© 1998 by Oxford University Press
Journal Of The National Cancer Institute, Vol 90, 761-766, Copyright © 1998 by Oxford University Press
JS Brunet, P Ghadirian, TR Rebbeck, C Lerman, JE Garber, PN Tonin, J Abrahamson, WD Foulkes, M Daly, J Wagner-Costalas, A Godwin, OI Olopade, R Moslehi, A Liede, PA Futreal, BL Weber, GM Lenoir, HT Lynch and SA Narod
BACKGROUND: Smoking has carcinogenic effects, and possibly antiestrogenic
effects as well, but it has not been found to be a risk factor for breast
cancer in women in the general population. However, hereditary breast
cancer is primarily a disease of premenopausal women, and interactions
between genes and hormonal and environmental risk factors may be
particularly important in this subgroup. METHODS: We conducted a matched
case-control study of breast cancer among women who have been identified to
be carriers of a deleterious mutation in either the BRCA1 or the BRCA2
gene. These women were assessed for genetic risk at one of several genetic
counseling programs for cancer in North America. Information about lifetime
smoking history was derived from a questionnaire routinely administered to
women who were found to carry a mutation in either gene. Smoking histories
of case subjects with breast cancer and age-matched healthy control
subjects were compared. Odds ratios for developing breast cancer were
determined for smokers versus nonsmokers by use of conditional logistic
regression for matched sets after adjustment for other known risk factors.
RESULTS: Subjects with BRCA1 or BRCA2 gene mutations and breast cancer were
significantly more likely to have been nonsmokers than were subjects with
mutations and without breast cancer (two-sided P = .007). In a multivariate
analysis, subjects with BRCA1 or BRCA2 mutations who had smoked cigarettes
for more than 4 pack-years (i.e., number of packs per day multiplied by the
number of years of smoking) were found to have a lower breast cancer risk
(odds ratio = 0.46, 95% confidence interval = 0.27-0.80; two-sided P =
.006) than subjects with mutations who never smoked. CONCLUSIONS: This
study raises the possibility that smoking reduces the risk of breast cancer
in carriers of BRCA1 or BRCA2 gene mutations.
ARTICLES
Effect of smoking on breast cancer in carriers of mutant BRCA1 or BRCA2 genes
Department of Medicine, Women's College Hospital, University of Toronto, ON, Canada.
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