Good Reasons to Quit Smoking: A Breast Patient's Perspective

None

If you’re a smoker and have breast cancer or if you are interested in decreasing your breast cancer risk, there are many reasons that quitting smoking can help you.

1. Breast cancer risk is higher in those who smoke.
Many studies have proven a strong link between smoking and increased risk of lung, esophageal, upper airway/ mouth and pancreatic cancers. Not all research shows as strong a connection between smoking and breast cancer, but a recent study did find that former and current smokers had a 21% higher occurrence of breast cancer compared to women who never smoked.

2. Women with a BRCA2 gene mutation and who have smoked longer than 4 years have an increased breast cancer risk.
BRCA2 gene mutations greatly increase a woman’s lifetime risk of breast cancer. One study documented a higher risk of breast cancer in women with BRCA2 mutations and who had a history of smoking longer than 4 years as compared to women with BRCA2 mutations who never smoked.

3. Breast cancer patients who are active smokers when diagnosed and who continue to smoke have lower survival rates.
A recent study found that women who smoked within the year before their breast cancer diagnosis had a higher risk of death from breast cancer than nonsmokers. These same women also had a higher risk of death from breast cancer if they continued to smoke after they were diagnosed with breast cancer than women who did not smoke.

4. Nonsmokers have fewer complications from anesthesia during surgery.
Smoking adversely affects airways and lung tissue. It destroys cilia (tiny hairs that line the airway and help clear secretions such as fluid or phlegm) and can break down the lung’s alveoli (small air sacs in the lung tissue where the exchange of oxygen and carbon dioxide take place). This makes it more difficult for a person to get oxygen.

Smoking also increases the likelihood of developing heart disease, where the arteries feeding the heart narrow or become completely blocked. This can lead to a heart attack.
Heart and/or lung disease caused from smoking can make it more difficult to recover from a general anesthetic. Those who smoke also have higher rates of  pneumonia after surgery as compared to those who do not smoke.

5. Smoking can negatively affect healing after surgery.
Nicotine in cigarettes makes small blood vessels constrict (clamp down), so that it is harder for the body to bring oxygen to tissues. Smoking also keeps the immune system from working well. This causes smokers to have higher rates of wound complications after surgery. This includes wound infections and tissue death (tissue necrosis).

6. Smoking can cause serious complications for breast reconstruction.
Smoking is also well known to cause major issues with wound healing after plastic surgery and breast reconstruction. Current smokers are more likely to have mastectomy flap loss, wound separation, and skin/tissue loss (necrosis) than nonsmokers. For women who have tissue expanders placed, smokers are more likely to need their tissue expanders removed due to complications (such as infection) when compared to those who do not smoke. Those who smoke while on chemotherapy for their breast cancer also are more likely to need the tissue expanders removed than those who are on chemotherapy for their breast cancer but do not smoke.

7. Quitting smoking 3-4 weeks before surgery can decrease the risk of surgical complications from smoking.
If you can quit smoking 3-4 weeks before your surgery date, many of the complications due to wound healing can be avoided.

8. Quitting smoking can be difficult, but you CAN do it!
There are many ways to assist someone who decides to quit smoking. There are medications, nicotine replacement options, and counseling that help. Talk to your health care providers to find out which options are best for you.

Additional information about smoking cessation is available at:

Centers for Disease Control: How to Quit
https://www.cdc.gov/tobacco/quit_smoking/how_to_quit/index.htm

American College of Surgeons: Quit Smoking Before Your Surgery
https://www.facs.org/education/patient-education/patient-resources/prepare/quit-smoking
Telephone Counseling: 1-800-QUIT-NOW (784-8669)

REFERENCES
Ordóñez-Mena et al. Quantification of the smoking-associated cancer risk with rate advancement periods: meta-analysis of individual participant data from cohorts of the CHANCES consortium. BMC Medicine (2016) 14:62.

Macacu, A et al. Active and passive smoking and risk of breast cancer: a meta-analysis. Breast Cancer Res Treat (2015) 154:213–224.

Gram, IT et al. The fraction of breast cancer attributable to smoking: The Norwegian women and cancer study 1991–2012. British Journal of Cancer (2016), Jun 9.

Friebel, TM et al. Modifiers of Cancer Risk in BRCA1 and BRCA2 Mutation Carriers: A Systematic Review and Meta-Analysis. J Natl Cancer Inst (2014) 106(6): dju091.

Bérubé, S et al. Smoking at time of diagnosis and breast cancer-specific survival: new findings and systematic review with meta-analysis. Breast Cancer Research 2014, 16:R42

Passarelli, MN et al. Cigarette Smoking Before and After Breast Cancer Diagnosis:Mortality From Breast Cancer and Smoking-Related Diseases. J Clin Oncol 34:1315-1322.

Padubidri, A et al. Complications of Postmastectomy Breast Reconstructions in Smokers, Ex-Smokers, and Nonsmokers. Plast Reconstr Surg. 2001. Feb;107(2):350-351. 

Dolen, UC et al. Impact of Neoadjuvant and Adjuvant Chemotherapy on Immediate Tissue Expander Breast Reconstruction. Ann Surg Oncol (2016) 23:2357–2366.

Sorensen LT. Wound healing and infection in surgery: the pathophysiological impact of smoking, smoking cessation, and nicotine replacement therapy: a systematic review. Ann Surg. 2012 Jun;255(6):1069-79.