The Who, What, Where, When and Sometimes, Why.

Smoking and breast cancer survival

This summary table contains detailed information about research studies. Summary tables are a useful way to look at the science behind many breast cancer guidelines and recommendations. However, to get the most out of the tables, it’s important to understand some key concepts. Learn how to read a research table.

Introduction: Growing evidence suggests smoking lowers the chances of survival for women with breast cancer.

A pooled analysis of data from about 10,000 breast cancer survivors found smoking increased the risk of [1]:

  • Breast cancer recurrence (a return of breast cancer)
  • Breast cancer-specific mortality (death from breast cancer)
  • Overall mortality (death from any cause, not necessarily breast cancer)

The more women smoked, the higher these risks [1].  

Learn more about smoking and breast cancer survival.

Learn about smoking and breast cancer risk.

Learn about the strengths and weaknesses of different types of studies.

Study selection criteria: Prospective cohort studies with at least 900 participants, pooled analyses and meta-analyses.

All studies measured smoking after breast cancer diagnosis.

Table note: Relative risk above 1 indicates increased risk. Relative risk below 1 indicates decreased risk.   

Study

Study Population
(number of participants)

Follow-up
(years)

Breast Cancer Mortality in
Current Smokers Compared to
Never Smokers,
RR (95% CI)

Prospective cohort studies

Nurses’ Health Study [2]

5,031

8

1.02
(0.83-1.24)

Collaborative Breast Cancer and Women’s Longevity Study [3]

4,562

6

1.72
(1.13-2.60)

Life After Cancer Epidemiology [4]

2,265

12

2.01
(1.27-3.18)

Parada et al. [5]

1,508

18

1.08
(0.77-1.51)

U.S. Health and Functioning in Women study [6]

975

11

1.38
(0.99-1.91)

Pooled and meta-analyses

California Breast Cancer Survivorship Consortium [7]

12,210

 

1 or fewer packs of
cigarettes per day:
1.22
(1.01-1.47)

More than 1 pack of
cigarettes per day:
1.63
(1.11-2.38)

After Breast Cancer Pooling Project [1,8]

9,975

 

1.61
(1.28-2.03)*

Duan et al. [9]

12 studies

 

1.30
(1.16-1.45)

*Among survivors who had estrogen receptor-positive breast cancers, current smokers did not have an increased risk of late recurrence (5 or more years after diagnosis) compared to never smokers, 1.30 (0.94-1.81).

References

  1. Pierce JP, Patterson RE, Senger CM, et al. Lifetime cigarette smoking and breast cancer prognosis in the after breast cancer pooling project. J Natl Cancer Inst. 106(1):djt359, 2014.
  2. Holmes MD, Murin S, Chen WY, Kroenke CH, Spiegelman D, Colditz GA. Smoking and survival after breast cancer diagnosis. Int J Cancer. 120(12):2672-7, 2007.
  3. Passarelli MN, Newcomb PA, Hampton JM, et al. Cigarette smoking before and after breast cancer diagnosis: mortality from breast cancer and smoking-related diseases. J Clin Oncol. 34(12):1315-22, 2016.
  4. Braithwaite D, Izano M, Moore DH, et al. Smoking and survival after breast cancer diagnosis: a prospective observational study and systematic review. Breast Cancer Res Treat. 136(2):521-33, 2012.
  5. Parada H Jr, Bradshaw PT, Steck SE, et al. Postdiagnosis changes in cigarette smoking and survival following breast cancer. JNCI Cancer Spectr. 1(1): pkx001, 2017.
  6. Izano M, Satariano WA, Hiatt RA, Braithwaite D. Smoking and mortality after breast cancer diagnosis: the health and functioning in women study. Cancer Med. 4(2):315-24, 2015.
  7. Wu AH, Gomez SL, Vigen C, et al. The California Breast Cancer Survivorship Consortium (CBCSC): prognostic factors associated with racial/ethnic differences in breast cancer survival. Cancer Causes Control. 24(10):1821-36, 2013.
  8. Nechuta S, Chen WY, Cai H, et al. A pooled analysis of post-diagnosis lifestyle factors in association with late estrogen-receptor-positive breast cancer prognosis. Int J Cancer. 138(9):2088-97, 2016.
  9. Duan W, Li S, Meng X, Sun Y, Jia C. Smoking and survival of breast cancer patients: A meta-analysis of cohort studies. Breast. 33:117-124, 2017.