Fentiman I S, Allen D S, Hamed H
Department of Academic Oncology, Guy's Hospital, London, UK.
Int J Clin Pract. 2005 Sep;59(9):1051-4. doi: 10.1111/j.1742-1241.2005.00581.x.
The hypothesis was that smokers might have more aggressive types of breast cancer because of either delayed diagnosis or higher grade and hence have a worse prognosis. A cohort of breast cancer patients completed a lifestyle questionnaire at the time of diagnosis, including whether they were current smokers, ex-smokers or lifelong non-smokers. Ex-smokers were asked when they had stopped. The participants were 166 women with stage I/II invasive breast cancer diagnosed between October 1984 and March 1987. Participants were divided into three groups: current smokers, ex-smokers and non-smokers. Survival curves were produced by using Cox proportional hazards analysis, with outcome variables for overall and breast cancer-specific survival together with distant relapse-free survival. Smoking was the third most important predictor of distant relapse-free, breast cancer-specific and overall survival after stage and age at diagnosis. These results suggest that smokers are not only more likely to die of other diseases, but also have a higher mortality from breast cancer, compared with those with the disease who have never smoked. The best prognosis, however, was found in those who had given up smoking.
研究假设是，吸烟者可能因诊断延迟或肿瘤分级较高而患有侵袭性更强的乳腺癌类型，因此预后更差。一组乳腺癌患者在确诊时填写了一份生活方式问卷，内容包括她们是当前吸烟者、既往吸烟者还是终身不吸烟者。既往吸烟者被问及戒烟时间。研究对象为1984年10月至1987年3月期间确诊的166例I/II期浸润性乳腺癌女性患者。参与者被分为三组：当前吸烟者、既往吸烟者和不吸烟者。采用Cox比例风险分析生成生存曲线，将总生存、乳腺癌特异性生存以及远处无复发生存作为结局变量。吸烟是继诊断时的分期和年龄之后，远处无复发生存、乳腺癌特异性生存和总生存的第三大重要预测因素。这些结果表明，与从未吸烟的乳腺癌患者相比，吸烟者不仅更有可能死于其他疾病，而且乳腺癌死亡率也更高。然而，预后最好的是那些已经戒烟的人。
