Smoking and the Breast Cancer Link

Dr. Susan Love looks at the smoking/breast cancer link

I must confess: I was a smoker. I smoked for a decade, from age 20 to 30, and I really liked it. Quitting cold turkey—before the days of nicotine substitutes—was one of the hardest things I have ever done.

I didn't quit because smoking causes lung cancer, which, after all, can often kill you...I quit because as a surgeon I never amputated the leg of a nonsmoker—only those of smokers with vascular disease. I quit because I was scared that I'd get cancer of the mouth, voice box or throat. These cancers may not always kill you, but they often require having to cut out most of your face to remove them. I quit because I thought being 30 years old meant I was finally a grown-up, and I did not think that grown-ups should smoke.

My younger sister died tragically when she was just 26. At her wake I wanted a cigarette so badly I almost gave in. My dad, an ex-smoker, warned, "Don't do it. If you do, you will never get off cigarettes again." And so I resisted. Now, at age 60, I am happy that my last 30 years have been smoke-free. Since my days as a smoker, we have discovered even more cancers that cigarettes cause, or increase the risk of getting, including cancer of the cervix, esophagus, kidney, bladder, pancreas and stomach. Smoking even has been linked to cancer of the breast. What is particularly interesting about this data is that someone who was exposed to passive (or secondhand) smoke seems to be at as high or higher a risk of getting breast cancer as someone who smokes.

There are many theories to explain this finding, including the fact that cigarette smoke contains potent anti-estrogens that tend to decrease breast cancer as well as carcinogens that can cause breast cancer. It may be that these things more or less cancel each other out in women who actively smoke. Passive smokers, on the other hand, are exposed to the cancer-causing carcinogens but don't get the positive anti-estrogen effect of smoking directly. Regardless of the explanation, it is clear that both firsthand and secondhand smoke are deadly. As hard as it is to quit, there is no doubt that quitting is the single most important thing you can do for your health.

Check out Dr. Susan Love's blog for the latest on breast cancer.

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