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Post-diagnostic coffee and tea consumption and breast cancer survival



We examined the role of post-diagnostic coffee and tea consumption in relation to breast cancer-specific and all-cause mortality among women with breast cancer in prospective cohort studies.


We identified 8900 women with stage I–III breast cancer from 1980 through 2010 in the Nurses’ Health Study (NHS) and from 1991 through 2011 in the NHSII. Post-diagnostic coffee and tea consumption was assessed by a validated food frequency questionnaire every 4 years after diagnosis.


During up to 30 years of follow-up, we documented 1054 breast cancer-specific deaths and 2501 total deaths. Higher post-diagnostic coffee consumption was associated with a lower breast cancer-specific mortality: compared with non-drinkers, >3 cups/day of coffee was associated with a 25% lower risk (hazard ratio (HR) = 0.75, 95% confidence interval (CI) = 0.59–0.96; Ptrend = 0.002). We also observed a lower all-cause mortality with coffee consumption: compared with non-drinkers, >2 to 3 cups/day was associated with a 24% lower risk (HR = 0.76, 95% CI = 0.66–0.87) and >3 cups/day was associated with a 26% lower risk (HR = 0.74, 95% CI = 0.63–0.87, Ptrend < 0.0001). Post-diagnostic tea consumption was associated with a lower all-cause mortality: compared with non-drinkers, >3 cups/day was associated with a 26% lower risk (HR = 0.74, 95% CI = 0.58–0.95; Ptrend = 0.04).


Among breast cancer survivors, higher post-diagnostic coffee consumption was associated with better breast cancer and overall survival. Higher post-diagnostic tea consumption may be related to better overall survival.

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  1. 1.

    Wu, T., Willett, W. C., Hankinson, S. E. & Giovannucci, E. Caffeinated coffee, decaffeinated coffee, and caffeine in relation to plasma C-peptide levels, a marker of insulin secretion, in U.S. women. Diabetes Care 28, 1390–1396 (2005).

    CAS  Article  Google Scholar 

  2. 2.

    Lopez-Garcia, E., van Dam, R. M., Qi, L. & Hu, F. B. Coffee consumption and markers of inflammation and endothelial dysfunction in healthy and diabetic women. Am. J. Clin. Nutr. 84, 888–893 (2006).

    CAS  Article  Google Scholar 

  3. 3.

    Kempf, K., Herder, C., Erlund, I., Kolb, H., Martin, S., Carstensen, M. et al. Effects of coffee consumption on subclinical inflammation and other risk factors for type 2 diabetes: a clinical trial. Am. J. Clin. Nutr. 91, 950–957 (2010).

    CAS  Article  Google Scholar 

  4. 4.

    Jacobs, S., Kroger, J., Floegel, A., Boeing, H., Drogan, D., Pischon, T. et al. Evaluation of various biomarkers as potential mediators of the association between coffee consumption and incident type 2 diabetes in the EPIC-Potsdam Study. Am. J. Clin. Nutr. 100, 891–900 (2014).

    CAS  Article  Google Scholar 

  5. 5.

    Yamashita, K., Yatsuya, H., Muramatsu, T., Toyoshima, H., Murohara, T. & Tamakoshi, K. Association of coffee consumption with serum adiponectin, leptin, inflammation and metabolic markers in Japanese workers: a cross-sectional study. Nutr. Diabetes 2, e33 (2012).

    CAS  Article  Google Scholar 

  6. 6.

    Martini, D., Del, Bo. C., Tassotti, M., Riso, P., Del Rio, D., Brighenti, F. et al. Coffee consumption and oxidative stress: a review of human intervention studies. Molecules 21, 979 (2016).

    Article  Google Scholar 

  7. 7.

    Saintot, M., Mathieu-Daude, H., Astre, C., Grenier, J., Simony-Lafontaine, J. & Gerber, M. Oxidant-antioxidant status in relation to survival among breast cancer patients. Int. J. Cancer 97, 574–579 (2002).

    CAS  Article  Google Scholar 

  8. 8.

    Duggan, C., Irwin, M. L., Xiao, L., Henderson, K. D., Smith, A. W., Baumgartner, R. N. et al. Associations of insulin resistance and adiponectin with mortality in women with breast cancer. J. Clin. Oncol. 29, 32–39 (2011).

    CAS  Article  Google Scholar 

  9. 9.

    Goodwin, P. J., Ennis, M., Pritchard, K. I., Trudeau, M. E., Koo, J., Madarnas, Y. et al. Fasting insulin and outcome in early-stage breast cancer: results of a prospective cohort study. J. Clin. Oncol. 20, 42–51 (2002).

    CAS  Article  Google Scholar 

  10. 10.

    Pierce, B. L., Ballard-Barbash, R., Bernstein, L., Baumgartner, R. N., Neuhouser, M. L., Wener, M. H. et al. Elevated biomarkers of inflammation are associated with reduced survival among breast cancer patients. J. Clin. Oncol. 27, 3437–3444 (2009).

    CAS  Article  Google Scholar 

  11. 11.

    Lehrer, S., Green, S. & Rosenzweig, K. E. Coffee consumption associated with increased mortality of women with breast cancer. J. Caffeine Res. 3, 38–40 (2013).

    CAS  Article  Google Scholar 

  12. 12.

    Simonsson, M., Soderlind, V., Henningson, M., Hjertberg, M., Rose, C., Ingvar, C. et al. Coffee prevents early events in tamoxifen-treated breast cancer patients and modulates hormone receptor status. Cancer Causes Control. 24, 929–940 (2013).

    Article  Google Scholar 

  13. 13.

    Harris, H. R., Bergkvist, L. & Wolk, A. Coffee and black tea consumption and breast cancer mortality in a cohort of Swedish women. Br. J. Cancer 107, 874–878 (2012).

    CAS  Article  Google Scholar 

  14. 14.

    Ding, M., Satija, A., Bhupathiraju, S. N., Hu, Y., Sun, Q., Han, J. et al. Association of coffee consumption with total and cause-specific mortality in 3 large prospective cohorts. Circulation 132, 2305–2315 (2015).

    CAS  Article  Google Scholar 

  15. 15.

    Gapstur, S. M., Anderson, R. L., Campbell, P. T., Jacobs, E. J., Hartman, T. J., Hildebrand, J. S. et al. Associations of coffee drinking and cancer mortality in the cancer prevention study-II. Cancer Epidemiol. Biomark. Prev. 26, 1477–1486 (2017).

    CAS  Article  Google Scholar 

  16. 16.

    Gunter, M. J., Murphy, N., Cross, A. J., Dossus, L., Dartois, L., Fagherazzi, G. et al. Coffee drinking and mortality in 10 European countries: a multinational cohort study. Ann. Intern Med. 167, 236–247 (2017).

    Article  Google Scholar 

  17. 17.

    Kuruto-Niwa, R., Inoue, S., Ogawa, S., Muramatsu, M. & Nozawa, R. Effects of tea catechins on the ERE-regulated estrogenic activity. J. Agric Food Chem. 48, 6355–6361 (2000).

    CAS  Article  Google Scholar 

  18. 18.

    Trevisanato, S. I. & Kim, Y. I. Tea and health. Nutr. Rev. 58, 1–10 (2000).

    CAS  Article  Google Scholar 

  19. 19.

    Mujtaba, T. & Dou, Q. P. Black tea polyphenols inhibit tumor proteasome activity. Vivo 26, 197–202 (2012).

    CAS  Google Scholar 

  20. 20.

    Hudlikar, R. R., Venkadakrishnan, V. B., Kumar, R., Thorat, R. A., Kannan, S., Ingle, A. D. et al. Polymeric black tea polyphenols (PBPs) inhibit benzo(a)pyrene and 4-(methylnitrosamino)-1-(3-pyridyl)-1- butanone-induced lung carcinogenesis potentially through down-regulation of p38 and Akt phosphorylation in A/J mice. Mol. Carcinog. 56, 625–640 (2017).

    CAS  Article  Google Scholar 

  21. 21.

    Otton, R., Bolin, A. P., Ferreira, L. T., Marinovic, M. P., Rocha, A. L. S. & Mori, M.A. Polyphenol-rich green tea extract improves adipose tissue metabolism by down-regulating miR-335 expression and mitigating insulin resistance and inflammation. J. Nutr. Biochem. 57, 170–179 (2018).

    CAS  Article  Google Scholar 

  22. 22.

    Salvini, S., Hunter, D. J., Sampson, L., Stampfer, M. J., Colditz, G. A., Rosner, B. et al. Food-based validation of a dietary questionnaire: the effects of week-to-week variation in food consumption. Int. J. Epidemiol. 18, 858–867 (1989).

    CAS  Article  Google Scholar 

  23. 23.

    Willett, W. & Lenart, E. Reproducibility and validity of food frequency questionnaires. In Nutritional Epidemiology (ed. Willett, W.) 96–141 (Oxford University Press, 2013).

  24. 24.

    Yuan, C., Spiegelman, D., Rimm, E. B., Rosner, B. A., Stampfer, M. J., Barnett, J. B. et al. Relative Validity of nutrient intakes assessed by questionnaire, 24-hour recalls, and diet records as compared with urinary recovery and plasma concentration biomarkers: findings for women. Am. J. Epidemiol. 187, 1051–1063 (2018).

    Article  Google Scholar 

  25. 25.

    Bhupathiraju, S. N., Pan, A., Malik, V. S., Manson, J. E., Willett, W. C., van Dam, R. M. et al. Caffeinated and caffeine-free beverages and risk of type 2 diabetes. Am. J. Clin. Nutr. 97, 155–166 (2013).

    CAS  Article  Google Scholar 

  26. 26.

    Willett, W. Implications of total energy intake for epidemiologic analyses. In Nutritional Epidemiology (ed. Willett, W.) 261–283 (Oxford University Press, 2013).

  27. 27.

    Oh, H., Eliassen, A. H., Wang, M., Smith-Warner, S. A., Beck, A. H., Schnitt, S. J. et al. Expression of estrogen receptor, progesterone receptor, and Ki67 in normal breast tissue in relation to subsequent risk of breast cancer. NPJ Breast Cancer 2, 16032 (2016).

    Article  Google Scholar 

  28. 28.

    Tamimi, R. M., Baer, H. J., Marotti, J., Galan, M., Galaburda, L., Fu, Y. et al. Comparison of molecular phenotypes of ductal carcinoma in situ and invasive breast cancer. Breast Cancer Res. 10, R67 (2008).

    Article  Google Scholar 

  29. 29.

    Collins, L. C., Marotti, J. D., Baer, H. J. & Tamimi, R. M. Comparison of estrogen receptor results from pathology reports with results from central laboratory testing. J. Natl Cancer Inst. 100, 218–221 (2008).

    CAS  Article  Google Scholar 

  30. 30.

    Wang, J., Zhang, X., Beck, A. H., Collins, L. C., Chen, W. Y., Tamimi, R. M. et al. Alcohol consumption and risk of breast cancer by tumor receptor expression. Horm. Cancer 6, 237–246 (2015).

    CAS  Article  Google Scholar 

  31. 31.

    Colditz, G. A., Stampfer, M. J., Willett, W. C., Stason, W. B., Rosner, B., Hennekens, C. H. et al. Reproducibility and validity of self-reported menopausal status in a prospective cohort study. Am. J. Epidemiol. 126, 319–325 (1987).

    CAS  Article  Google Scholar 

  32. 32.

    Durrleman, S. & Simon, R. Flexible regression models with cubic splines. Stat. Med. 8, 551–561 (1989).

    CAS  Article  Google Scholar 

  33. 33.

    Fine, J. P. & Gray, R. J. A proportional hazards model for the subdistribution of a competing risk. J. Am. Stat. Assoc. 94, 496–509 (1999).

    Article  Google Scholar 

  34. 34.

    Guo, C. & So, Y. Cause-specific analysis of competing risks using the PHREG procedure. SAS Institute Inc. 2018. Paper No.: SAS2159-2018. Available from:

  35. 35.

    Wang, J., Light, K., Henderson, M., O’Loughlin, J., Mathieu, M. E., Paradis, G. et al. Consumption of added sugars from liquid but not solid sources predicts impaired glucose homeostasis and insulin resistance among youth at risk of obesity. J. Nutr. 144, 81–86 (2014).

    CAS  Article  Google Scholar 

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We would like to thank the participants and staff of the NHS and NHSII for their valuable contributions as well as the following state cancer registries for their help: AL, AZ, AR, CA, CO, CT, DE, FL, GA, ID, IL, IN, IA, KY, LA, ME, MD, MA, MI, NE, NH, NJ, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, TX, VA, WA and WY.

Author information




M.S.F.: study concept and design, statistical analysis, funding acquisition, interpretation of data, drafting of the paper, critical revision of the paper for important intellectual content, and approval of final paper for submission. N.D.S.: interpretation of the data, critical revision of the paper for important intellectual content and approval of final paper for submission. B.A.R.: statistical analysis, interpretation of the data, critical revision of the paper for important intellectual content and approval of final paper for submission. W.C.W.: interpretation of the data, critical revision of the paper for important intellectual content and approval of final paper for submission. A.H.E.: interpretation of the data, critical revision of the paper for important intellectual content and approval of the final manuscript for submission. M.D.H.: interpretation of the data, critical revision of the paper for important intellectual content and approval of final paper for submission.

Corresponding author

Correspondence to Maryam S. Farvid.

Ethics declarations

Ethics approval and consent to participate

The study protocol was approved by the institutional review boards of Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health (Boston, MA, USA).

Consent to publish

Completion of the questionnaire was considered to imply informed consent when the study protocol was approved in 1976 (NHS) and 1989 (NHSII) by the institutional review boards of the Brigham and Women’s Hospital (Boston, MA, USA) and Harvard T.H. Chan School of Public Health (Boston, MA, USA), and those of participating registries as required. The studies were conducted in accordance with recognised ethical guidelines (Declaration of Helsinki).

Data availability

The datasets used and analysed during this study are available from the corresponding author on reasonable request.

Competing interests

M.D.H. reported grants from FHI Solutions, nonfinancial support from Bayer AG (Bayer supplies aspirin and placebo for the Aspirin after Breast Cancer trial) and personal fees from Arla Foods (participated in a systematic review of dietary intake in Nigerian children for this company) outside the submitted work. The remaining authors declare no competing interests.

Funding information

The study was supported by the National Institutes of Health Grants (U01 CA176726, UM1 CA186107), American Institute for Cancer Research (AICR) to M.S.F., and the Breast Cancer Research Foundation (BCRF) to W.C.W. The study sponsors were not involved in the study design and collection, analysis and interpretation of the data, or the writing of the article or the decision to submit it for publication. The authors were independent of study sponsors.

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Farvid, M.S., Spence, N.D., Rosner, B.A. et al. Post-diagnostic coffee and tea consumption and breast cancer survival. Br J Cancer 124, 1873–1881 (2021).

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