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00925njm 22002777a 4500 dc Peñalver-Argüeso, Belén author García-Esquinas, Esther author Castelló Pastor, Adela author Fernandez de Larrea-Baz, Nerea author Castaño-Vinyals, Gemma author Amiano, Pilar author Fernández-Villa, Tania author Guevara, Marcela author Fernández-Tardón, Guillermo author Alguacil, Juan author Obón-Santacana, Mireia author Gómez-Acebo, Inés author Pinto-Carbó, Marina author Marcos-Gragera, Rafael author Aragones, Nuria author Aizpurua, Amaia author Martín-Sánchez, Vicente author Ardanaz, Eva author Dierssen-Sotos, Trinidad author Jimenez-Moleon, Jose J. author Kogevinas, Manolis author Pollan-Santamaria, Marina author Perez-Gomez, Beatriz author 2023-11 Introduction: The role of cigarette smoking on breast cancer risk remains controversial, due to its dual carcinogenic-antiestrogenic action. Methods: In the population-based multi-case-control study (MCC-Spain), we collected epidemiological and clinical information for 1733 breast cancer cases and 1903 controls, including smoking exposure. The association with breast cancer, overall, by pathological subtype and menopausal status, was assessed using logistic and multinomial regression models. Results: Smokers had higher risk of premenopausal breast cancer, particularly if they had smoked ≥30 years (AOR=1.75; 95% CI: 1.04-2.94), although most estimates did not achieve statistical significance. In contrast, among postmenopausal women, smoking was associated with lower risk of breast cancer, mainly in overweight and obese women. The strongest risk reductions were observed among postmenopausal women who had stopped smoking ≥10 years before cancer diagnosis, particularly for HER2+ tumors (AOR=0.28; 95% CI: 0.11-0.68); p for heterogeneity = 0.040). Also, those who had smoked <10 pack-years (AOR=0.68; 95% CI: 0.47-0.98) or 10-25 pack-years (AOR=0.62; 95% CI: 0.42-0.92) during their lifetime were at a reduced risk of all breast cancer subtypes (p for heterogeneity: 0.405 and 0.475, respectively); however, women who had smoked more than 25 pack-years showed no reduced risk. Conclusions: Menopausal status plays a key role in the relationship between tobacco and breast cancer for all cancer subtypes. While smoking seems to increase the risk in premenopausal woman, it might be associated to lower risk of breast cancer among postmenopausal women with excess weight. Tob Induc Dis. 2023 Nov 30:21:157. 10.18332/tid/174132 1617-9625 Tobacco induced diseases 38034128 http://hdl.handle.net/20.500.12105/16751 HER2 Breast cancer Hormone receptor Obesity Smoking Smoking history and breast cancer risk by pathological subtype: MCC-Spain study