Birth control pill question/ high risk

KARW41 · January 2012

My Mom had breast cancer twice, the first time at age 52. She is still alive today but suffered a lot. I am now almost 42 and have had three biopsies and three fibroadenomas. I am thinking that I fall into the high risk category, at least partly. Someone from the other forum said I should come to this one instead.

My question is, does anyone here either have an opinion on whether it is wise to discontinue birth control pills if one is, in fact, "high risk?"

I stopped using Seasonale when I first went overseas with the military and could not get it for a while. Now, I have the option of taking it again, and I am just wondering if it could somehow cause things like fibroadenomas and/or breast cancer in the long term.

I have taken birth control pills with just a couple of years' break for nearly 20 years. I prefer it because I have less difficulty and fewer symptoms with fewer periods.

Or, in the alternative, do you know where I should look online at references to help make a decision?

Thank you very much and please let me know if this is not a question to be asking here.

I really am starting to think about it after just having the last two core biopsies, even though these came back benign. I do feel that, at some point, I'll get breast cancer like my Mom did, so I want to try to do whatever the most "healthy" things are, if I can.

Moderators · January 2012

Hi KARW41,

While you wait for the ever-helpful advice from the ladies here, you may find some good information on the main Breastcancer.org site, specifically, the Lower Your Risk section. In addition, this is what the Breastcancer.org site has to say about oral contraceptives as a risk factor on the Breast Cancer Risk Factors page:

"Recent oral contraceptive use. Using oral contraceptives (birth control pills) appears to slightly increase a woman's risk for breast cancer, but only for a limited period of time. Women who stopped using oral contraceptives more than 10 years ago do not appear to have any increased breast cancer risk."

Hope you find this helpful!

--The Mods

KARW41 · January 2012

Thank you very much. I did not know that type of information was there. This helps me to decide and I will look at that page.

SarahsMom · January 2012

Hi there, here is a risk calculator for you - http://www.halls.md/breast/risk.htm

Use the "Gail Model" on the drop down menu in the middle of the page. Not perfect, not 100% accurate, etc but the best we have and definitely will show you the increased risk with birth control.

I was on it way too long, I took it to control heavy periods. That has increased my risk factor (I have other issues, as well)

I hope your mom is doing well. There are lots of us on this board that understand the angst and fear you have about your risks and the psychological pain of the every 6 month checks, every bump you feel, every twinge. etc The "what if" factor is alive and well on this board.

There are great ladies here, so please come back anytime you need a shoulder or have questions!

KARW41 · January 2012

Thank you so much. I really like your profile name.

In reading the posts already, I am really inspired by the positive attitudes and support that are on this board.

I will take a look at the link to the risk calculator. It is somewhat of a new idea to me that I am high risk, but I seem to keep adding things to my risk profile so I had better just acknowledge that is what I am and deal with it.

I may also try to get back to a major U.S. metropolitan area from overseas in light of all this, since I do not have access to a breast care center over here like I did back at home. Thank you very much for the support.

leaf · January 2012

Well, I have some caveats about Hall's breast cancer calculator. I have classic LCIS, with a weak family history. When I stuck my numebrs into the calculator, before tamoxifen, I could get a value of nearly 90% lifetime chance of breast cancer. That is at least twice as much as the estimation of my onc or of the genetics counselor.

The Hall calculator assumes that risk factors are additive: that, for example, if you have a strong family history and started mestruating early, then your risk is higher than either factor alone. This MAY or MAY NOT be true.

Dr. Hall does stipulate that while his calculator is based on journal figures, his calculator has NOT been compared to the actual populations. For example, if you have both LCIS and started menstruating early, he has not compared the risk that the calculator predicts with the actual group of people who both have LCIS and started menstruating early. Because LCIS is an unusual condition, they don't know the risk very well.

In addition, even if you are at average risk, and not using Hall's calculator, but are using the Gail model (which HAS been compared to the respective populatons), the number you come up with is pretty accurate for the group with your features **BUT** it does a really ROTTEN job in predicting YOUR breast cancer risk. http://jnci.oxfordjournals.org/cgi/reprint/98/23/1673.pdf

In brief, the Gail model *is* better than a coin toss for predicting if you will get breast cancer. In this test, they compared the Gail model score of one random woman with breast cancer and a random woman withOUT breast cancer. If the Gail model was perfect, every women with breast cancer would have a higher score than the random woman withOUT breast cancer and have a 'concordance' figure of 1. If the Gail model was rotten, and had no predictive value at all, it would have a 'concordance' figure of 0.5. The Gail model in this paper had a concordance figure of about 0.58. So, yes, the Gail model is better than the toss of a coin, but not by much.

Birth control pill question/ high risk

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