Malik Abhidha, Jeyaraj Pamela Alice, Shankar Abhishek, Rath Goura Kishore, Mukhopadhyay Sandip, Kamal Vineet Kumar
Department of Radiation Oncology, Dr B.R.A Institute of Rotary Cancer Hospital, Delhi, India E-mail :
Asian Pac J Cancer Prev. 2015;16(14):5715-9. doi: 10.7314/apjcp.2015.16.14.5715.
Breast cancer is the most common malignancy of women in the world. The disease is caused by infectious and non-infectious, environmental and lifestyle factors. Tobacco smoke has been one of the most widely studied environmental factors with possible relevance to breast cancer. The purpose of this study was to assess the impact of tobacco smoking in breast cancer patients in a hospital based cohort and to establish prognostic implications if any.
A retrospective audit of 100 women with pathological diagnosis of invasive breast cancer was included in this study. The verbal questionnaire elicited information on current and previous history of exposure to smoking in addition to active smoking. All analyses were adjusted for potential confounders, including stage at presentation, alcohol intake, hormonal replacement therapy, oral contraceptive intake, obesity and menopausal status.
The mean age at presentation of breast cancer was 51.4 ± 10.86 years. Mean age of presentation was 53.1±11.5 and 45.7±11.9 years in never smokers and passive smokers, respectively. Age at presentation varied widely in patients exposed to tobacco smoke for >10 years in childhood from 40.3± 12.0 years to 47.7± 13.9 in patients exposed for > 20 years as adults. Among passive smokers, 60.9% were premenopausal and 39.1% of patients were postmenopausal. In never smokers, 71.4% were post menopausal. Expression of receptors in non-smokers vs passive smokers was comparable with no significant differences. Metastatic potential in lung parenchyma was slightly elevated in passive smokers as compared to never smokers although statistically non-significant.
An inverse relationship exists between the intensity and duration of smoking and the age at presentation and poor prognostic factors. The results strongly suggest efforts should be taken to prevent smoking, encourage quitting and restrict exposure to second hand smoke in India.
乳腺癌是全球女性中最常见的恶性肿瘤。该疾病由感染性和非感染性、环境和生活方式因素引起。烟草烟雾是与乳腺癌可能相关的研究最为广泛的环境因素之一。本研究的目的是评估在一个基于医院的队列中吸烟对乳腺癌患者的影响，并确定是否有任何预后意义。
本研究纳入了100例经病理诊断为浸润性乳腺癌的女性患者进行回顾性分析。口头问卷除了询问主动吸烟情况外，还收集了当前和既往接触吸烟的病史信息。所有分析均对潜在混杂因素进行了校正，包括就诊时的分期、酒精摄入、激素替代疗法、口服避孕药摄入、肥胖和绝经状态。
乳腺癌患者的平均就诊年龄为51.4±10.86岁。从不吸烟者和被动吸烟者的平均就诊年龄分别为53.1±11.5岁和45.7±11.9岁。童年时期接触烟草烟雾超过10年的患者，就诊年龄差异很大，成年后接触超过20年的患者，就诊年龄从40.3±12.0岁到47.7±13.9岁不等。在被动吸烟者中，60.9%为绝经前，39.1%为绝经后。在从不吸烟者中，71.4%为绝经后。非吸烟者与被动吸烟者中受体的表达相当，无显著差异。与从不吸烟者相比，被动吸烟者肺实质中的转移潜能略有升高，尽管在统计学上无显著差异。
吸烟的强度和持续时间与就诊年龄及不良预后因素之间存在负相关关系。结果强烈表明，印度应努力预防吸烟、鼓励戒烟并限制二手烟暴露。
