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Five categories of alcohol intake were determined at each assessment; change in alcohol consumption was categorized as stable, quit, reduced, and increased. Change occurred at a median of two years before (pre-diagnosis) and two years after (post-diagnosis) diagnosis. Cox proportional hazards regression was used to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for the associations between change groups and ACM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over a median follow-up of 12.6 years, 750 women died (130 breast cancer deaths). Compared to stable consumption, the association between cessation and ACM varied by change interval: pre-diagnosis (HR:0.91, CI:0.69\u20131.21), pre- to post-diagnosis: (HR:1.39, CI:1.12\u20131.73), post-diagnosis: (HR:0.98, CI:0.70\u20131.35). Alcohol reduction was not associated with ACM. Among women consuming\u2009\u2265\u20091 drink\/day pre-diagnosis, increasing consumption elevated ACM risk (HR:1.83, 95%CI:1.02\u20133.31).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Alcohol reduction or cessation was not associated with a decrease in ACM among older breast cancer survivors. Among those drinking\u2009\u2265\u20091 drink\/day, an increase in consumption pre-diagnosis was associated with higher mortality. Findings may be limited by uncontrolled confounding, a low prevalence of heavy drinking, or an insufficient duration of sustained change.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10549-026-08113-1","type":"journal-article","created":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T07:41:19Z","timestamp":1792741279000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Change in alcohol consumption and all-cause mortality among postmenopausal women diagnosed with breast cancer"],"prefix":"10.1007","volume":"220","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1466-9357","authenticated-orcid":false,"given":"Samantha","family":"Rees","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Bodelon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saptarshi","family":"Chakraborty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy E.","family":"Millen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kierstin","family":"Faw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren R.","family":"Teras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marissa M.","family":"Shams-White","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alpa V.","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo L.","family":"Freudenheim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,23]]},"reference":[{"key":"8113_CR1","unstructured":"Surveillance, Epidemiology, and End Results (SEER) (2023) Cancer of the breast (female) - cancer stat facts. 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