Contraceptive Use in Breast Cancer Patients and Survivors.

IMPORTANCE: Breast cancer is one of the most common malignancies among women globally, with significant implications for reproductive health, including the use of contraception. The intersection of breast cancer and contraception presents unique challenges due to concerns about cancer recurrence, patient safety, and hormonal roles in cancer. The hormonal sensitivity of many breast cancers creates a complex approach to safe contraceptive options for patients. However, recent studies highlight the nuanced role of low-dose and nonestrogenic hormonal options, such as progestin-only methods, while emphasizing the need for further research on their long-term safety. OBJECTIVES: An important aspect of breast cancer survivorship is addressed: reproductive health and contraceptive choices. EVIDENCE ACQUISITION: A PubMed review was conducted using terms "breast cancer" AND "contraception" OR "contraceptive use." The search included review articles, original research databases, and guidelines on contraception for breast cancer patients and survivors. RESULTS: Nonhormonal contraceptives, including copper intrauterine devices, barrier methods, and sterilization, provide safe and effective alternatives but may be less preferred by some patients due to side effects or other limitations. Current guidelines may not offer specific recommendations for both breast cancer patients and breast cancer survivors. CONCLUSIONS: A comprehensive counseling approach to address fertility in patients with breast cancer and survivors is most appropriate; nonhormonal contraceptive options provide the safest methods for patients. RELEVANCE: Current guidelines may not offer specific recommendations for both breast cancer patients and breast cancer survivors. TARGET AUDIENCE: Obstetricians and gynecologists, family physicians. LEARNING OBJECTIVES: After completing this activity, the learner will be better able to describe the unique contraceptive needs for breast cancer patients and survivors; discuss the safety and efficacy of various contraceptive options for patients; and identify gaps in current contraceptive guidelines for patients and survivors.

Duke Scholars

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