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  • Title: Oral contraception and breast pathology.
    Author: Ragni N, Boccardo E, Viglino S, Larosa E.
    Journal: Acta Eur Fertil; 1981 Jun; 12(2):141-63. PubMed ID: 6794288.
    Abstract:
    After a rapid examination of the international literature concerning human, animal, histological and epidemiological experimental data, the Authors state that the use of oral contraceptives considerably reduces the risk of benign disease of the breast. This risk reduction seems to be connected to the presence of progestin in this type of contraception. The Authors then expound the data regarding a group of patients (3527), who came to the center for the diagosis and prevention of cancer of the breast at the S. Martino hospital of Genoa during the years 1977-1980. The results of the study are comparable to those found in international literature, in that they confirm the protective effect of hormonal contraception on benign pathology of the breast. Finally we have shown the data of the retrospective and prospective studies conducted up till now on the effects of hormonal contraception on malignant breast pathology. In conclusion we have shown which lines of study should be taken in order to clarify once and for all the links existing between estroprogestins and cancer of the breast. Extensive studies conducted on laboratory animals have shown that administration of estroprogestin at the doses used in the preparation of human hormonal contraceptives do not cause any mammary alterations of either the benign or malignant type. A review of the published literature on the cytological and histological studies conducted in humans on both normal and pathological mammary tissue have been unable to show any particular microscopic aspects which distinguished users of estroprogestins from women who do not use this type of contraception, both in the case of benign and of malignant lesions. Published literature shows a reduction of about 20% of the risk of benign breast disease in women using oral contraception (OC) as compared to nonusers; this benign effect of OC use is seen in all age groups, and it seems to be linked to the presence of progestin in the contraceptives. A research study was done on a group of 2104 women aged 20-50 who had come to the breast cancer center of the San Martino Hospital in Genova, Italy, during the period 1977-80. 79.6% of women had never used contraception, 6.6% had been using estroprogestins for more than 2 years, 2.5% had been using the mini-pill for more than 2 years. Fibroadenoma was found in 22% of women who had not used OC, in 20% of those who had used it for a year or less, and in 15% of those who had used it for more than 2 years; cystic diseases were found in 29%, 25%, and 16% of the patients, respectively. The incidence of benign breast lesion was not linked with age, and was lower in women who had used the highest progestin content. Most retrospective and prospective studies have concluded that there is no epidemiological data or evidence to demonstrate that OC use is linked to the development of malignant breast tumors in women under 40 years of age. This does not exclude the possibility that one or more risk factors for the development of breast cancer (age, nulliparity, familial antecedents, viral factors, radiation, age at first pregnancy) can be modified by the use of OC. Further studies must be made in order to define more clearly the connection between OC use and breast cancer, especially in women who have been exposed to estroprogestins for prolonged periods of time.
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