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Alcohol consumption, cigarette smoking, and risk of breast cancer for BRCA1 and BRCA2 mutation carriers: results from The BRCA1 and BRCA2 Cohort Consortium: Alcohol and smoking and breast cancer risk for BRCA carriers

Mary Beth Terry 1 Catherine Noguès 2 Daniel Barrowdale 3 Debra Frost 3 Carole Brewer 4 D. Gareth Evans 5 Louise Izatt 6 Lucy Side 7 Lisa Walker 8 Marc Tischkowitz 9 Mark Rogers 10 Mary Porteous 11 Hanne E.J. Meijers-Heijboer 12 Johan Jp Gille 12 Marinus Blok 13 Nicoline Hoogerbrugge 14 Mary Daly 15 Irene Andrulis 16 Saundra Buys 17 Esther John 18 Sue-Anne Mclachlan 19 Michael Friedlander 20 Yen Tan 21 Ana Osorio 22 Trinidad Caldés 23 Anna Jakubowska 24 Jacques Simard 25 Christian Singer 26 Edith Olah 27 Marie Navratilova 28 Lenka Foretova 28 Anne-Marie Gerdes 29 Marie-José Roos-Blom 30 Brita Arver 31 Håkan Olsson 32 Rita Schmutzler 33 John Hopper 34 Roger Milne 35 Douglas Easton 36 Flora van Leeuwen 37 Matti Rookus 38 Nadine Andrieu 39 David Goldgar 40, 41
Abstract : BACKGROUND: Tobacco smoking and alcohol consumption have been intensively studied in the general population to assess their effects on the risk of breast cancer (BC), but very few studies have examined these effects in BRCA1 and BRCA2 mutation carriers. Given the high BC risk for mutation carriers and the importance of BRCA1 and BRCA2 in DNA repair, better evidence on the associations of these lifestyle factors with BC risk is essential. METHODS: Using a large international pooled cohort of BRCA1 and BRCA2 mutation carriers, we conducted retrospective (5,707 BRCA1 mutation carriers; 3,525 BRCA2 mutation carriers) and prospective (2,276 BRCA1 mutation carriers; 1,610 BRCA2 mutation carriers) analyses of alcohol and tobacco consumption using Cox proportional hazards models. RESULTS: For both BRCA1 and BRCA2 mutation carriers, none of the smoking-related variables was associated with BC risk, except smoking for more than five years before a first full-term pregnancy (FFTP) when compared to parous women who never smoked. For BRCA1 mutation carriers, the HR from retrospective analysis (HRR) was 1.19 (95%CI:1.02,1.39) and the HR from prospective analysis (HRP) was 1.36 (95%CI:0.99,1.87). For BRCA2 mutation carriers, smoking for more than five years before a FFTP showed an association of a similar magnitude, but the confidence limits were wider (HRR=1.25,95%CI:1.01,1.55 and HRP=1.30,95%CI:0.83,2.01). For both carrier groups, alcohol consumption was not associated with BC risk. CONCLUSIONS: The finding that smoking during the pre-reproductive years increases BC risk for mutation carriers warrants further investigation. IMPACT: This is the largest prospective study of BRCA mutation carriers to assess these important risk factors.
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Mary Beth Terry, Catherine Noguès, Daniel Barrowdale, Debra Frost, Carole Brewer, et al.. Alcohol consumption, cigarette smoking, and risk of breast cancer for BRCA1 and BRCA2 mutation carriers: results from The BRCA1 and BRCA2 Cohort Consortium: Alcohol and smoking and breast cancer risk for BRCA carriers. Cancer Epidemiology, Biomarkers and Prevention, American Association for Cancer Research, 2019, 27, cebp.0546.2019. ⟨10.1158/1055-9965.EPI-19-0546⟩. ⟨inserm-02438388⟩

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