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Impact of smoking history on the outcomes of women with early-stage breast cancer: a secondary analysis of a randomized study

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Abstract

To assess the impact of smoking history on the outcomes of early-stage breast cancer patients treated with sequential anthracyclines–taxanes in a randomized study. This is a secondary analysis of patient-level data of 1242 breast cancer patients referred for adjuvant chemotherapy in the BCIRG005 clinical trial. Overall survival was assessed according to smoking history through Kaplan–Meier analysis. Univariate and multivariate Cox regression analyses of factors affecting overall and relapse-free survival were subsequently conducted. Factors that were evaluated included: age, performance status, number of chemotherapy cycles, T stage, lymph node ratio, estrogen receptor status, adjuvant radiotherapy and smoking history. Kaplan–Meier analysis of overall survival according to smoking status (ever smoker vs. never smoker) was conducted. There was a trend toward a better overall survival among never smokers compared to ever smokers; however, it was not statistically significant (P = 0.098). The following factors were associated with better overall survival in multivariate analysis: older age (P = 0.011), complete chemotherapy course (P = 0.002), lower T stage (P < 0.0001), lower lymph node ratio (P < 0.0001) and positive estrogen receptor status (P = 0.006). Otherwise, the following factors were associated with better relapse-free survival in multivariate analysis: older age (P = 0.001), never smoking status (P = 0.021), lower T stage (P = 0.028), lower lymph node ratio (P < 0.0001) and positive estrogen receptor status (P < 0.0001). Early-stage breast cancer patients with a positive smoking history experienced worse relapse-free survival compared to never smokers. Physicians managing breast cancer patients should prioritize discussion about the benefits of smoking cessation when counseling their patients.

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Acknowledgements

This publication is based on research using information obtained from www.projectdatasphere.org, which is maintained by Project Data Sphere, LLC. Neither Project Data Sphere, LLC nor the owner(s) of any information from the web site have contributed to, approved or are in any way responsible for the contents of this publication.

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Authors and Affiliations

  1. Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Omar Abdel-Rahman

  2. Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, AB, Canada

    Omar Abdel-Rahman & Winson Y. Cheung

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  1. Omar Abdel-Rahman
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  2. Winson Y. Cheung
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Correspondence to Winson Y. Cheung.

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This article does not contain any studies with human participants or animals performed by the authors.

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As this study is based on a publicly available dataset without identifying patient information, informed consent was not needed.

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Abdel-Rahman, O., Cheung, W.Y. Impact of smoking history on the outcomes of women with early-stage breast cancer: a secondary analysis of a randomized study. Med Oncol 35, 68 (2018). https://doi.org/10.1007/s12032-018-1129-0

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