From Our 2007 Archives

Smoking Does Not Worsen Breast Cancer

By Madeline Vann
HealthDay Reporter

MONDAY, Oct. 29 (HealthDay News) -- It may be unhealthy in many other ways, but smoking does not appear to raise the odds that a woman with breast cancer will have more aggressive or later-stage malignancy at the time of diagnosis, researchers report.

Their results come from an analysis of data gathered on more than 6,000 women for more than 35 years.

"Smoking did not affect treatment options either," noted lead researcher Dr. Matthew Abramowitz, a resident in radiation oncology at Fox Chase Cancer Center in Philadelphia.

Abramowitz said he had expected to find that smokers were less likely to have surgeries, such as mastectomies, because of the physical health problems associated with smoking, but the data showed otherwise. Women with breast cancer who smoked or had ever smoked were just as likely to have surgery as those who did not smoke.

About one in 10 of the breast cancer patients was a smoker when she was diagnosed with breast cancer, Abramowitz said.

The findings were expected to be presented Sunday at the annual meeting of the American Society for Therapeutic Radiology and Oncology, in Los Angeles.

Smoking has been shown to be a risk factor for cancers of the lung, head, neck, esophagus and bladder. However, studies testing for a possible link between smoking and breast cancer risk have been inconclusive.

"This study says nothing about the rate of breast cancer or whether women are more likely to get breast cancer if they smoke. But it's interesting that smoking did not affect the cancer that we saw," said Abramowitz.

Despite the findings, women who smoke are still putting their health at great risk, stressed Dr. Michael J. Thun, vice president of epidemiology and surveillance research at the American Cancer Society.

"The study results don't change anything for women who smoke. They still have a one in two chance of being killed by smoking if they don't quit and a one in eight lifetime risk of developing breast cancer. More American women have died from lung cancer than breast cancer since 1987," Thun noted.

In fact, lung cancer remains the leading killer of both women and men. According to the American Cancer Society, about 70,880 U.S. women will die from lung cancer in 2007, compared to 40,460 who will succumb to breast cancer.

In their study, Abramowitz and his research team analyzed data from 6,162 breast cancer patients who were initially evaluated between 1970 and 2006 at the Fox Chase Cancer Center. The women were asked about their past and present smoking habits as part of the initial health interview. Almost half (45 percent) had ever smoked, although only 9 percent were smokers at the time of diagnosis.

The researchers found no statistically significant correlation between smoking and tumor stage or aggressiveness at the time the women were diagnosed.

There was a slight but statistically insignificant trend toward smokers having more Her2/Neu positive tumors than nonsmokers. Her2/Neu positive tumors are more aggressive and difficult to treat, said Abramowitz, although treatment options have improved in recent years.

The possible correlation between smoking and Her2/Neu tumors could not be explored due to the small number of patients who had undergone Her2/Neu screening, which was not available for the full 35 years of the study period. However, it's a potential avenue for future research, Abramowitz said.

His team also found no correlation between tumor stage at diagnosis and family history of breast cancer, use of hormone therapy or menopausal status. According to Abramowitz, the promotion of early screening for breast cancer during the study period might have had an effect on the stage of the tumors at diagnosis.

Still, too many women continue to put their health in jeopardy by smoking. "The major challenges are to help women who are addicted to nicotine quit smoking and to prevent adolescents from starting," emphasized Thun.

SOURCES: Matthew Abramowitz, M.D., radiation oncology resident, Fox Chase Cancer Center, Philadelphia, Pa.; Michael J. Thun, M.D., vice president, Epidemiology and Surveillance Research, American Cancer Society; Oct. 28, 2007, presentation, American Society for Therapeutic Radiology and Oncology annual meeting, Los Angeles

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