Oral contraceptives and pathologic changes in the breast

Expressed concern that oral contraceptives may be carcinogenic for the breast is based upon experimental observations and toxicity studies in lower animals, and has been directed primarily at the estrogenic component. A comparison has been made of the histologic appearance of normal breast tissue and a variety of benign and malignant epithelial lesions in women using oral anti-ovulants and in age-matched controls. No histologic changes have been found that can reliably be attributed to the oral steroids by either light or electron microscopy. Reported changes in fibroadenomas and in carcinomas associated with oral contraceptive use have not been confirmed in studies utilizing controls. Additionally, no differences in the prevalence or in the age of patients at the time of diagnosis have been found for fibroadenomas. chronic cystic disease, or carcinoma. The lack of any demonstrable morphological changes in women's breasts related to oral contraceptives does not necessarily mean that these agents do not have a carcinogenic or cocarcinogenic potential, but it makes such a possibility seem quite remote, and makes the publicity given unsupported allegations to the contrary most regrettable.