Active and passive cigarette smoke and breast cancer survival.
OBJECTIVE
The association between active and passive cigarette smoking before breast cancer diagnosis and survival was investigated among a cohort of invasive breast cancer cases (n = 1273) participating in a population-based case-control study.


METHODS
Participants diagnosed with a first primary breast cancer between August 1, 1996, and July 31, 1997, were followed-up until December 31, 2002, for all-cause mortality (n = 188 deaths), including breast cancer-specific mortality (n = 111), as reported to the National Death Index.


RESULTS
In Cox models, the adjusted hazards ratios (HRs) for all-cause mortality were slightly higher among current and former active smokers, compared with never smokers (HR, 1.23; 95% confidence interval [95% CI], 0.83-1.84) and 1.19 (95% CI, 0.85-1.66), respectively). No association was found between active or passive smoking and breast cancer-specific mortality. All-cause and breast cancer-specific mortality was higher among active smokers who were postmenopausal (HR, 1.64; 95% CI, 1.03-2.60 and HR, 1.45; 95% CI, 0.78-2.70, respectively) or obese at diagnosis (HR, 2.10; 95% CI, 1.03-4.27 and HR, 1.97; 95% CI, 0.89-4.36, respectively). Associations between smoking and all-cause and breast cancer-specific mortality did not differ by cancer treatment.


CONCLUSIONS
These data do not provide strong evidence for an association between smoking and all-cause or breast cancer-specific mortality, although smokers who are postmenopausal or obese at diagnosis may be at higher risk.
Sagiv
Sharon K
SK
Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, NC, USA. sharon.sagiv@channing.harvard.edu
Gaudet
Mia M
MM
Eng
Sybil M
SM
Abrahamson
Page E
PE
Shantakumar
Sumitra
S
Teitelbaum
Susan L
SL
Britton
Julie A
JA
Bell
Paula
P
Thomas
Joyce A
JA
Neugut
Alfred I
AI
Santella
Regina M
RM
Gammon
Marilie D
MD
D000368:Aged; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy; D016022:Case-Control Studies; D002423:Cause of Death; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009518:New York / Q000453:epidemiology; D017698:Postmenopause; D016016:Proportional Hazards Models; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000706:statistics & numerical data
D014028:Tobacco Smoke Pollution