Cigarette smoking and other risk factors in relation to p53 expression in breast cancer among young women

p53 mutations may be a fingerprint for cigarette smoking and other environm ental carcinogens, including breast carcinogens. This study was undertaken to explore whether p53 mutations are associated with environmental or other suspected or established risk factors for breast cancer. p53 protein detec tion by immunohistochemistry (which is more easily quantified in large epid emiological studies than are mutations, and are highly correlated with them ) was determined for 378 patients from a case-control study of breast cance r. In this population-based sample of women under the age of 45 Sears, 44.4 % (168/378) of the cases had p53 protein detected by immunohistochemistry ( p53+), Polytomous logistic regression was used to calculate the odds ratios (ORs) for p53+ and p53- breast cancer, as compared with the controls, in r elation to cigarette smoking and other factors. The ratio of the ORs was us ed as an indicator of heterogeneity in risk for p53+ versus p53- cancer. Th e ratio of the ORs in a multivariate model was substantially elevated among women with a greater than high school education [2.39; 95% confidence inte rval (CI), 1.43-4.00], current cigarette smokers (1.96; 95% CI, 1.10-3.52), and users of electric blankets, water beds, or mattresses (1.78; 95% CI, 1 .11-2.86). Nonsignificant heterogeneity was noted for family history of bre ast cancer and ethnicity but not for other known or suspected risk factors, Coupled with the strong biological plausibility of the association, our da ta support the hypothesis that in breast cancer, as with other tumors, p53 protein immunohistochemical detection may be associated with exposure to en vironmental carcinogens such as cigarette smoking.