Dear Concerned,

The jury is still out on whether the pill may increase the risk for breast cancer in some people. Parsing out your breast cancer risk can be tricky, but there are several other birth control options if you decide to steer clear of the pill.

According to the Mayo Clinic, research on the link between oral contraceptives (OCs) and breast cancer shows mixed results. Recent studies indicate that newer low-dose forms of OCs do not increase the risk of breast cancer. However the true story may be more nuanced — some studies show OC use increases the risk of breast cancer among women with the abnormal BRCA1 gene, but not among women with the abnormal BRCA2 gene. Since you have a close family member with a history of breast cancer, you may or may not have inherited an abnormal gene such as BRCA1 or BRCA2, both of which can cause cancer. On the other hand, OCs may protect against breast and ovarian cancer by stabilizing hormones, so the pill is sometimes recommended for women with a family history of these cancers. Your health care provider can help you decide if OCs are a good choice for you and discuss the option of genetic testing and counseling for abnormal BRCA genes.

With one in eight women developing breast cancer in their lifetime, many of whom have no genetic risk factors, every woman should be aware of the following precautionary and preventative steps:

• Be aware of how your breasts normally feel and look and periodically assess whether there have been any changes. If you notice changes, like a new lump, excess discharge, dimpling, puckering, or changes in size, shape, or symmetry, consider making an appointment with your health care provider.  
• Have an annual breast exam by a health care provider.
• Cut down on fatty foods (i.e., soft cheese, whole milk, red meat, sour cream, etc.) and eat more vegetables and fruits.
• Talk with your health care provider about current medical research findings that may apply to you.

If you're wary of taking the pill, there are several other contraceptives to choose from. For long-term protection, an IUD (intra-uterine device) is a good option. For more spontaneous protection, there are barrier methods such as the diaphragm or female condom, both of which you can use in combination with spermicidal gels or foam. As you mentioned, it is possible for male condoms to tear. To prevent breakage and keep things moving, try using a little bit of extra lubricant and check out the tips in How to use a condom properly — avoid breakage and slippage.

To discuss your contraceptive options or get more information about your risk of breast cancer, you can make an appointment with a health care provider. If you are at Columbia, call Primary Care Medical Services at x4-2284 or log on to Open Communicator.

There's no easy answer when it comes to the pill and breast cancer risk. Thankfully though, women have a large menu of contraceptives to choose from. Good luck finding the method that puts your mind (and love life) at ease!

Alice

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