Cancer Causes & Control

, Volume 22, Issue 5, pp 775–783 | Cite as

Smoking and alcohol consumption in relation to risk of triple-negative breast cancer in a cohort of postmenopausal women

  • Geoffrey C. KabatEmail author
  • Mimi Kim
  • Amanda I. Phipps
  • Christopher I. Li
  • Catherine R. Messina
  • Jean Wactawski-Wende
  • Lewis Kuller
  • Michael S. Simon
  • Shagufta Yasmeen
  • Sylvia Wassertheil-Smoller
  • Thomas E. Rohan
Original paper



Little is known about the risk factors for triple-negative breast cancer (TNBC), which has a worse prognosis compared to hormone receptor-positive breast cancer. We examined the association of smoking and alcohol intake with TNBC and estrogen receptor-positive (ER+) breast cancer.


Among 148,030 women enrolled in the Women’s Health Initiative, 300 TNBC cases and 2,479 ER+ cases were identified over a median of 8.0 years of follow-up. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI).


Cigarette smoking was not associated with TNBC, whereas drinkers had reduced risk compared to never drinkers. In contrast, both exposures showed slight positive associations with ER+ breast cancer: for women with ≥40 pack-years of smoking, the HR was 1.24, 95% CI 1.06–1.44; for women consuming ≥7 servings of alcohol per week, the HR was 1.26, 95% CI 1.06–1.50. Intakes of wine and hard liquor were also significantly positively associated with ER+ breast cancer.


These findings from a large cohort of postmenopausal women suggest that smoking and alcohol consumption are not associated with increased risk of TNBC, but may be modestly associated with increased risk of ER+ breast cancer.


Breast neoplasms Triple-negative Estrogen receptor-positive Cigarette smoking Alcohol consumption Postmenopausal women 


Conflicts of interest



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Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Geoffrey C. Kabat
    • 1
    Email author
  • Mimi Kim
    • 1
  • Amanda I. Phipps
    • 2
  • Christopher I. Li
    • 2
  • Catherine R. Messina
    • 3
  • Jean Wactawski-Wende
    • 4
  • Lewis Kuller
    • 5
  • Michael S. Simon
    • 6
  • Shagufta Yasmeen
    • 7
  • Sylvia Wassertheil-Smoller
    • 1
  • Thomas E. Rohan
    • 1
  1. 1.Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxUSA
  2. 2.Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleUSA
  3. 3.Department of Preventive MedicineStony Brook UniversityStony BrookUSA
  4. 4.Department of Social and Preventive Medicine, School of Public Health and Health ProfessionsUniversity of BuffaloBuffaloUSA
  5. 5.Department of Epidemiology, Graduate School of Public HealthUniversity of PittsburghPittsburghUSA
  6. 6.Department of Oncology, Karmanos Cancer InstituteWayne State UniversityDetroitUSA
  7. 7.Department of Obstetrics and GynecologyUniversity of California at DavisSacramentoUSA

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