Susan G Komen  
I've Been Diagnosed With Breast Cancer Someone I Know Was Diagnosed Share Your Story Join Us And Stay Informed Donate To End Breast Cancer
Home > Understanding Breast Cancer > Breast Cancer Research > Table 3: Alcohol and breast cancer risk

  


Table 3: Alcohol and breast cancer risk

This summary table contains detailed information about research studies. Summary tables offer an informative look at the science behind many breast cancer guidelines and recommendations. However, they should be viewed with some caution. In order to read and interpret research tables successfully, it is important to understand some key concepts. Learn how to read a research table.

Introduction: More than 40 cohort and case-control studies support a link between alcohol and breast cancer risk. Overall, having one to two drinks (or more) per day appears to increase the risk of breast cancer compared to not drinking. A meta-analysis that combined the results of 98 studies found women who drank alcohol were 11 percent more likely than non-drinkers to get breast cancer [1].  

Learn more about alcohol and breast cancer risk.

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

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

Komen Perspectives 

 Read our perspective on alcohol and breast cancer risk (March 2011).* 

* 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 Therefore, some information may be out of date at this time.   

 

Study selection criteria: Prospective cohort studies with at least 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 Drink Alcohol Compared to Women who Do 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)

Kaiser Permanente [6]

70,033
(2,829 cases)

16

1.2
(1.1-14)

1.4
(1.1-1.7)

Women’s Health Initiative Observational Study [7]

87,724
(2,944 cases)

7-12¶

1.27
(1.05-1.53)

1.24
(1.00-1.55)

Iowa Women's Health Study [8]

 34,393
(1,875 cases)

14

Significant increase║

 

Nurses' Health Study II [9]

44,187
(1,722 cases)

13

 1.33
 (1.12-1.58)║

 

California Teachers Study [10]

103,460
(1,742 cases)

4-5¶

0.91
(0.71-1.16)

1.32
(1.06-1.63)

Women's Health Study [11]    

38,454
(1,484 cases)

10

1.14
(0.92-1.40)║,**

 1.32
(0.96-1.82)║

Cancer Prevention Study-II [12]

66,561
(1,303 cases)

5

1.26
(1.04-1.53)

 

Sweden Mammography Cohort [13]

51,847
(1,188 cases)

8

  1.43
(1.16-1.76)║,††

 

PLCO Screening Trial [14]

25,400
(691 cases)

5

1.37
(1.08-1.76)║ 

 

Japan Public Health Center-based Prospective Study [15]

50,757
(572 cases)
 

14

1.06
(0.78-1.44)║

1.76
(1.16-2.67)║,‡‡

Melbourne Collaborative Cohort Study [16]

17,447
(537 cases)

10

0.87 
(0.62-1.22)║

1.41
(0.90-2.23)║

Canadian National Breast Screening Study [17]

56,837
(519 case)

6

1.39
(0.90-2.13)

1.89
(1.02-3.49)

Meta-analyses and pooled analyses 

Bagnardi et al. [18]

110 studies
(114,897 cases)

 

1.05
(1.02-1.08)§§

 

Collaborative Group on Hormonal Factors in Breast Cancer [19]

 53 studies 

153,582
(58,515 cases)

 

1.13
(1.08-1.19)

1.21
(1.14-1.28)¶¶

Longnecker et al. [20]

50 studies


 

1.11
(1.07-1.16)║

1.38
(1.23-1.55)║ 

Smith-Warner et al. [21]

322,647
(4,335 cases)


 

1.16
(0.98-1.38)

1.41
(1.18-1.69)

† In the U.S., there is an average of 13.2 grams (g) of alcohol in a bottle or can of beer, 10.8 g in a glass of wine and 15.1 g in a shot of whiskey. Relative risk categories are based on the amount of alcohol in a glass of wine.

‡ Categorized as 15 or more drinks per week.

§ Average alcohol intake over follow-up time.

║ The number of drinks per day was estimated from the number of grams of alcohol given in the study.

¶ Estimated from study dates.

** Results also showed that increasing alcohol use by 10 grams (about one drink) per day increased the overall risk of breast cancer as well as the risk of ER+/PR+ tumors (relative risk 1.07 (1.01-1.14) and 1.11 (1.03-1.20), respectively).

†† Results also showed that compared to non-drinkers, women who drank 10 or more grams of alcohol per day had an increased risk of ER+ breast cancers.

‡‡ Categorized as more than 150 grams per week (more than 2 drinks per day). 

§§ Categorized as 1 or fewer drinks per day.

¶¶ Categorized as 3 drinks per day.

 

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. 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.
  7. 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.
  8. 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.
  9. 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.
  10. 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.
  11. Zhang SM, Lee IM, Manson JE, et al. Alcohol consumption and breast cancer risk in the Women's Health Study. Am J Epidemiol. 165(6):667-76, 2007.
  12. Feigelson HS, Jonas CR, Robertson AS, McCullough ML, Thun MJ, Calle EE. Alcohol, folate, methionine, and risk of incidental breast cancer in the American Cancer Society Cancer Prevention Study II Nutrition Study. Cancer Epidemiol Biomarkers Prev. 12(2):161-4, 2003.
  13. Suzuki R, Weimin Y, Rylander-Rudqvist T, et al. Alcohol and postmenopausal breast cancer risk defined by estrogen and progesterone receptor status: a prospective cohort study. J Natl Cancer Inst. 97(21):1601-8, 2005.
  14. Stolzenberg-Solomon RZ, Chang SC, Leitzmann MF, et al. Folate intake, alcohol use, and postmenopausal breast cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Am J Clin Nutr. 83(4):895-904, 2006.
  15. Suzuki R, Iwasaki M, Inoue M, et al. for the Japan Public Health Center-based Prospective Study Group. Alcohol consumption-associated breast cancer incidence and potential effect modifiers: the Japan Public Health Center-based Prospective Study. Int J Cancer. 127(3):685-95, 2010.
  16. Baglietto L, English DR, Gertig DM, et al. Does dietary folate intake modify effect of alcohol consumption on breast cancer risk? Prospective cohort study. BMJ. 331(7520):807, 2005.
  17. Friedenreich CM, Howe GR, Miller AB, et al. A cohort study of alcohol consumption and risk of breast cancer. Am J Epidemiol. 137:512-520, 1993.
  18. Bagnardi V, Rota M, Botteri E, et al. Light alcohol drinking and cancer: a meta-analysis. Ann Oncol. 24(2):301-8, 2013.
  19. 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.
  20. Longnecker MP. Alcoholic beverage consumption in relation to risk of breast cancer: meta-analysis and review. Cancer Causes Control. 5(1):73-82, 1994.
  21. 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.  

Updated 08/31/13