Journal of the National Cancer Institute · 2026
Association between smoking habits and breast density, changes in breast density, and breast cancer in Asian women.
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Park Boyoung, Yoon Junghyun, Jeon Somin, Nguyen Thi Huyen Trang, Jang Yoonyoung
Аннотация
BACKGROUND: To examine the associations among the smoking status, breast density, changes in breast density, and subsequent breast cancer (BC) risk.
METHODS: We conducted a nationwide population-based cohort study of 4.7 million cancer-free women aged ≥40 years who participated in the Korean National Breast Cancer Screening Program from 2009 to 2010. Of them, 4.2 million cancer-free women with the subsequent screening during 2011-2016 were included for changes in breast density. Breast density was assessed using BI-RADS categories, and changes were evaluated among women with repeated screenings from 2011 to 2016. Breast cancer incidence was ascertained using medical records from the NHIS-NHID until December 31, 2023.
RESULTS: Former and current smokers had lower odds of dense breasts compared with never smokers (Odds ratio (OR)=0.94, 95% confidence interval (CI): 0.92-0.95; OR = 0.88, 95% CI: 0.87-0.89). Longer smoking durations, greater daily cigarette use, and greater pack-years were associated with progressively lower odds of having dense breasts. Smokers showed a reduced likelihood of increased density (OR = 0.95, 95% CI: 0.94-0.96) and higher likelihood of decreased density (OR = 1.07, 95% CI: 1.06-1.09), particularly among premenopausal women. Smoking was linked to a higher BC risk, especially among postmenopausal women; adjustments for density and density changes did not alter these associations.
CONCLUSION: Smoking was associated with a lower baseline breast density and greater density decline yet increased BC risk in a dose-dependent manner. These findings suggest that the carcinogenic effects of smoking on BC are independent of the breast density or its changes measured using four broad categories.
METHODS: We conducted a nationwide population-based cohort study of 4.7 million cancer-free women aged ≥40 years who participated in the Korean National Breast Cancer Screening Program from 2009 to 2010. Of them, 4.2 million cancer-free women with the subsequent screening during 2011-2016 were included for changes in breast density. Breast density was assessed using BI-RADS categories, and changes were evaluated among women with repeated screenings from 2011 to 2016. Breast cancer incidence was ascertained using medical records from the NHIS-NHID until December 31, 2023.
RESULTS: Former and current smokers had lower odds of dense breasts compared with never smokers (Odds ratio (OR)=0.94, 95% confidence interval (CI): 0.92-0.95; OR = 0.88, 95% CI: 0.87-0.89). Longer smoking durations, greater daily cigarette use, and greater pack-years were associated with progressively lower odds of having dense breasts. Smokers showed a reduced likelihood of increased density (OR = 0.95, 95% CI: 0.94-0.96) and higher likelihood of decreased density (OR = 1.07, 95% CI: 1.06-1.09), particularly among premenopausal women. Smoking was linked to a higher BC risk, especially among postmenopausal women; adjustments for density and density changes did not alter these associations.
CONCLUSION: Smoking was associated with a lower baseline breast density and greater density decline yet increased BC risk in a dose-dependent manner. These findings suggest that the carcinogenic effects of smoking on BC are independent of the breast density or its changes measured using four broad categories.