title: Breast change perception in women after smoking cessation. A pilot study.
abstract: OBJECTIVE
  There are several barriers to smoking cessation that are unique to women. Compared to men, women report lower levels of motivation to quit and greater perceived difficulty with cessation. However, recent studies might favor commitment by women to quit through higher risk perception related e.g. to the development of premature facial wrinkling or the decrease in mammographic density due to cigarette smoking.
  
  
  METHODS
  A pilot study to evaluate the perception of breast change after cessation and its possible motivational effect on maintenance was carried out. We interviewed 25 premenopausal women who had quit ≥1 year before. We obtained information from the women and discussed changes in breast size and fullness. The two groups of women with and without breast change were statistically compared using the nonparametric Mann-Whitney test (continuous variables) and the Fisher test (categorical variables).
  
  
  RESULTS
  Median age was 41 years (range, 30-49 years). Median carbon monoxide (CO) before quitting was 18 ppm and median pack years (PY) was 22.5; both parameters characterize a category of mild smokers. Sixteen women (64%) reported breast changes 6 months after quitting smoking. This outcome was paralleled by only moderate effects on weight or body mass index (BMI) increase after quitting. Notably, of the 16 women with breast change, only 3 (19%) with a normal baseline BMI showed a BMI increase to >25.
  
  
  CONCLUSIONS
  Within the limitations of the small size of a pilot study, these results indicate that premenopausal women experience subjective perception of change in breast size after smoking cessation, which may not be totally explained by weight gain. Further studies are needed to understand the effect, if any, of such perception on the motivation to quit smoking.
authors.affiliation: Tobacco Control Unit, Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: De Marco
authors.forename: Giovanni
authors.initials: G
authors.lastname: Invernizzi
authors.forename: Rosalba
authors.initials: R
authors.lastname: Miceli
authors.forename: Luigi
authors.initials: L
authors.lastname: Mariani
authors.forename: Anna
authors.initials: A
authors.lastname: Villarini
authors.forename: Elena
authors.initials: E
authors.lastname: Munarini
authors.forename: Roberto
authors.initials: R
authors.lastname: Mazza
authors.forename: Roberto
authors.initials: R
authors.lastname: Boffi
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D001940:Breast / Q000473:pathology*; D002248:Carbon Monoxide / Q000378:metabolism; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D009042:Motivation; D010865:Pilot Projects; D017697:Premenopause; D012858:Size Perception; D012907:Smoking; D016540:Smoking Cessation
chemical_list: D002248:Carbon Monoxide