The impact of smoking on adjuvant breast cancer radiation treatment: A systematic review

•There is a well-documented association between exposure to cigarette smoking and overall poorer health, including a higher risk for cancer.•There are many patients who have previously smoked or continue to smoke throughout their breast cancer radiation treatment.•There has been some speculation of the negative influence of smoking exposure on the efficacy of radiotherapy.•This review aims to observe the relationship between smoking and post-radiotherapy effects, in order to better educate patients enrolled in smoking cessation programs.•We observed differences in skin reactions, pulmonary changes, cardiovascular risk, secondary carcinomas, reconstruction outcomes and mortality.