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. 2020 Feb;29(2):368-378.
doi: 10.1158/1055-9965.EPI-19-0546. Epub 2019 Dec 2.

Alcohol Consumption, Cigarette Smoking, and Risk of Breast Cancer for BRCA1 and BRCA2 Mutation Carriers: Results from The BRCA1 and BRCA2 Cohort Consortium

Hongyan Li  1 , Mary Beth Terry  2   3 , Antonis C Antoniou  4 , Kelly-Anne Phillips  5   6   7 , Karin Kast  8   9   10 , Thea M Mooij  11 , Christoph Engel  12 , Catherine Noguès  13 , Dominique Stoppa-Lyonnet  14   15 , Christine Lasset  16 , Pascaline Berthet  17 , Veronique Mari  18 , Olivier Caron  19 ; GENEPSO study; Daniel Barrowdale  4 , Debra Frost  4 , Carole Brewer  20 , D Gareth Evans  21 , Louise Izatt  22 , Lucy Side  23 , Lisa Walker  24 , Marc Tischkowitz  25 , Mark T Rogers  26 , Mary E Porteous  27 , Katie Snape  28 ; EMBRACE study; Hanne E J Meijers-Heijboer  29 , Johan J P Gille  29 , Marinus J Blok  30 , Nicoline Hoogerbrugge  31 ; HEBON Investigators; Mary B Daly  32 , Irene L Andrulis  33   34 , Saundra S Buys  35 , Esther M John  36 , Sue-Anne McLachlan  37   38 , Michael Friedlander  39   40 ; kConFab Investigators; Yen Y Tan  41 , Ana Osorio  42 , Trinidad Caldes  43 , Anna Jakubowska  44   45 , Jacques Simard  46 , Christian F Singer  41 , Edith Olah  47 , Marie Navratilova  48 , Lenka Foretova  48 , Anne-Marie Gerdes  49 , Marie-José Roos-Blom  11 , Brita Arver  50   51 , Håkan Olsson  51 , Rita K Schmutzler  52   53 , John L Hopper  5 , Roger L Milne  5   54   55 , Douglas F Easton  4   56 , Flora E Van Leeuwen  11 , Matti A Rookus  11 , Nadine Andrieu #  57   58   59   60 , David E Goldgar #  61   62
Affiliations

Alcohol Consumption, Cigarette Smoking, and Risk of Breast Cancer for BRCA1 and BRCA2 Mutation Carriers: Results from The BRCA1 and BRCA2 Cohort Consortium

Hongyan Li et al. Cancer Epidemiol Biomarkers Prev. 2020 Feb.

Abstract

Background: Tobacco smoking and alcohol consumption have been intensively studied in the general population to assess their effects on the risk of breast cancer, but very few studies have examined these effects in BRCA1 and BRCA2 mutation carriers. Given the high breast cancer risk for mutation carriers and the importance of BRCA1 and BRCA2 in DNA repair, better evidence on the associations of these lifestyle factors with breast cancer risk is essential.

Methods: Using a large international pooled cohort of BRCA1 and BRCA2 mutation carriers, we conducted retrospective (5,707 BRCA1 mutation carriers and 3,525 BRCA2 mutation carriers) and prospective (2,276 BRCA1 mutation carriers and 1,610 BRCA2 mutation carriers) analyses of alcohol and tobacco consumption using Cox proportional hazards models.

Results: For both BRCA1 and BRCA2 mutation carriers, none of the smoking-related variables was associated with breast cancer risk, except smoking for more than 5 years before a first full-term pregnancy (FFTP) when compared with parous women who never smoked. For BRCA1 mutation carriers, the HR from retrospective analysis (HRR) was 1.19 [95% confidence interval (CI), 1.02-1.39] and the HR from prospective analysis (HRP) was 1.36 (95% CI, 0.99-1.87). For BRCA2 mutation carriers, smoking for more than 5 years before an FFTP showed an association of a similar magnitude, but the confidence limits were wider (HRR = 1.25; 95% CI, 1.01-1.55 and HRP = 1.30; 95% CI, 0.83-2.01). For both carrier groups, alcohol consumption was not associated with breast cancer risk.

Conclusions: The finding that smoking during the prereproductive years increases breast cancer risk for mutation carriers warrants further investigation.

Impact: This is the largest prospective study of BRCA mutation carriers to assess these important risk factors.

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Conflict of interest statement

Disclosure of Potential Conflicts of Interest

No potential conflicts of interest were disclosed.

Figures

Figure 1
Figure 1. Design of the BRCA1 and BRCA2 cohort consortium.
Each line represents a sample IBCCS-BCFR-KConFab participant from birth to censure: a diagnosis of primary breast cancer (BC); a Risk Reduction Mastectomy (RRM); a last FUP questionnaire; and the most recent information from an external source (last linkage). BL: BRCA1 B2: BRCA2 BC: Breast Cancer
Figure 2
Figure 2. Cumulative risk of breast cancer for never smoking parous women and those who smoked for more than five years before the first full-term pregnancy among BRCA1 mutation carriers (prospective analysis)
See this image and copyright information in PMC

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