Cigarette Smoking in Relation to Risk of Ductal Carcinoma In Situ of the Breast in a Cohort of Postmenopausal Women

Abstract

In numerous studies, investigators have examined the association of active smoking with risk of invasive breast cancer, but to the authors' knowledge, no cohort study has assessed smoking in relation to the risk of in situ breast cancer, the postulated penultimate stage preceding invasive breast cancer. The authors examined the latter association using data collected at baseline from 63,393 women in the Women's Health Initiative Clinical Trial. A total of 486 cases of ductal carcinoma in situ (DCIS) of the breast were identified during 8 years of follow-up between 1993 and 2005. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals. For the primary analysis, invasive breast cancer was treated as a competing risk. After adjustment for covariates, associations with smoking status, smoking intensity, duration, pack-years, and age at quitting were all close to the null value and showed few meaningful trends. Sensitivity analyses performed to address different possibilities with respect to the natural history of breast cancer also did not provide consistent evidence of an association of smoking with DCIS. The results of this large cohort study provide little support for an association of cigarette smoking with risk of DCIS in postmenopausal women.

Smoking and alcohol consumption in relation to risk of triple-negative breast cancer in a cohort of postmenopausal women

“…Whether cigarette smoking is associated with increased risk of breast cancer overall is unresolved [21, 23, 24, 30]. Many studies have shown no association of smoking status (being a current or former smoker vs. never having smoked) or other aspects of smoking with increased risk [21, 24, 31–37], whereas other studies have indicated that greater intensity, early age of initiation, and longer duration of smoking are associated with increased risk [38–43].…”

Self-perceived physical health predicts cardiovascular disease incidence and death among postmenopausal women

“…Pack-years of cigarette smoking were computed by multiplying the midpoint of the smoking frequency interval with the midpoint of the duration interval and dividing the product by 20 [19]. Fruits and vegetables consumption was assessed with a standardized Food Frequency Questionnaire (FFQ) and categorized as <3, 3–5, and 5+ servings/day [20].…”

Perspectives of breast cancer etiology: synergistic interaction between smoking and exogenous hormone use

“…A synergistic interaction between smoking and hormone use on the risk of breast ductal carcinoma in situ was reported by Kabat et al [28]. Many RCTs have reported that the treatment group receiving either nutrients or HRT for a long time had no decrease in cancers, or even an increase in cancers or other diseases compared to control/placebo groups[52].…”

“…In addition, recent reports provide evidence that breast cancer risk from smoking may be modified by other factors including the hormone receptor status of the tumor[23], metabolite enzyme genes [24]–[27], familial history of breast cancer[6], and exogenous hormone use[8],[28].…”