酒精摄入对乳腺癌（BC）预后的影响仍不清楚。本研究作者在“路径研究”中对3659名于2003至2015年间被诊断出患有I至IV期BC的妇女进行了短期酒精摄入与复发及死亡的研究。通过食物摄入频率问卷调查，研究人员评估了入组时（即平均诊断后2个月）和6个月后的近6个月内的饮酒情况。研究终点包括BC的复发和死亡、心血管疾病和所有死因。利用多变量Cox比例风险模型估计了危险比（HR）和95%置信区间（CI）。在平均随访时间为11.2年的过程中，发生了524次复发和834次死亡（其中369例BC特异性死亡和314例心血管疾病特异性死亡）。与不喝酒者（36.9%）相比，饮酒者更年轻、受教育程度更高，并且更容易是现在或曾经吸烟者。总体而言，饮酒与复发或死亡无关。然而，身体质量指数（BMI≥30 kg/m2）较高的女性在诊断时和之后6个月内，偶尔饮酒（HR为0.71；95％CI为0.54-0.94）和常规饮酒（HR为0.77；95％CI为0.56-1.08）与总体死亡风险降低存在剂量-反应关系（p < .05）。BMI<30 kg/m2的女性没有更高的死亡风险，但在偶尔饮酒（HR为1.29；95％CI为0.97-1.71）和常规饮酒（HR为1.19；95％CI为0.88-1.62）中，均可能存在更高但不显著的复发风险。乳腺癌诊断时及之后6个月内饮酒与肥胖妇女全因死亡风险降低有关。而非肥胖妇女可能存在更高的复发风险。©2023美国癌症学会。

The impact of alcohol consumption on breast cancer (BC) prognosis remains unclear.The authors examined short-term alcohol intake in relation to recurrence and mortality in 3659 women who were diagnosed with stage I-IV BC from 2003 to 2015 in the Pathways Study. Alcohol drinking in the past 6 months was assessed at cohort entry (mean, 2 months postdiagnosis) and 6 months later using a food-frequency questionnaire. Study end points were recurrence and death from BC, cardiovascular disease, and all causes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards models.Over an average follow-up of 11.2 years, 524 recurrences and 834 deaths (369 BC-specific and 314 cardiovascular disease-specific) occurred. Compared with nondrinkers (36.9%), drinkers were more likely younger, more educated, and current or past smokers. Overall, alcohol consumption was not associated with recurrence or mortality. However, women with higher body mass index (BMI ≥ 30 kg/m2 ) had lower risk of overall mortality with increasing alcohol consumption for occasional drinking (HR, 0.71; 95% CI, 0.54-0.94) and regular drinking (HR, 0.77; 95% CI, 0.56-1.08) around the time of diagnosis, along with 6 months later, in a dose-response manner (p < .05). Women with lower BMI (<30 kg/m2 ) were not at higher risk of mortality but were at possibly higher, yet nonsignificant, risk of recurrence for occasional drinking (HR, 1.29; 95% CI, 0.97-1.71) and regular drinking (HR, 1.19; 95% CI, 0.88-1.62).Alcohol drinking around the time of and up to 6 months after BC diagnosis was associated with lower risk of all-cause mortality in obese women. A possible higher risk of recurrence was observed in nonobese women.© 2023 American Cancer Society.