Birth control and breast cancer: What’s the real risk?

A close up of a packet of birth control pills.
The benefits of hormonal birth control outweigh the slight increase in breast cancer risk for many women.

A December 2017 study published in The New England Journal of Medicine has sparked conversation about the link between hormonal birth control and breast cancer risk. The study, which followed 1.8 million women in Denmark, found a slight increase in the overall risk of breast cancer among women who used oral birth control (“the pill”) or intrauterine devices (IUDs) containing the hormone progestin.

It’s important to put these findings in perspective. The benefits of using modern hormonal birth control far outweigh the small increase in breast cancer risk. In fact, pregnancy actually poses more health risks than progestin IUDs or birth-control pills. 

Comparing the risks and benefits of hormonal birth control

As the National Cancer Institute notes, 12.4 percent of American women will develop breast cancer in their lifetimes due to risk factors such as family history of the disease or obesity. That equates to 12,400 cases of breast cancer per 100,000 women. The Danish study on hormonal birth control estimates that hormonal contraceptive methods account for 13 breast cancer cases out of 100,000 women, which translates to a 0.013 percent risk. That’s an incredibly low risk compared to traditional risk factors as well as to the risks a woman might encounter if she ceases using hormonal birth control. 

Obviously, the most important benefit of hormonal birth control is avoiding unplanned pregnancy. Another related benefit is avoiding potential pregnancy-related complications that can seriously affect a woman’s health. Some of these include gestational diabetes, preeclampsia (high blood pressure during pregnancy), and complications during delivery.

The current U.S. maternal death rate, or the number of women who die during or shortly after childbirth, is 14 per 100,000 live births. In Texas, the 2014 maternal death rate was nearly 36 per 100,000 live births. Maternal death rate increases with age and with obesity. Both of these statistics are higher than the Danish study’s finding of 13 cases of breast cancer out of 100,000 women on hormonal birth control.

Related reading: Talking about death and pregnancy in Texas: a tough discussion

Hormonal birth control has many other benefits, including reductions in:

How to choose the right form of birth control

I’ve been involved with research into oral contraceptives for more than 40 years and have prescribed contraceptives to many patients. My very first patient was on an 80-microgram birth-control pill, compared to the 20- or 15-microgram dose we prescribe today. Modern, low-dose birth-control pills carry a much lower risk of:

Today’s IUDs are a safe, highly-effective contraception option without having to take a pill every day. Many of my patients love them. We insert the tiny device into the cervix one time, and it’s effective for up to 10 years, depending on the specific device. We can take the IUD out anytime if a woman decides she wants to get pregnant. Additionally, many women stop having monthly periods while using IUDs.  

Related reading: Would an IUD or birth control implant work for me?

If a patient can’t tolerate hormonal birth control or would prefer not to use it, she may choose a nonhormonal IUD, ParaGard, that’s highly effective without progestin. Other nonhormonal options are available, though these might be less appropriate or effective based on a woman’s needs:

  • Condoms: dependent on the woman’s partner and aren’t as effective as oral birth control or IUDs
  • Diaphragms: require more work to use and aren’t as effective
  • Emergency contraceptives: must be used every time after sex and aren’t as effective
  • Tubal ligation (having your tubes tied) and/or vasectomy: permanent options that prevent any possible pregnancies in the future

The Danish study’s findings aren’t something to be alarmed about or a reason for a woman to stop taking birth control. The very small risk for breast cancer associated with these hormonal medications is much less than the many conditions they help prevent. Talk to your doctor about what this means for your overall risk of breast cancer, as well as other conditions that your birth control may be helping to prevent. 

Request an appointment for more information about choosing an effective and safe method of birth control.

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