Researchers say women know other breast cancer risks but aren’t fully aware of the link with alcohol consumption.

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Health officials say women should not have more than one alcoholic drink a day. Getty Images

There’s a link between alcohol consumption and breast cancer risk.

And the risk of breast cancer increases with age.

However, some middle-aged women are disregarding this risk and others may not be fully aware of its significance, according to a new .

The women interviewed for the study were more aware of short-term effects of alcohol on weight, mental health, and relationships, than the risk of cancer.

It was a small study, involving 35 women between the ages of 45 and 64 who had never had cancer. The women were questioned about their level of education, personal drinking habits, and perceived risk of breast cancer.

Most weren’t aware that alcohol is a risk factor for breast cancer.

They were more aware of alcohol as a risk factor in pregnancy complications or for liver disease. And they knew more about other breast cancer risk factors such as age, diet, inactivity, genetics, and stress.

In a press release, the study’s lead author, Emma Miller, PhD, MPH, an epidemiologist and lecturer at South Australia’s Flinders University said, “Alcohol is firmly entrenched in the fabric of Australian society, providing pleasure and defining the major events in most of our lives.”

“Raising awareness of alcohol-related cancer risk, despite the importance of this, will not be sufficient to counter patterns of consumption,” she continued.

The research article is published in the journal PLOS ONE.

Most breast cancers are diagnosed and, aside from some skin cancers, it’s the cancer among women in the United States, according to the Centers for Disease Control and Prevention (CDC).

Dr. Therese B. Bevers is a professor of clinical cancer prevention, and medical director of the Cancer Prevention Center and prevention outreach programs at MD Anderson Cancer Center in Texas.

“I will say that the alcohol to breast cancer risk has been replicated in a number of studies,” she told Healthline.

She also said that the Australian study findings are probably similar to what’s happening in the United States.

“We ask patients if they know the alcohol guidelines. Most do not. We explain that for women it’s one drink a day or less and for men it’s two a day. They don’t know the guidelines, so they don’t understand the link,” said Bevers.

“If they think about alcohol and liver disease, they might think they’re not drinking enough to get liver disease. Some women are surprised that alcohol is linked to breast cancer,” she said.

Some women only drink rarely, but Bevers suspects that some may be drinking more than they realize.

“For people who commonly drink a glass of wine with dinner or several times a week, the amount has probably inched up and they’re not aware what a [true] serving size looks like. And many women would attribute the problem more to spirits, maybe less so with wine because there’s data that suggests that red wine may be helpful for cardiovascular risk,” said Bevers.

Dr. Sagar Sardesai is a breast medical oncologist at The Ohio State University Comprehensive Cancer Center — Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

Sardesai told Healthline that excessive alcohol consumption can have widespread health effects. And it’s hard for a layperson to remember the magnitude of the problem in specific health issues such as breast cancer.

“I think it’s the vagueness surrounding this topic and conflicting evidence from some studies suggesting improved overall health and cardiovascular outcomes with low-to-moderate alcohol consumption,” he said.

There are some risk factors you can’t change.

Age, genetics, family history, and personal medical history are non-modifiable risk factors.

How much alcohol you drink is something you have control of.

Any amount of alcohol can increase the risk of breast cancer, according to Sardesai.

“However, absolute increase in risk with low-to-moderate alcohol consumption is small. It is better to avoid alcohol consumption to reduce breast cancer risk,” he added.

According to the , a standard drink is equal to 0.6 ounces of pure alcohol. That’s about 12 ounces of beer, 5 ounces of wine, or a 1.5 ounce shot of 80-proof alcohol.

Alcohol consumption isn’t the only modifiable risk factor for breast cancer.

The most important, said Sardesai, are excess body weight and lack of physical activity.

The Australian study suggests that talking about physical appearance and mental health may be a more effective strategy than focusing on long-term consequences.

“Interestingly enough, we have seen this in other areas,” said Bevers. “Sun exposure, for example. We are more likely to be successful talking about how the sun makes your skin leathery and wrinkly than talking about the far-off risk of skin cancer.”

Bevers doesn’t tell her patients who carry genetic mutations not to drink alcohol.

“But I do make it a point that it increases their risk a little more. They’re already at higher risk, so if they can, they should limit it,” she said.

Bevers said primary care physicians are talking about weight, physical activity, smoking, and excessive alcohol use. But they may not think to counsel a patient who drinks three to five glasses of wine a week.

“I think health organizations should be talking not only about breast cancer risk, but alcohol’s relationship to other diseases, like diabetes. It’s a good educational point,” she said.

As far as his patients go, Sardesai said that timing of these conversations is important. Patients are most receptive to changes at the time of a new diagnosis and immediately following active treatment.

“At OSU, we have incorporated these discussions as a part of our cancer survivorship program, as well as the high-risk breast clinic, to address the impact of alcohol, weight, and physical activity in our patient population,” he explained.

“This is a complex issue and it needs a comprehensive approach with investment from the community, patient advocates, health providers — including nutritionists and exercise physiologists — health centers, and political initiatives to address these issues,” said Sardesai.

“Anybody at higher risk who can do things to reduce or limit risk would be good,” said Bevers.