Polycyclic aromatic hydrocarbons (PAH) are mammary carcinogens in animal studies, and a few epidemiologic studies have suggested a link between elevated levels of PAH–DNA adducts and breast cancer incidence. An association between PAH–DNA adducts and survival among breast cancer cases has not been previously reported. We conducted a survival analysis among women with newly diagnosed invasive breast cancer between 1996 and 1997, enrolled in the Long Island Breast Cancer Study Project. DNA was isolated from blood samples that were obtained from cases shortly after diagnosis and assayed for PAH–DNA adducts using ELISA. Among the 722 cases with PAH–DNA adduct measurements, 97 deaths (13.4%) from all causes and 54 deaths (7.5%) due to breast cancer were reported to the National Death Index (NDI) by December 31, 2002. Using Cox proportional hazards models and controlling for age at diagnosis, we did not find evidence that all-cause mortality (hazard ratio (HR)=0.88; 95% confidence interval (CI): 0.57–1.37), or breast cancer mortality (HR=1.20; 95% CI: 0.63–2.28) was strongly associated with detectable PAH–DNA adduct levels compared with non-detectable adducts; additionally, no dose–response association was observed. Among a subgroup with treatment data (n=520), adducts were associated with over a two-fold higher mortality among those receiving radiation, but mortality for adducts was reduced among hormone therapy users. Results from this large population-based study do not provide strong support for an association between detectable PAH–DNA adducts and survival among women with breast cancer, except perhaps among those receiving radiation treatment.

PURPOSE: The association between active and passive cigarette smoking before breast cancer diagnosis and survival was investigated among a cohort of invasive breast cancer cases (n = 1273) participating in a population-based case-control study.METHODS: Participants diagnosed with a first primary breast cancer between August 1, 1996, and July 31, 1997, were followed-up until December 31, 2002, for all-cause mortality (n = 188 deaths), including breast cancer-specific mortality (n = 111), as reported to the National Death Index.RESULTS: In Cox models, the adjusted hazards ratios (HRs) for all-cause mortality were slightly higher among current and former active smokers, compared with never smokers (HR, 1.23; 95% confidence interval [95% CI], 0.83-1.84) and 1.19 (95% CI, 0.85-1.66), respectively). No association was found between active or passive smoking and breast cancer-specific mortality. All-cause and breast cancer-specific mortality was higher among active smokers who were postmenopausal (HR, 1.64; 95% CI, 1.03-2.60 and HR, 1.45; 95% CI, 0.78-2.70, respectively) or obese at diagnosis (HR, 2.10; 95% CI, 1.03-4.27 and HR, 1.97; 95% CI, 0.89-4.36, respectively). Associations between smoking and all-cause and breast cancer-specific mortality did not differ by cancer treatment.CONCLUSIONS: These data do not provide strong evidence for an association between smoking and all, cause or breast cancer-specific mortality, although smokers who are postmenopausal or obese at diagnosis may be at higher risk. Ann Epidemiol 2007;17:385-393. (C) 2007 Elsevier Inc. All rights reserved.

OBJECTIVE:To determine whether fruit, vegetable, and micronutrient intake 1 year prior to breast cancer diagnosis is associated with a reduction in the subsequent risk of all-cause or breast cancer-specific mortality.METHODS:Follow-up data from 1,235 invasive breast cancer cases age 25-98 years from the Long Island Breast Cancer Study Project were analyzed. At the 1996-1997 case-control interview, respondents completed a food frequency questionnaire, which assessed dietary intake of fruits, vegetables, and vitamin supplement use in the previous 12 months. All-cause mortality (n=186 deaths) and breast cancer-specific mortality status (n=125 deaths, 67.2%) were determined through December 31, 2002.RESULTS:Hazard ratios (HRs) for all-cause mortality were insignificantly reduced for intake of any fruits, fruit juices, and vegetables (HR=0.68, 95% CI: 0.42-1.09) and leafy vegetables (HR=0.72, 95% CI: 0.41-1.24) among post-menopausal women only. Both of these associations were more pronounced among those with ER+PR+ tumors (HR=0.54, 95% CI: 0.27-1.10, and HR=0.66, 95% CI: 0.33-1.31, respectively). Similar associations were observed for breast cancer-specific mortality.CONCLUSIONS:In a cohort of women diagnosed with breast cancer, higher intake of fruits, vegetables, and micronutrients was associated with a non-significant survival advantage in post-menopausal women only.