Birth control pill safe for young women at increased risk of breast cancer: study

According to Amsterdam researchers, young women with a significantly increased risk of breast and ovarian cancer due to genetic mutations can safely use the birth control pill up to the age of 25. After that, it is important that they are properly informed about their specific situation, recommended the scientists at the Netherlands Cancer Institute (NKI).

Taking birth control pills has both negative and positive effects. The risk of breast cancer is increased by almost a quarter, while the risk of ovarian and uterine cancer is reduced by half. So far it has been unclear what would make sense 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 for BRCA1 and 10 to 20 percent for BRCA2.

The study shows that taking the pill has little effect on the risk of cancer in adolescents and young adults. In the long term, the positive effects are stronger: the birth control 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, according to Antoni van Leeuwenhoek, women with the BRCA mutation have to make a decision of which the NKI is a part. “Do you think the short-term increased risk of cancer is acceptable given the benefits of the pill and the already high risk of cancer, or do you want to prevent further increases in risk by switching to non-hormonal contraceptives such as condoms or a non-hormonal IUD.”

Because of the high risks, many women with BRCA have their breasts or ovaries removed as a preventive measure. This also changes the risks of the pill significantly. For example, after a preventive breast removal, there is no longer any risk of breast cancer.

After preventive ovarian removal, the benefits of the pill largely disappear. “The more effective the preventive operation is, the more unfavorable the effect of taking the pill beforehand. Because taking the pill still leads to a higher risk of breast cancer, while ovarian cancer is almost impossible to prevent,” the researchers write. They published their findings in the Scientific Journal of the National Cancer Institute.

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