From Our 2011 Archives

Women Who Smoke May Raise Breast Cancer Risk

Study Shows Link Between Smoking Before Having Children and Breast Cancer

By Jennifer Warner
WebMD Health News

Reviewed by Laura J. Martin, MD

Jan. 24, 2011 -- Smoking early in life may raise a woman's risk of developing breast cancer, according to research that adds new evidence on the link between cigarettes and breast cancer.

The study showed smoking before menopause, especially before having children, slightly increased the risk of breast cancer among a large group of women who participated in the Nurses Health Study.

Breast cancer risk was18% higher among those who began smoking before giving birth to their first child and 4% higher for those who started smoking after the first birth but before menopause.

Breast cancer is the most common type of cancer among women worldwide. In the U.S. lung cancer is the No. 1 cause of cancer deaths in women; breast cancer is the second most common cause.

Tobacco smoke contains several known cancer-causing substances. But previous studies on the link between cigarette smoking and breast cancer have provided inconsistent and sometimes controversial results.

Researchers say a major issue is that lifetime smoking exposure consists of many factors, including active and secondhand or passive smoke exposure, which can be difficult to measure accurately.

Breast Cancer Risk

In this study, researchers looked at the effects of personal smoking history as well as passive smoke exposure on breast cancer risk using data from 111,140 women who were followed from 1976 to 2006 for active smoking status and 36,017 women who provided information from 1982 to 2006 on secondhand smoke exposure.

Overall, 8,772 cases of breast cancer were reported during the follow-up period.

The results showed breast cancer risk was higher among the following groups:

  • Heavy current and past smokers (25 or more cigarettes daily).
  • Those who started to smoke before age 17.
  • Women who had smoked for at least 20 years.
  • Current and past smokers with a history of 20 or more pack-years (number of packs of cigarettes smoked per day multiplied by the number of years smoked).

"Heavy smokers who started smoking early in life, smoked for a long duration and smoked a high quantity were at the highest risk of breast cancer," write researcher Fei Zue, MD, ScD, of Brigham and Women's Hospital and Harvard University, and colleagues in the Archives of Internal Medicine.

In contrast, never smoking and passive smoke exposure in childhood were not associated with an increase in breast cancer risk. Also, living with parents who smoked in the same house and secondhand smoke exposure while at work or at home were not linked to breast cancer risk, after adjusting for other potential risk factors.

Researchers say the findings support a modest, independent, and additive effect of active cigarette smoking on breast cancer risk, especially smoking before the first birth. Additional research in large groups of women is needed to further clarify this link.

SOURCES: Xue, F. Archives of Internal Medicine, Jan. 24, 2011; vol 171: pp 125-133.News release, American Medical Association.

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