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Do Birth Control Pills Increase Your Risk Of Breast Cancer?
(continued)

Unanswered questions:

It is not unusual for a medical study-especially an epidemiologic one--to raise more questions than it answers.† This study is no exception.† In fact, the major value of this study will be the questions that were raised which will stimulate further research.† These questions include:†

  • Is there a difference in family history relevance or study if the genetic tests for BRCA-1 and BRCA-2 are conducted and factored in?

  • Are the newer pills containing low doses of estrogen and progestin are safer (lower risk) than the previous pill formulations, particularly the latest low dose pills containing only 20 micrograms of estrogen?

Even in women with a strong family history of breast cancer, does the disadvantage of increased risk of breast cancer with the Pill outweigh the advantage of the greatly reduced risk of ovarian cancer from the Pill, especially since women with a strong family history of breast cancer have a greatly increased risk of ovarian cancer?†

This last question is the most troubling clinical issue when it comes to making recommendations on the basis of this study alone. †We know that women with the inherited genetic mutation for breast cancer are also at greatly increased risk for ovarian cancer.† We also know that birth control pill use is one of the few methods to reduce the risk of ovarian cancer.† In the accompanying editorial to the JAMA study, Dr. Wylie Burke of the University of Washington wrote that this study "argues for avoidance of oral contraceptives, but at the price of forgoing an attractive option for reducing ovarian cancer risk''.† This is a particular concern because ovarian cancer is harder to detect, harder to treat, and as a result usually more deadly than breast cancer. †

This highlights the challenges we face whenever making any clinical recommendations based upon the results of one study, especially one that is not a long-term, prospective clinical trial.

How this study applies to you:

If you have no family history of breast cancer (or no family history of the genetic type of breast cancer), this study DOES NOT apply to you, whether or not you took the Pill.† If you do have a family history of breast cancer, this study DOES NOT apply to you if you took the Pill only after 1975.

This study only applies to women who took the pill before 1975, who have 3 or more close relatives (mother, sister, aunt, grandmother) who had breast cancer.† If you are in that group, don't panic:† talk with your doctor about how this study might apply to you and whether you need to make any changes in your current Pill usage or in further diagnostic testing.

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Created: 10/13/2000  -  Donnica Moore, M.D.

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 ... donít panic: talk with your doctor about how this study might apply to you and whether you need to make any changes ... 


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