Contraceptive pill safe for young women with increased risk of breast cancer: Study

According to Amsterdam researchers, young women at a significantly increased risk of breast- and ovarian cancer due to genetic mutations can safely use the contraceptive pill until they are about 25 years old. After that, it is essential that they are properly informed about their specific situation, the scientists at the Netherlands Cancer Institute (NKI) recommended.

Contraceptive pill use has both unfavorable and beneficial effects. The risk of breast cancer is increased by almost a quarter, while the risk of ovarian and uterine cancer is reduced by half. Until now, it was unclear what would be wise for women with a BRCA1 or BRCA2 mutilation in their genes. According to previous studies, these abnormalities cause 5 to 10 percent of all breast cancer cases. About 70 percent of women with these mutations will develop breast cancer at some point in their lives. The risk of ovarian cancer is 35 to 45 percent with BRCA1 and 10 to 20 percent with BRCA2.

The study shows that the use of the pill has little influence on the cancer risk for teenagers and young adults. The beneficial effects are stronger in the long term: the contraceptive pill prevents more cancer cases in the risk group than it causes. The situation is different for women aged 25 to 30: their already high risk of breast cancer increases even further, while the protective effect against ovarian and uterine cancer only occurs later.

Therefore, women with the BRCA mutation have to make a decision, according to Antoni van Leeuwenhoek, to which the NKI belongs. "Do they think the increased cancer risk in the short term is acceptable, given the benefits of the pill and the high cancer risk they already have, or do they want to prevent further risk increases by switching to non-hormonal contraception, such as condoms or a non-hormonal spiral."

Due to the high risks, many women with BRCA have their breasts or ovaries removed as a preventive measure. As a result, the risks of the pill also change significantly. For example, there is no longer a risk of breast cancer after preventive breast removal.

After preventive ovary removal, the benefits of the pill largely disappear. "The more effective the preventive surgery is, the less favorable the effect of the previous pill use. This is because the use of the pill still leads to more risk of breast cancer, while little to no ovarian cancer can be prevented," the researchers write. They published their findings in the scientific Journal of the National Cancer Institute.