Abstract Alcohol intake has been related to an increase risk of breast cancer while dietary fiber intake has been inversely correlated to breast cancer risk. A beneficial effect of fiber on ethanol carcinogenesis through their impact on estrogen levels is still controversial. The purpose of this study is to investigate the role of dietary fiber as potential modifying factors of the association of alcohol to breast cancer using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) study. A prospective observational study of 334,850 women aged 35-70 years at baseline enrolled in the ten countries of the EPIC study and followed up for 11.0 years on average was conducted. Information on fiber and alcohol intake at baseline and average lifetime alcohol intake were calculated from country-specific dietary and lifestyle questionnaires. Hazard ratios (HR) and 95% confidence intervals (CI) of developing invasive breast cancer according to different levels of alcohol and fiber intake were calculated. During 3,670,439 person-years, 11,576 incident breast cancer cases were diagnosed. Among women with low intake of fiber (<18.5 g/day), the risk of breast cancer per 10g/day of alcohol intake was 1.057 (1.032;1.082) while among women with high intake of fiber (>24.2 g/day) the risk of breast cancer was 1.012 (0.983;0.1.04) (Test for interaction p = 0.01). This modulating effect was stronger for fiber from vegetables and for estrogen positive tumors. Our results suggest that fiber intake may modulate the positive association of alcohol intake to breast cancer risk. Women should be advised to control their alcohol intake, and increase their intake of fiber. Citation Format: Isabelle Romieu. Fiber intake modulates the effect of alcohol on breast cancer. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr LB-186. doi:10.1158/1538-7445.AM2015-LB-186