Breast Cancer in Oral Contraceptive Pill Users

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Given the long natural history of this neoplasm, it is certain that a large number of patients subsequently diagnosed with breast cancer have used oral contraceptive pills (OCP) during the genesis and progression of their malignant disease process; they are another group that deserves examination.

Rosner33 evaluated 347 women < 50 diagnosed with breast cancer, of whom 112 were OCP users. The distribution of tumor size, estrogen-receptor status, and family and reproductive history was the same between the two cohorts. There was no difference in disease-free survival or survival between the two groups. Women who used OCP within a year of diagnosis of their breast cancer had a similar survival to those who had discontinued use > 1 year before. There was no difference in survival among those who used OCP > 10 years prior to their diagnosis of breast cancer.

Schonborn and colleagues34 evaluated the influence of a positive history of OCP use on survival. Four hundred and seventy-one breast cancer patients were investigated. Two hundred and ninety-seven patients (63 percent) had used OCP during any period of their life, and 92 (20 percent) still used them at the time of diagnosis. Sixty months after diagnosis, the OCP users had a significantly increased overall survival (p = .037). Survival rates amounted to 79.5 percent and 70.3 percent for OCP users and nonusers, respectively.

Sauerbrei35 investigated the relationship between OCP use and standard prognostic factors, and the effect of OCP use on disease-free survival and overall survival, in 422 pre-menopausal node-positive patients from two tri als of the German Breast Cancer Study Group. One hundred and thirty-seven OCP users (32.5 percent) were younger than those who did not use OCP (mean age 41.5 years versus 45 years). Noteworthy was the fact that the percentage of patients with smaller tumors was higher in the group of OCP users. No significant effect of OCP use on either disease-free or overall survival could be demonstrated in univariate and multivariate analyses after adjustment for tumor size and other prognostic factors.

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