Oral contraceptives and breast cancer risk in BRCA1 and BRCA2 mutation carriers

Estrogen and progestin in oral contraceptives may be carcinogenic to the breast, and their use has been associated with a modest increase in the risk of breast cancer in the general female population. Women who carry deleterious mutations in breast cancer susceptibility genes, BRCA1 and BRCA2, have a significantly higher risk of breast and ovarian cancer. The literature on the role of oral contraceptives in carriers is sparse and the results are inconclusive. Findings from some case-control studies and the International BRCA1/2 Carrier Cohort Study suggest that oral contraceptive use may be associated with an increased risk of breast cancer in BRCA1 and BRCA2 carriers. Understanding the potential effects of oral contraceptive use among carriers has important implications for preventive strategies and clinical management. Both the possible protective effect for ovarian cancer risk and the increased potential risk of breast cancer must be considered.