HQ Team
January 17, 2025: A study has found a significant association between the use of hormonal contraceptives and an increased risk of breast cancer in women with BRCA1 gene abnormalities.
The research, conducted by the Peter MacCallum Cancer Centre and Cancer Council Victoria, analyzed data from nearly 5,400 women, including 3,882 with BRCA1 mutations. It was found that those who used hormonal contraceptives for at least one year faced a 29% increase in relative breast cancer risk, with an additional 3% risk for each subsequent year of use.
The participants in this long-term study were free from cancer at the outset and were followed over several years across multiple countries, including Australia, Europe, Canada, and the United States. Of the women with BRCA1 mutations, 488 developed breast cancer during the follow-up period.
This research underscores the need for personalized discussions regarding contraceptive options for women with BRCA1 mutations, balancing the benefits of hormonal contraception against their elevated cancer risk.
Professor Kelly-Anne Phillips, a lead researcher on the study, emphasizes that while hormonal contraception remains an important healthcare option, its risks must be carefully considered for those carrying BRCA1 mutations. She advocates for individualized risk assessments rather than general recommendations, noting that even a small increase in absolute risk can be significant over time.
Global breast cancer statistics
Breast cancer is one of the most prevalent cancers worldwide. According to the World Health Organization (WHO), it accounted for approximately 2.3 million new cases and 685,000 deaths globally in 2020. The incidence rates vary significantly by region; for instance, North America has some of the highest rates, while lower rates are observed in parts of Asia and Africa. The lifetime risk of a woman developing breast cancer is about 1 in 8 in many Western countries.
Similar studies and findings
The link between hormonal contraceptives and breast cancer risk has been explored in various studies over the years. A meta-analysis
published in 2022 indicated that oral contraceptive use is associated with a 24% increased risk of breast cancer among BRCA mutation carriers. Another study highlighted that long-term users (over five years) showed a notably higher risk compared to short-term users.
In contrast to these findings, some studies have reported no significant association between hormonal contraceptive use and breast cancer risk among BRCA2 mutation carriers. For instance, research indicated that while BRCA1 carriers face increased risks, BRCA2 mutation carriers did not show a statistically significant increase in breast cancer risk associated with hormonal contraceptive use.
Current status and recommendations
Given the emerging evidence linking hormonal contraceptives to increased breast cancer risk specifically among BRCA1 carriers, healthcare providers are urged to engage in thorough discussions with patients about their contraceptive choices. This includes evaluating personal and family medical histories to provide tailored advice that considers both the benefits of hormonal contraception—such as menstrual regulation and reduced ovarian cancer risk—and the potential risks.
Moreover, ongoing research is essential to further elucidate the relationship between different types of hormonal contraceptives (e.g., pills versus IUDs) and their specific impacts on breast cancer risk among genetic mutation carriers. Understanding these nuances will aid in developing comprehensive guidelines that prioritize women’s health while considering their reproductive choices.
