pinto, BS McEwen, C Peters, C Peters, C Wiltschke, CB Ebbeling, CL Caldwell, CM Bryla, CM Friedenreich, D Geffken, D Nerozzi, DC McMillan, DC Nieman, DC Nieman, DC Nieman, DC Nieman, DC Nieman, DC Nieman, DF Cella, DG Cruess, DH Bovbjerg, DM Golden-Kreutz, DV Schapira, DW Kissane, E Maunsell, EA Bermudez, G Borg, G van der Pompe, G van der Pompe, GG Kolden, H Davis, H Kervinen, HC Abercrombie, Helen Crank, Hilary Powers, HV Thomas, J Gallagher, J Kaukua, J Verloop, JA Cauley, JE Bower, JE Epping-Jordan, JF Sallis, JK Camoriano, JK Smith, JO Prochaska, John M Saxton, JR Calabrese, JS Goodwin, KL Jen, KM Rexrode, KS Courneya, KS Madden, L Bernstein, L Chang, M Maes, M Maes, M Maes, M Mezzetti, MD Gammon, MD Holmes, MD Holmes, ME Nelson, MK Baldwin, N Banu, Nanette Mutrie, Nicola Woodroofe, PJ Goodwin, RJ Benschop, Robert Coleman, RT Chlebowski, S Cohen, S Levy, S Yamasaki, SE Hankinson, SE Sephton, SI Mannering, SJ Schleifer, SJH Biddle, SK Lutgendorf, SM Levy, T Moradi, T Treasure, TA Wadden, TP Erlinger, U Ehlert, Vanessa Siddall, Y Touitou, Y Touitou, Z Djuric, Z Kronfol

Published: January 1, 2006

This randomized controlled trial of 100 breast cancer survivors includes moderate alcohol consumption as a specific dietary target within the lifestyle intervention. Participants in the intervention group receive individualized advice to take moderate amounts of alcohol alongside other dietary changes over 24 weeks. The study monitors estrogen status, inflammatory markers, stress hormones, and immune function as biomarkers associated with disease recurrence and survival.

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Alcohol and breast cancer risk: the alcoholism paradox

Authors: Adami, H-O, Ekbom, A, Kuper, H, Nyrén, O, Trichopoulos, D, Weiderpass, E, Ye, W

Published: January 1, 2000

A population-based cohort of 36,856 women diagnosed with alcoholism in Sweden between 1965 and 1995 demonstrated a 15% increase in breast-cancer incidence compared to the general female population. Despite presumed very high ethanol intake characteristic of clinical alcoholism, the standardized incidence ratio elevation was modest and disproportionately low relative to what dose-response extrapolations from moderate-drinking studies would predict. The cohort was followed over a 30-year period using national registry data, providing robust population-level linkage. The finding confirms that alcohol consumption is associated with increased breast cancer risk, though the so-called 'alcoholism paradox' suggests the relationship between ethanol dose and breast cancer incidence is not strictly linear at very high consumption levels.

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