Pill safe for young woman with high risk of breast cancer

According to Amsterdam researchers, young women who run a greatly increased risk of breast cancer and ovarian cancer due to genetic mutations can safely continue to use the contraceptive pill until they are about 25 years old.

After that, it is important that they are properly informed about their specific situation, recommend the scientists of the Netherlands Cancer Institute (NKI).

Both adverse and beneficial effects

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 wisdom is for women with a so-called BRCA1 or BRCA2 mutation in their genes. These abnormalities cause 5 to 10 percent of all breast cancer cases, according to previous studies. 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 now shows that the use of the pill has little influence on the cancer risk for teenagers and young adults. In the long term, the beneficial effects are stronger: 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.

Women with a BRCA mutation

Women with the BRCA mutation therefore have to make a decision, according to Antoni van Leeuwenhoek, of 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 avoid further risk increases by switching to non-hormonal contraception, such as condoms or a non-hormonal contraceptive? spiral.”

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

After a preventive ovary removal, the benefits of the pill largely disappear. “The more effective the preventive surgery is, the more unfavorable the effect of previous pill use is. This is because the use of the pill still leads to more breast cancer, while there is little to no prevention of ovarian cancer,” the researchers write. They have published their findings in the scientific Journal of the National Cancer Institute.

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