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    Does smoking decrease breast cancer treatment effectiveness?

    A new population-based cohort from Sweden indicates that aromatase inhibitors may not work as well among women who smoke as those who did not smoke.

    Researchers looked at a cohort of 1065 breast cancer patients without preoperative treatment from 2002 to 2012 in Lund, Sweden. Smoking status was assessed in connection with patient and tumor characteristics and prognosis in different treatment groups. At the preoperative visit, 21.0% of the cohort were smokers and median follow-up was 5.1 years.

    The researchers included 1016 patients in their survival analyses. Overall no significant link between smoking and the risk of breast cancer events was seen (adjusted hazard ratio [aHR]: 1.45; 95% confidence interval [CI]: 0.95–2.20). Among the 309 aromatase inhibitor-treated patients who were aged >50 years with estrogen receptor-positive tumors, smoking was tied to the risk of breast cancer events (aHR: 2.97; 95% CI: 1.44–6.13), distant metastasis (aHR: 4.19; 95% CI: 1.81–9.72), and death (aHR: 3.52; 95% CI: 1.59–7.81).

    The investigators concluded that preoperative smoking was tied to greater risk for breast cancer events and distant metastasis among women who were treated with aromatase inhibitors. They urge further study and if the connection is confirmed, they believe that smoking status should be considered when selecting an endocrine therapy.

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    Judith M. Orvos, ELS
    Judith M. Orvos, ELS, is a a BELS-certified medical writer and editor and an editorial consultant for Contemporary OB/GYN.
    Miranda Hester
    Ms. Hester is Content Specialist with Contemporary OB/GYN and Contemporary Pediatrics.

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