Breast Cancer Research and Treatment

, Volume 114, Issue 1, pp 127-135

First online:

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

  • Ophira GinsburgAffiliated withThe Campbell Family Institute for Breast Cancer Research at Princess Margaret Hospital
  • , Parviz GhadirianAffiliated withEpidemiology Research Unit, Centre Hospitalier de l’Universite de Montreal (CHUM) Hotel-Dieu, Faculty of Medicine, Universite de Montreal
  • , Jan LubinskiAffiliated withPomeranian Medical University
  • , Cezary CybulskiAffiliated withPomeranian Medical University
  • , Henry LynchAffiliated withDepartment of Preventive Medicine and Public Health, Creighton University School of Medicine
  • , Susan NeuhausenAffiliated withDepartment of Epidemiology, University of California
  • , Charmaine Kim-SingAffiliated withBritish Columbia Cancer Agency
  • , Mark RobsonAffiliated withClinical Genetics, Department of Medicine, Memorial-Sloan Kettering
  • , Susan DomchekAffiliated withDepartments of Medicine and Genetics, University of Pennsylvania
    • , Claudine IsaacsAffiliated withLombardi Cancer Center, Georgetown University Medical Center
    • , Jan KlijnAffiliated withDepartment of Medical Oncology, (Dr. Daniel den Hoed Kliniek) Rotterdam Cancer Institute, University Hospital Rotterdam
    • , Susan ArmelAffiliated withDepartment of Obstetrics and Gynecology, University Health Network
    • , William D. FoulkesAffiliated withProgram in Cancer Genetics, Departments of Oncology and Human Genetics, McGill University
    • , Nadine TungAffiliated withBeth Israel Deaconess Hospital
    • , Pal MollerAffiliated withDepartment for Cancer Genetics, The Norwegian Radium Hospital
    • , Ping SunAffiliated withWomens College Research Institute, Women’s College Hospital, University of Toronto
    • , Steven A. NarodAffiliated withWomens College Research Institute, Women’s College Hospital, University of Toronto Email author 
    • , Hereditary Breast Cancer Clinical Study GroupAffiliated withWomens College Research Institute

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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.


BRCA1 BRCA2 Smoking