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Breast cancer - managing family history - Management
Basis for recommendation
- These recommendations are based on the UK Medical Eligibility Criteria (UKMEC) for contraceptive use [FFPRHC, 2006] and a guideline from the Faculty of Sexual and Reproductive Healthcare [FSRH, 2007].
- The National Institute for Health and Clinical Excellence (NICE) reviewed the evidence and concluded that [McIntosh et al, 2004]:
- Consistent evidence is provided by three meta-analyses of case-control and cohort studies, plus one large case-controlled study (4575 women with breast cancer and 4682 women without breast cancer), that the effect of oral contraception on breast cancer risk is similar in women with or without a family history of breast cancer.
- In women with a BRCA1 mutation, taking the combined oral contraceptive (COC) may increase the risk of breast cancer. However, the evidence for this originates only from a case-control study and a retrospective cohort study, and should be balanced against the lifetime protection against ovarian-cancer associated with the COC.
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