DEAR DR. ROACH: I want to point out a serious health concern. My daughter turned 40 last year and got her mammogram, which came back with a shocking diagnosis of stage 3 microinvasive carcinoma. She underwent three surgeries, the last of which was a double mastectomy.
I read that cancer incidence increases with hormone usage greater than five years in a row. My daughter’s doctor prescribed “the pill” to her for much greater than five years and never even warned her of the risk.
How many other women are unaware of the risks? These women are in many cases busy, young professionals as my daughter is. They are using the pill because it is so easy. Please warn them and their parents. — M.R. ANSWER: The association of combined oral contraceptives with breast cancer is controversial. Many large studies, such as the Nurses’ Health Study, found no association of “the pill” with breast cancer, either while a woman is using it or after she stops.
There have been some studies that have shown an increase in risk, but the magnitude of the risk is small. In a large Danish study, the overall increase in risk was about one additional case of breast cancer in 8,000 women taking the pill for a year. For women under 35, the risk was one case in 50,000 women per year. The studies that showed a risk for breast cancer did not show an increased risk when women are taking them longer.
Oral contraceptives certainly have risks. Blood clots are more common among users. They have side effects that can be very bothersome and sometimes prevent women from using them. However, there is an overall improvement in mortality risk among users because even in 2025, having a baby puts a mother’s life at risk, and oral contraceptives are effective at preventing pregnancy.
