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Cancer Epidemiol Biomarkers Prev. 2014 Jun;23(6):934-45. doi: 10.1158/1055-9965.EPI-13-0901. Epub 2014 Mar 17.

Alcohol consumption and survival after a breast cancer diagnosis: a literature-based meta-analysis and collaborative analysis of data for 29,239 cases.

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Authors' Affiliations: Department of Public Health and Primary Care, University of Cambridge; Department of Public Health and Primary Care and Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge; Faculty of Health, Social Care & Education, Anglia Ruskin University, Cambridge; Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton and Breakthrough Breast Cancer Research Centre, Institute of Cancer Research, London; School of Public Health, Imperial College London, London; and Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom; Department of Biostatistics and Cancer Epidemiology, South Egypt Cancer Institute, Assiut, Egypt; Divisions of Psychosocial Research and Epidemiology and Molecular Pathology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam; Department for Health Evidence, Radboud University Medical Centre, Nijmegen; National Institute for Public Health and the Environment, Bilthoven; Department of Gastroenterology and Hepatology, University Medical Centre; Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, the Netherlands; Genomic Medicine Group, Galician Foundation of Genomic Medicine, Complejo Hospitalario Universitario de Santiago, Servicio Galego de Saude (SERGAS), Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela; Oncology and Genetics Unit, University Hospital of Vigo, Galicia Health Service (SERGAS); Radiotherapy Department, University Hospital of Vigo, Vigo; Navarre Public Health Institute, Pamplona; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP); Chief Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO), Barcelona; Andalusian School of Public Health, Granada; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid; Public Health D



Evidence for an association of alcohol consumption with prognosis after a diagnosis of breast cancer has been inconsistent. We have reviewed and summarized the published evidence and evaluated the association using individual patient data from multiple case cohorts.


A MEDLINE search to identify studies published up to January 2013 was performed. We combined published estimates of survival time for "moderate drinkers" versus nondrinkers. An analysis of individual participant data using Cox regression was carried out using data from 11 case cohorts.


We identified 11 published studies suitable for inclusion in the meta-analysis. Moderate postdiagnosis alcohol consumption was not associated with overall survival [HR, 0.95; 95% confidence interval (CI), 0.85-1.05], but there was some evidence of better survival associated with prediagnosis consumption (HR, 0.80; 95% CI, 0.73-0.88). Individual data on alcohol consumption for 29,239 cases with 4,839 deaths were available from the 11 case cohorts, all of which had data on estrogen receptor (ER) status. For women with ER-positive disease, there was little evidence that pre- or postdiagnosis alcohol consumption is associated with breast cancer-specific mortality, with some evidence of a negative association with all-cause mortality. On the basis of a single study, moderate postdiagnosis alcohol intake was associated with a small reduction in breast cancer-specific mortality for women with ER-negative disease. There was no association with prediagnosis intake for women with ER-negative disease.


There was little evidence that pre- or post-diagnosis alcohol consumption is associated with breast cancer-specific mortality for women with ER-positive disease. There was weak evidence that moderate post-diagnosis alcohol intake is associated with a small reduction in breast cancer-specific mortality in ER-negative disease.


Considering the totality of the evidence, moderate postdiagnosis alcohol consumption is unlikely to have a major adverse effect on the survival of women with breast cancer.

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