[Oral contraceptives and breast cancer]

Hormonal contraception is important for the way of life of many modern women. Since the oral contraceptives were introduced 30 years ago, millions of women were using the pill and large number of experimental, clinical and epidemiological studies have analyzed the risks of their administration. The question whether the usage of exogenous sex-steroids as hormonal contraception may favor the development of breast malignancy is a much debated problem, but a complete answer to the question of the relationship between contraception pill and breast cancer is at present still unresolved. Most studies have not found an overall increased risk of breast cancer associated with the use of the pill, but several recent studies suggested a link between the early-onset breast cancer and a long-term use of oral contraceptives at young ages. The risks for some subpopulations of women seem small (relative risk about 2.0 or less), but consistency of the findings has enforced further study. Women under the age of 35, if they have used the pill long-term or if they are at increased risk of breast cancer for other reasons, should discuss the risks of oral contraceptive use. Contraindications of pill usage must be strictly respected and their users carefully watched, including routine breast examinations. It is equally important to inform our patients about important and numerous positive impacts of pill usage on women's health, to reassure these women and prevent cancerophobia. Sufficient time has now elapsed to permit prospective epidemiological studies with large numbers of women who took the pill for many years beginning at a young age, and follow them as they come in age when breast cancer is most common. So we should carefully examine their results.