Prescribing Oral Contraceptives in Women With Breast Diseases: A Matter of Concern for the Gynecologist

Background: The association of exogenous steroid hormones with breastmalignancy has long been, and still is, a subject of investigation. This manuscript,as part of a series of articles about effects of exogenous sex hormones on breastconditions, reviews the adverse and beneficial effects of oral contraceptives invarious entities separately: benign and malignant breast diseases, women withrisk factors of breast cancer, and the general population. Methods: We first reviewed international clinical guidelines about the subject.Then, a comprehensive search of the literature was carried out using appropriatekeywords. Clinical trials, population-based or cohort studies, nested case-controlstudies, and narrative/systematic reviews were reviewed and relevant data wereextracted. Results: Oral contraceptives are contraindicated in women with current orprevious breast cancer. Among women at high risk for breast cancer, those withpreceding chest wall irradiation should not use pills, while these are allowed incases with BRCA mutations or with a positive family history of breast cancer. Oralcontraceptives may be beneficial for benign breast diseases. For low-risk woman,pills either pose no risk or may induce a very mild risk for breast cancer. Conclusion: Oral contraceptives are generally safe regarding breast diseasesexcept in breast cancer patients or high-risk women, especially those with ahistory of chest wall irradiation.

Keywords:

Breast Cancer , contraception , disease , hormones , steroid