Smoking Increased Risk of Death in Women With Breast Cancer
• Connection between smoking and breast cancer death had been unclear.
• Risk existed independent of socioeconomic, clinical and life-style factors.
• BMI, molecular breast cancer subtype and menopausal status modified risk.
PHILADELPHIA — Being a current smoker or having a history of smoking significantly increased the risk of breast cancer progression and overall death among a group of multiethnic women with breast cancer, according to the results of a large prospective cohort study.
“We found that women who are current smokers or have history of smoking had a 39 percent higher rate of dying from breast cancer, even after we took into account a wide array of known prognostic factors including clinical, socioeconomic and behavioral factors,” said Dejana Braithwaite, Ph.D, assistant professor, division of cancer epidemiology, department of epidemiology and biostatistics at the University of California, San Francisco.
Researchers presented these results at the Ninth Annual AACR Frontiers in Cancer Prevention Research Conference, held Nov. 7-10, 2010.
Although smoking is associated with lung cancer and implicated in several other cancers, it is unclear what effect smoking has on breast cancer, according to Braithwaite.
“Specifically, it is unclear how long women live following breast cancer diagnosis and whether smoking increases the risk of death because of breast cancer progression or whether there is an association between smoking and life expectancy following breast cancer diagnosis that works through affecting non-breast cancer causes of death,” she said.
Therefore, Braithwaite and colleagues set out to examine the relationship between smoking and the risk of death due to breast cancer progression or non-breast cancer causes of death in a large group of women.
They enrolled 2,265 multi-ethnic women diagnosed with breast cancer between 1997 and 2000. The women were followed for an average of nine years. Researchers examined whether smoking affected death from breast cancer, non-breast cancer related causes and death from all causes.
Results showed that 164 deaths from breast cancer and 120 deaths from non-breast cancer causes occurred during follow-up.
Those women who had a history of smoking or who were current smokers also had a twofold increased risk for dying from non-breast cancer related causes compared with women with breast cancer who had never smoked.
An analysis was also conducted to examine whether body mass index, molecular breast cancer subtype or menopausal status modified risk. Women who were current or past smokers and also had a HER2-negative tumor subtype had a 61 percent increased risk for breast cancer death compared with those who never smoked. Smokers with a body mass index less than 25 kg/m2 had an 83 percent increased risk for breast cancer death, and postmenopausal women had a 47 percent increased risk for breast cancer death compared with those who never smoked.
“The implication of this research is that it is important for physicians to improve smoking cessation efforts, especially among women newly diagnosed with breast cancer, in order to improve breast cancer specific outcomes and overall health outcomes,” Braithwaite said.
The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, the AACR is the world’s oldest and largest professional organization dedicated to advancing cancer research. The membership includes 32,000 basic, translational and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and more than 90 other countries. The AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants, research fellowships and career development awards. The AACR Annual Meeting attracts more than 18,000 participants who share the latest discoveries and developments in the field. Special conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment and patient care. Including Cancer Discovery, the AACR publishes seven major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; Cancer Epidemiology, Biomarkers & Prevention; and Cancer Prevention Research. AACR journals represented 20 percent of the market share of total citations in 2009. The AACR also publishes CR, a magazine for cancer survivors and their families, patient advocates, physicians and scientists.
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