Can Breast Cancer Survivors Safely Use Birth Control Pills?

Can breast cancer patients take contraceptive pills?

Hello Doctor: I was diagnosed with stage II breast cancer in 2008 and underwent chemotherapy, radiation therapy, and targeted therapy.
Currently, I am on regular follow-up visits.
However, I have recently noticed that my menstrual cycle has become shorter, and I have experienced abdominal pain twice, which prompted me to visit the hospital.
The physician performed a transvaginal ultrasound and found a cyst on my left ovary (which the doctor visually assessed as likely benign), hydrosalpinx on the left fallopian tube, and a 2 cm fibroid.
The doctor advised me to return for follow-up in two months and prescribed a one-month course of oral contraceptives (Family Planning No.
1).
I informed the doctor of my medical history, but I remember that breast cancer patients should not take contraceptives, as they may stimulate existing breast cancer cells.
Therefore, I am very concerned and unsure whether I should take them.
Although the attending physician indicated that it would not affect my breast cancer, I still feel somewhat anxious.
Can breast cancer patients take contraceptives? Thank you.

amy, 40~49 year old female. Ask Date: 2016/02/20

Dr. Lai Yicheng reply Oncology

Dear Ms.
Amy,
In response to your inquiry, my recommendations are as follows:
1.
It is advisable to postpone the use of contraceptive pills.
2.
The decrease in menstrual flow may indicate the onset of menopause.
You can check the levels of LH and FSH in your blood to confirm whether you are entering menopause.
3.
Regarding the left ovarian cyst, hydrosalpinx on the left side, and the two-centimeter fibroid, it is important for your gynecologist to be aware of your history of breast cancer from eight years ago (as breast cancer patients often have a 30% chance of developing ovarian issues).
Please ensure that the doctor confirms that the cyst, hydrosalpinx, and fibroid are not related to your breast cancer before proceeding with the standard treatment for the cyst, hydrosalpinx, and fibroid.
Changhua Hospital is concerned about your health.
Sincerely,
Director Lai Yi-Cheng

Reply Date: 2016/02/20

More Info

The question of whether breast cancer survivors can safely use birth control pills is a nuanced one, particularly for those with a history of hormone-sensitive cancers. Your concerns are valid, especially given your medical history of stage II breast cancer and the treatments you have undergone, including chemotherapy, radiation, and targeted therapy.

Firstly, it is important to understand that hormonal contraceptives, including birth control pills, contain synthetic hormones that can influence the body’s hormonal balance. For women with a history of breast cancer, particularly those whose tumors were hormone receptor-positive, there has been considerable debate regarding the safety of using hormonal contraceptives. The concern is that these hormones could potentially stimulate any remaining cancer cells, leading to a recurrence of the disease.

The current consensus among medical professionals is that the use of hormonal contraceptives may not be advisable for all breast cancer survivors. The American Cancer Society and other organizations suggest that women with a history of breast cancer should discuss their contraceptive options thoroughly with their healthcare providers. This is particularly crucial for those who had hormone receptor-positive breast cancer, as the risk of recurrence may be higher with hormonal contraceptives.

In your case, since your doctor has prescribed birth control pills and believes they will not negatively impact your health, it is essential to consider a few factors:
1. Type of Breast Cancer: If your breast cancer was hormone receptor-positive, the use of hormonal contraceptives may be more concerning. If it was hormone receptor-negative, the risks associated with hormonal birth control may be lower.

2. Current Health Status: Your overall health, including any current symptoms such as abdominal pain or the presence of ovarian cysts, should be taken into account. If you are experiencing new symptoms, it may be worth discussing these with your healthcare provider before starting any new medication.

3. Alternative Options: If you are uncomfortable with the idea of using hormonal birth control, there are non-hormonal contraceptive methods available, such as copper IUDs or barrier methods (condoms, diaphragms). These options do not carry the same risks associated with hormonal contraceptives and may be more suitable for you.

4. Regular Monitoring: Since you are already under regular follow-up care, ensure that any new symptoms or concerns are communicated to your healthcare team. They can provide tailored advice based on your individual health status and history.

5. Second Opinion: If you remain uncertain about the safety of using birth control pills, seeking a second opinion from an oncologist or a specialist in reproductive health for cancer survivors may provide additional clarity and reassurance.

In conclusion, while some healthcare providers may feel comfortable prescribing hormonal contraceptives to breast cancer survivors, it is crucial to weigh the potential risks and benefits carefully. Open communication with your healthcare team is key to making an informed decision that aligns with your health needs and personal comfort level. Always prioritize your health and well-being, and do not hesitate to advocate for what feels right for you in your treatment and care plan.

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