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. 2023 Nov 30:21:157.
doi: 10.18332/tid/174132. eCollection 2023.

Smoking history and breast cancer risk by pathological subtype: MCC-Spain study

Belén Peñalver-Argüeso  1   2 , Esther García-Esquinas  2   3   4 , Adela Castelló  2   4 , Nerea Fernández de Larrea-Baz  2   4 , Gemma Castaño-Vinyals  4   5   6   7 , Pilar Amiano  4   8   9 , Tania Fernández-Villa  4   10 , Marcela Guevara  4   11   12 , Guillermo Fernández-Tardón  4   13   14 , Juan Alguacil  4   15 , Mireia Obón-Santacana  4   16   17 , Inés Gómez-Acebo  4   18   19 , Marina Pinto-Carbó  20 , Rafael Marcos-Gragera  4   21   22 , Nuria Aragonés  4   23 , Amaia Aizpurua  4   8   9 , Vicente Martín-Sánchez  4   10 , Eva Ardanaz  4   11   12 , Trinidad Dierssen-Sotos  4   18   19 , Jose Juan Jiménez-Moleón  4   24 , Manolis Kogevinas  4   5   6   7 , Marina Pollán  2   4 , Beatriz Pérez-Gómez  1   2   4
Affiliations

Smoking history and breast cancer risk by pathological subtype: MCC-Spain study

Belén Peñalver-Argüeso et al. Tob Induc Dis. .

Abstract

Introduction: The role of cigarette smoking on breast cancer risk remains controversial, due to its dual carcinogenic-antiestrogenic action.

Methods: In the population-based multi-case-control study (MCC-Spain), we collected epidemiological and clinical information for 1733 breast cancer cases and 1903 controls, including smoking exposure. The association with breast cancer, overall, by pathological subtype and menopausal status, was assessed using logistic and multinomial regression models.

Results: Smokers had higher risk of premenopausal breast cancer, particularly if they had smoked ≥30 years (AOR=1.75; 95% CI: 1.04-2.94), although most estimates did not achieve statistical significance. In contrast, among postmenopausal women, smoking was associated with lower risk of breast cancer, mainly in overweight and obese women. The strongest risk reductions were observed among postmenopausal women who had stopped smoking ≥10 years before cancer diagnosis, particularly for HER2+ tumors (AOR=0.28; 95% CI: 0.11-0.68); p for heterogeneity = 0.040). Also, those who had smoked <10 pack-years (AOR=0.68; 95% CI: 0.47-0.98) or 10-25 pack-years (AOR=0.62; 95% CI: 0.42-0.92) during their lifetime were at a reduced risk of all breast cancer subtypes (p for heterogeneity: 0.405 and 0.475, respectively); however, women who had smoked more than 25 pack-years showed no reduced risk.

Conclusions: Menopausal status plays a key role in the relationship between tobacco and breast cancer for all cancer subtypes. While smoking seems to increase the risk in premenopausal woman, it might be associated to lower risk of breast cancer among postmenopausal women with excess weight.

Keywords: HER2; breast cancer; hormone receptor; obesity; smoking.

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Conflict of interest statement

The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. All the authors report that since the initial planning of the work, this study was supported by the Instituto de Salud Carlos III and the CIBERESP (PI08/1770, PI08/0533, PI08/1359, PS09/00773, PS09/01286, PS09/01903, PS09/02078, PS09/01662, PI11/01403, PI11/01889, PI11/00226, PI11/01810, PI11/02213, PI12/00488, PI12/00265, PI12/01270, PI12/00715, PI12/00150). The study was partially funded by the 'Acción Transversal del Cáncer' project, approved by the Spanish Council of Ministers on 11 October 2007.

Figures

Figure 1
Figure 1
Adjusted odds ratio for the risk of female breast cancer associated with tobacco use by menopausal status, multi-case-control study (MCC-Spain), 2008–2013, Spain (Pre-menopausal women: N=1157; Cases=610; Controls=547; Post-menopausal women: N=2474; Cases=1122; Controls=1352)
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