Active and Passive Cigarette Smoke and Breast Cancer Survival

• Published in: Annals of epidemiology 2007-05, Vol.17 (5), p.385-393
• Main Authors: Sagiv, Sharon K., PhD, Gaudet, Mia M., PhD, Eng, Sybil M., PhD, Abrahamson, Page E., PhD, Shantakumar, Sumitra, PhD, Teitelbaum, Susan L., PhD, Britton, Julie A., PhD, Bell, Paula, MSW, Thomas, Joyce A., MPH, Neugut, Alfred I., MD, PhD, Santella, Regina M., PhD, Gammon, Marilie D., PhD
• Format: Article
• Language: English
• Subjects: Aged; Body Mass Index; Breast Neoplasms; Breast Neoplasms - drug therapy; Breast Neoplasms - mortality; Breast Neoplasms - radiotherapy; Case-Control Studies; Cause of Death; Female; Humans; Internal Medicine; Middle Aged; Mortality; Neoplasm Staging; New York - epidemiology; Passive smoking; Postmenopause; Proportional Hazards Models; Smoking; Smoking - adverse effects; Smoking - epidemiology; Surveys and Questionnaires; Survival Analysis; Tobacco Smoke Pollution - adverse effects; Tobacco Smoke Pollution - statistics & numerical data
• ISSN: 1047-2797; 1873-2585
• DOI: 10.1016/j.annepidem.2006.11.004

Purpose 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.