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Smoking and the risk of breast cancer in BRCA1 and BRCA2 carriers: an update

  • Epidemiology
  • Published:
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Abstract

Among women with a mutation in BRCA1 or BRCA2, the risk of breast cancer is high, but it may be modified by exogenous and endogenous factors. There is concern that exposure to carcinogens in cigarette smoke may increase the risk of cancer in mutation carriers. We conducted a matched case–control study of 2,538 cases of breast cancer among women with a BRCA1 (n = 1,920) or a BRCA2 (n = 618) mutation. One non-affected mutation carrier control was selected for each case, matched on mutation, country of birth, and year of birth. Odds ratios were calculated using conditional logistic regression, adjusted for oral contraceptive use and parity. Ever-smoking was not associated with an increased breast cancer risk among BRCA1 carriers (OR = 1.09; 95% CI 0.95–1.24) or among BRCA2 carriers (OR = 0.81; 95% CI 0.63–1.05). The result did not differ when cases were restricted to women who completed the questionnaire within two years of diagnosis. A modest, but significant increase in risk was seen among BRCA1 carriers with a past history of smoking (OR = 1.27; 95% CI 1.06–1.50), but not among current smokers (OR = 0.95; 0.81–1.12). There appears to be no increase in the risk of breast cancer associated with current smoking in BRCA1 or BRCA2 carriers. There is a possibility of an increased risk of breast cancer among BRCA1 carriers associated with past smoking. There may be different effects of carcinogens in BRCA mutation carriers, depending upon the timing of exposure.

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Abbreviations

BRCA1:

Breast cancer susceptibility gene 1

BRCA2:

Breast cancer susceptibility gene 2

OR:

Odds ratio

CI:

Confidence interval

DNA:

Deoxyribonucleic acid

RR:

Relative risk

HR:

Hazard ratio

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Acknowledgement

SNL was supported by grant R01 CA744175.

Author information

Authors and Affiliations

  1. The Campbell Family Institute for Breast Cancer Research at Princess Margaret Hospital, Toronto, ON, Canada

    Ophira Ginsburg

  2. Epidemiology Research Unit, Centre Hospitalier de l’Universite de Montreal (CHUM) Hotel-Dieu, Faculty of Medicine, Universite de Montreal, Montreal, QC, Canada

    Parviz Ghadirian

  3. Pomeranian Medical University, Szczecin, Poland

    Jan Lubinski & Cezary Cybulski

  4. Department of Preventive Medicine and Public Health, Creighton University School of Medicine, Omaha, NE, USA

    Henry Lynch

  5. Department of Epidemiology, University of California, Irvine, CA, USA

    Susan Neuhausen

  6. British Columbia Cancer Agency, Vancouver, BC, Canada

    Charmaine Kim-Sing

  7. Clinical Genetics, Department of Medicine, Memorial-Sloan Kettering, New York, NY, USA

    Mark Robson

  8. Departments of Medicine and Genetics, University of Pennsylvania, Philadelphia, PA, USA

    Susan Domchek

  9. Lombardi Cancer Center, Georgetown University Medical Center, Washington, DC, USA

    Claudine Isaacs

  10. Department of Medical Oncology, (Dr. Daniel den Hoed Kliniek) Rotterdam Cancer Institute, University Hospital Rotterdam, Rotterdam, The Netherlands

    Jan Klijn

  11. Department of Obstetrics and Gynecology, University Health Network, Toronto, ON, Canada

    Susan Armel

  12. Program in Cancer Genetics, Departments of Oncology and Human Genetics, McGill University, Montreal, QC, Canada

    William D. Foulkes

  13. Beth Israel Deaconess Hospital, Boston, MA, USA

    Nadine Tung

  14. Department for Cancer Genetics, The Norwegian Radium Hospital, Oslo, Norway

    Pal Moller

  15. Womens College Research Institute, Women’s College Hospital, University of Toronto, 790 Bay Street, 7th Floor, Toronto, ON, Canada, M5G 1N8

    Ping Sun & Steven A. Narod

Authors
  1. Ophira Ginsburg
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  2. Parviz Ghadirian
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  3. Jan Lubinski
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  4. Cezary Cybulski
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  5. Henry Lynch
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  6. Susan Neuhausen
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  7. Charmaine Kim-Sing
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  8. Mark Robson
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  9. Susan Domchek
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  10. Claudine Isaacs
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  11. Jan Klijn
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  12. Susan Armel
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  13. William D. Foulkes
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  14. Nadine Tung
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  15. Pal Moller
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  16. Ping Sun
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  17. Steven A. Narod
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Consortia

Hereditary Breast Cancer Clinical Study Group

Corresponding author

Correspondence to Steven A. Narod.

Additional information

Other members of the Hereditary Breast Cancer Clinical Study Group: Olufunmilayo Olopade, Shelly Cummings, Fergus Couch, Barry Rosen, Dominique Stoppa-Lyonnet, Ruth Gershoni-Baruch, David Horsman, Teresa Wagner, Howard Saal, Ellen Warner, Wendy Meschino, Kenneth Offit, Amber Trivedi, Michael Osborne, Dawna Gilchrist, Charis Eng, Jeffrey Weitzel, Wendy McKinnon, Marie Wood, Christine Maugard, Barbari Pasini, Peter Ainsworth, Kevin Sweet, Boris Pasche, Beth Karlan, Raluca N. Kurz, Anna Tulman, Ed Lemire, Jane Mclennan, Gareth Evans, Tomas Byrski, Tomas Huzarski, Jacek Gronwald, Bohdan Gorski, Eitan Friedman, Andrea Eisen, Mary Daly, Judy Garber, Sofia Merajver.

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Ginsburg, O., Ghadirian, P., Lubinski, J. et al. Smoking and the risk of breast cancer in BRCA1 and BRCA2 carriers: an update. Breast Cancer Res Treat 114, 127–135 (2009). https://doi.org/10.1007/s10549-008-9977-5

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  • DOI: https://doi.org/10.1007/s10549-008-9977-5

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