Best Birth Control For Family History Of Breast Cancer

What Are Oral Contraceptives

Oral contraceptives are hormone-containing medications that are taken by mouth to prevent pregnancy. They prevent pregnancy by inhibiting ovulation and also by preventing sperm from penetrating through the cervix.

By far the most commonly prescribed type of oral contraceptive in the United States contains synthetic versions of the natural female hormones estrogen and progesterone. This type of birth control pill is often called a combined oral contraceptive. Another type of oral contraceptive, sometimes called the mini pill, contains only progestin, which is a man-made version of progesterone.

The Pill Might Cause A Small Increase In Breast Cancer Its Unclear If Hormonal Iuds Do The Same

The link between birth control pills and breast cancer has been controversial, says Dr. Goldfrank. Studies looking at this have gone back and forth.

Birth control pills might increase the risk of breast cancer a small amount, especially for women who currently use or who recently used birth control pills. Any elevated risk seems to decrease over time after stopping use.

Even less is known about the link between hormonal IUDs and breast cancer, says Dr. Goldfrank. Its not clear yet, she says.

How Could Oral Contraceptives Influence Cancer Risk

Naturally occurring estrogen and progesterone stimulate the development and growth of some cancers . Because birth control pills contain synthetic versions of these female hormones, they could potentially also increase cancer risk.

In addition, oral contraceptives might increase the risk of cervical cancer by changing the susceptibility of cervical cells to persistent infection with high-risk HPV types .

Researchers have proposed multiple ways that oral contraceptives may lower the risks of some cancers, including

• suppressing endometrial cell proliferation
• reducing the number of ovulations a woman experiences in her lifetime, thereby reducing exposure to naturally occurring female hormones
• lowering the levels of bile acids in the blood for women taking oral conjugated estrogens

Selected References

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Family Health History And Cancer

Genetic testing may have a ripple effect to other family members for multiple generations, oncologist Dr. Alter explains in this video about collecting cancer patients family health history. You can actually save a life.

Learn your familys health history and share it with your doctor.

Your family health history is a record of diseases and conditions that run in your family. Your family members may share genes, habits, and environments that can affect your risk of getting cancer.

Does Taking Birth Control Pills Increase My Risk Of Developing Breast Cancer

Maybe. Studies that have examined the use of oral contraceptives as a risk factor for breast cancer have produced conflicting results. Some researchers think this might be due to the fact that the level of hormones in birth control pills has changed since they were first studied. Early birth control pills contained much higher levels of hormones than today’s low-dose pills and posed a higher risk.

Scandinavian researchers have noted an increase in breast cancer in a group of women that were currently taking or had recently taken birth control pills. Longer use of the pill seemed to increase the risk. Similar research found that 10 years or more after women stopped using birth control pills, their breastcancer risk returned to the same level as if they had never used birth control pills.

However, another reputable study by Women’s Contraceptive and Reproductive Experience done between 1994 and 1998 showed there was no increased risk of breastcancer in current or former users of birth control pills.

In general, most studies have not found an overall increased risk of breast cancer due to the use of oral contraceptives.

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Comparing The Risks And Benefits Of Hormonal Birth Control

Obviously, the most important benefit of hormonal birth control is avoiding unplanned pregnancy. Another related benefit is avoiding potential pregnancy-related complications that can seriously affect a womans health. Some of these include gestational diabetes, preeclampsia , and complications during delivery.

The current U.S. maternal death rate, or the number of women who die during or shortly after childbirth, is 14 per 100,000 live births. In Texas, the 2014 maternal death rate was nearly 36 per 100,000 live births. Maternal death rate increases with age and with obesity. Both of these statistics are higher than the Danish studys finding of 13 cases of breast cancer out of 100,000 women on hormonal birth control.

• Hormonal birth control has many other benefits, including reductions in:
• Abnormal uterine bleeding

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If a patient cant tolerate hormonal birth control or would prefer not to use it, she may choose a nonhormonal IUD, ParaGard, thats highly effective without progestin. Other nonhormonal options are available, though these might be less appropriate or effective based on a womans needs:

Request an appointment for more information about choosing an effective and safe method of birth control.

What Should You Do If Youre At Risk

If you fall into any of the patterns or groups above, then you should have a chat with your GP to discuss whether a referral to a breast or genetic clinic is worthwhile. This is especially important if you are over 35 years of age.

You should not request the combined pill from us until youre happy about your own risk of breast cancer.

If you are currently taking the pill but are in one of the at-risk groups please dont just stop the combined pill. Talk to your GP first, as it may be fine for you to continue..

References

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How Do I Collect Family Health History Information

Take time to ask about your family history of cancer at family gatherings. Respectfully ask your relatives to help fill in the gaps and confirm what you remember. Also, look through any family records, death certificates, or obituaries.

You can enter your family health history into My Family Health Portrait, update it over time, and print it out to share with your doctor and relatives.

Research Table: Birth Control Pills And Breast Cancer Risk

Introduction: Women who currently use birth control pills have a slightly increased risk of breast cancer.

A pooled analysis of over 50 studies found a small increase in breast cancer risk among women who were currently taking the pill or had recently used it for 10 or more years . However, this risk disappeared 10 years after women stopped taking the pill .

Although most studies have looked at older, higher dose forms of the pill, todays lower-dose pills also appear to increase breast cancer risk .

Study selection criteria: Prospective cohort studies with at least 500 breast cancer cases, pooled analyses and meta-analyses.

Table note: Relative risk above 1 indicates increased risk. Relative risk below 1 indicates decreased risk.

* Past use was defined as one year to less than 5 years. Results also showed no increase in risk when past use was defined as less than one year, 5-10 years and more than 10 years.

Past use was defined as 5-15 years ago.

All women had a family history of breast cancer.

§ All women were premenopausal.

|| Follow-up time was estimated from start and end dates of the study.

¶ Past use was defined as more than 4 years ago.

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Questions To Ask Your Health Care Team About The Pill And Your Personal Cancer Risk

All medications, including oral contraceptives, can carry risks, so its important to talk with your health care team about the best birth control option for you. Together, you can take into account factors like your lifestyle, overall health, cancer history, budget, age, and short- and long-term goals in preventing pregnancy or starting a family.

Although birth control pills are an important treatment option for many premenopausal women, for some, the risks may outweigh the benefits. Discuss your personal and family medical history with your doctor to determine if birth control pills are an appropriate option for you. Norah Lynn Henry, MD, PhD, FASCO, professor and Interim Chief of the University of Michigan’s Division of Hematology/Oncology in the Department of Internal Medicine and the 2022 Cancer.Net Associate Editor for Breast Cancer

Here are some questions you can ask your health care provider to start the conversation around birth control pills and your personal cancer risk:

How Does Taking Birth Control Affect My Risk For Cancer

Overall, research has shown that taking the pill can decrease your risk for ovarian and uterine cancers, but the effect on breast cancer risk is not clear. However, how much birth control influences your cancer risk is still being studied.

How the birth control pill impacts your risk of ovarian cancer

Nearly 20,000 people will be diagnosed with ovarian cancer in the United States this year. Taking the pill has been found to reduce the risk of ovarian cancer by 30% to 50%, according to several studies. Additionally, studies on lower-dose pill formulations, like a 2000 study in the American Journal of Epidemiology, found that taking the pill reduced the risk of ovarian cancer by 40% compared to people who had never taken the pill. Birth control pills can also help protect people with a family history of ovarian cancer and those who have genetic mutations linked to hereditary ovarian cancer, such as BRCA1 and BRCA2.

How the birth control pill impacts your risk of uterine cancer

About 66,000 people will be diagnosed with uterine cancer this year. Taking the pill has been found to reduce the risk for uterine cancer, and those protections are strengthened the longer the pill is taken. A 2018 study in JAMA Oncology reported that taking the pill reduced the risk for uterine cancer by 34%. People who smoked, were overweight, and who rarely exercised were found to have even more benefit from taking the pill.

How the birth control pill impacts your risk of breast cancer

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Can Birth Control Cause Breast Cancer

According to one 2017 study, hormonal contraception can slightly increase a persons risk of breast cancer.

The study involved 1.8 million females in Denmark who were aged 1549. The females had not had cancer or received fertility treatment.

The researchers revealed that participants using hormonal contraception had a slightly higher risk of developing breast cancer than those who were not. This meant that around 1 participant in every 7,690 developed breast cancer.

However, the researchers noted that other factors, including age, may affect a persons risk of developing breast cancer.

Participants younger than 35 years had a lower risk of developing breast cancer. Among the females who had been using hormonal contraception for a year, only 1 participant in every 50,000 developed breast cancer.

Once a person stops taking hormonal contraception, their risk of breast cancer seems to return to normal after around 5 years.

Overall, the risk of breast cancer was higher among females who currently use or recently used contemporary hormonal contraceptives than among those who had never used hormonal contraceptives.

This risk increased with longer durations of use, but absolute increases in risk were small.

Women With Family History Of Breast Cancer Have Added Risk With Pill Use

Women whose sisters or mothers have had breast cancer are at increased risk of developing the disease, and an examination of data from a multigenerational family study suggests that their risk is further elevated if they use oral contraceptives.1Overall, among sisters and daughters of women with breast cancer, those who had ever used the pill had 3.3 times the breast cancer risk of those who had never used this method the relative risk increased if breast or ovarian cancer occurred more than once among blood relatives. The elevated risk associated with pill use appeared only among women who had taken oral contraceptives during or before 1975 after that year, all oral contraceptives introduced to the market contained less than 50 mcg of estrogen.

The study, which took place between 1991 and 1996, followed up families of 462 women who had had breast cancer diagnosed between 1944 and 1952. Researchers conducted telephone interviews with 6,150 adult relatives of these women: 394 sisters and daughters , 3,002 nieces and granddaughters , and 2,754 women who had married into the families. Interviews covered participants’ cancer history and risk factors for breast cancer, including ever-use of oral contraceptives and the ages at which pill use began and ended.

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What Should You Do If You’re At Risk

If you fall into any of the patterns or groups above, then you should have a chat with your GP to discuss whether a referral to a breast or genetic clinic is worthwhile. This is especially important if you are over 35 years of age.

You should not request the combined pill from us until youre happy about your own risk of breast cancer.

If you are currently taking the pill but are in one of the at-risk groups please dont just stop the combined pill. Talk to your GP first, as it may be fine for you to continue..

References

Increased Risk: Breast Cancer

If you take or have taken birth control pills in the recent past, you are slightly more likely to develop breast cancer than women who’ve never used them. Researchers aren’t sure if the link is due to the estrogen or progesterone. Some research hints it might be caused by high-dose estrogen, but women in studies who took the progesterone-only shot Depo-Provera have also been found to have higher rates of breast cancer.

“It is just not really clear,” says Gaudet. “But interestingly, the increased risk goes away after you’ve been off the oral contraceptive for 10 or more years.”

Things that might lower your risk:

• Reducing the number of years you are taking birth control pills.
• Choosing a different form of contraception. For example, a non-hormonal intrauterine device is a reversible form of birth control that is not linked to breast cancer. Bonus: It might also lower your risk of cervical and endometrial cancer.

Read Also: How Can You Know If You Have Breast Cancer

Oral Contraceptives And Breast Cancer Risk

Researchers continue to unravel the web concerning the use of oral contraceptives and the risk of breast cancer. A study published in June 2002 indicated that birth control pills don’t increase the risk of breast cancer for women in the general population . But a new study published in the December 4, 2002, issue of the Journal of the National Cancer Institute shows oral contraceptives can increase the risk of breast cancer in women with a particular genetic mutation.

The study examined whether the use of oral contraceptives increased the risk of breast cancer in women with a mutation in the BRCA1 or BRCA2 gene. Women who have such a mutation are already known to have a high risk of developing breast cancer and ovarian cancer. A person inherits these types of gene mutations.

The study involved 1,311 pairs of women who have the BRCA1 mutation, BRCA2 mutation, or both. Each pair of women shared certain characteristics, including mutation type, age, country, and history of ovarian cancer. Each pair included one woman who had been diagnosed with breast cancer and one who had not. Participants completed a questionnaire regarding their use of oral contraceptives based on their memory.

A woman’s age and how long she plans to use the pill should also be considered use after the age of 30 and for fewer than five years was not associated with a significant increase in risk of breast cancer.

Weighing The Pros And Cons Of Birth Control Pill Use

Birth control pills have some risks including a small increased risk of breast cancer . However, in addition to preventing pregnancy, birth control pills decrease the risk of uterine and ovarian cancers .

Before making any decisions about birth control pills , talk with your health care provider about the benefits and risks.

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Birth Control And Breast Cancer: Whats The Real Risk

A December 2017 study has sparked conversation about the link between hormonal birth control and breast cancer risk. The study, which followed 1.8 million women in Denmark, found a slight increase in the overall risk of breast cancer among women who used oral birth control or intrauterine devices containing the hormone progestin.

Its important to put these findings in perspective. The benefits of using modern hormonal birth control far outweigh the small increase in breast cancer risk. In fact, pregnancy actually poses more health risks than progestin IUDs or birth-control pills.

Do Faulty Brca Genes Run In Families

Our genes are inherited from our parents. So if your parents have the BRCA gene mutations theres a chance you will inherit these, and if so, you could pass them onto any of your children.

A woman who inherits a BRCA1 or BRCA2 gene mutation will have a high risk of breast and ovarian cancer, and has a 50% chance of passing this mutation onto each of her children.

A man who inherits a BRCA1 or BRCA2 gene mutation may have a small increased risk of male breast cancer. They also may have an increased risk of prostate or pancreatic cancer, and has a 50% chance of passing this mutation onto each of his children.

But its important to mention that not everyone with a BRCA1 or BRCA2 mutation has a family history of cancer.

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