Up in smoke…smoking and breast cancer in the postmenopausal years

Posted by Liz on Mar 14, 2011 in breast cancer | 5 comments

Cigarette smoking is something that appears to keep on giving. And giving. Not only do former smokers find that their habits, even once discarded, might come back to bite them in the hot flash ass and even lead to early menopause, but both active and passive smoking habits are being linked to a increased risk of breast cancer, even 20 years past the expiration date. So, when I was hanging with my bestie behind the fence of my childhood home sucking away at those Kool cigarettes, I guess was I truly making an unconscious choice that is starting to rear its ugly head.

Listen up: don’t smoke.

Okay, enough of the lecture; here are the facts.

Researchers have recently taken a look at the association between smoking and breast cancer risk in almost 80,000 women enrolled in a larger trial (the Women’s Health Initiative Observational Study) that took place in the ’90s. Granted, the study relied upon self-reports, which of course, are subject to some degree of what scientists call “recall bias,” meaning that the findings can be subject to some discrepancies. Nevertheless, after collecting information on smoking (never, former or current), age when started smoking, number of cigarettes smoked daily and number of years that cigarettes were smoked, along with age when quitting, as well as potential exposures to passive smoking (as a child, in the home or at work both formerly and currently), they discovered the following:

• Former smokers had a 9% increased risk of breast cancer and current smokers, a 16% increased risk. These figures were related to smoking intensity and years of smoking.
• If a woman had started smoking before their first full time pregnancy, she had a 21% increased breast cancer risk.
• Among former smokers, time since quitting was relevant, and it took as long as 20 years for a former smoker to return to a risk level that would be considered equal to someone who had never smoked.
• Passive smoking was also a huge factor; in fact women who’s exposure to passive smoke in childhood, at home and at work for 10 years or more had a 32% excess risk of developing breast cancer compared to women who had never been exposed to passive smoke. Note that that the researchers emphasize that this particular association is only suggestive and since this is the first study to so closely examine the link between passive smoking and cancer in postmenopausal women, more data are needed.

So, what about the factors that might have influenced or skewed these findings? Well, the researchers did account for age ethnicity, education, body mass index, physical activity, alcohol use, whether or not women had ever been pregnant or brought a child to term, and history of hormone therapy use. And still, the results remained solid.

The upshot of this is that many of us grew up during a time when smoking was a rite of passage, “cool,” or simply habitual. Many of us quit during our 20s or 30s. Some of us still smoke. However, not only does smoking make those menopausal symptoms ever so much worse, but it’s also risky as hell when it comes to breast cancer.

It’s time to do due diligence. Conduct monthly breast checks. Despite controversy as to their value or lack thereof, make a conscious decision about mammography. Instill healthy habits now, including physical activity, a healthy diet and moderate alcohol intake. We might not be able to take back past habits but we can certainly do all we can to alter current habits.

If I knew then what I know now, I might not have picked up those Marlboro Lights so frequently. Oh well. Payback is certainly a bitch.