title: Smoking and survival in male breast cancer patients.
abstract: The purpose of the article was to assess whether smoking affects survival in male breast cancer patients for the overall population and when stratified by race, ethnicity, and socioeconomic status. Data were obtained by linking the 1996-2007 Florida Cancer Data System, the Florida Agency for Health Care Administration, and the US Census. Inclusion criteria were males ≥18 years, diagnosed with breast cancer and residing in Florida (n = 1573). To analyze the association between smoking and survival, we performed sequential multivariate Cox proportional hazards regression models with progressive adjustment for main confounders. Compared to never smokers, worse survival was found in current (hazard ratio = 1.63; 95 % CI = 1.23-2.16) but not in former smokers (1.26; 0.99-1.59). Those who smoked ≥1 packs/day had worse survival (2.48; 1.59-3.87) than never smokers with a significant dose-response (P for linear trend <0.001). Race-ethnic stratified models comparing current and former smokers with never smokers found significant differences among Whites [(1.88; 1.44-2.44) and (1.31; 1.04-1.65, respectively)] and non-Hispanics, [(1.73; 1.31-2.28) and (1.31; 1.04-1.66, respectively)]. Overall, current smokers were found to have significantly reduced survival, which was worse by intensity of smoking. Also, any smoking history is associated with worse survival in White and non-Hispanic male breast cancer patients compared to never smokers. Thus, male breast cancer patients should be advised to quit smoking.
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA. alicia.padron.monedero@gmail.com.|National Centre for Epidemiology, Instituto de Salud Carlos III. Madrid, Monforte de Lemos 5, Madrid, Spain. alicia.padron.monedero@gmail.com.
authors.forename: Alicia
authors.initials: A
authors.lastname: Padron-Monedero
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.|Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Tulay
authors.initials: T
authors.lastname: Koru-Sengul
authors.affiliation: Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Stacey L
authors.initials: SL
authors.lastname: Tannenbaum
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.|Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Feng
authors.initials: F
authors.lastname: Miao
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Damien
authors.initials: D
authors.lastname: Hansra
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Lee
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.|Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Byrne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018567:Breast Neoplasms, Male / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D015897:Comorbidity; D005431:Florida / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009026:Mortality; D011159:Population Surveillance; D012042:Registries; D012907:Smoking; D012959:Socioeconomic Factors
keywords: Health inequalities; Male breast cancer; Smoking; Survival