Consensus statement of the Russian society of obstetricians and gynecologists and the Russian association of mammologists on the effect of combined oral contraceptives on breast tissue

The All-Russian Expert Concilium about the influence of combined oral contraceptives on breast tissue took place in the 18^th of April 2024 in Moscow. It is necessary to study how to manage controlled risk factors of malign breast tumours. The influence of combined oral contraceptives on female breast tissue is widely discussed due to enlargement of possible estrogen components list. It is also actual to study if the combines oral contraceptives may act as potential enhancer/silencer for benign mammary dysplasia and breast cancer risk. The present article demonstrates. Consensus statement of the Russian society of obstetricians and gynecologists and the Russian association of mammologists on the effect of combined oral contraceptives on breast tissue.

1. Ministry of Health of the Russian Federation. Clinical guidelines. Benign breast dysplasia. 2020. (in Russian)

2. Ministry of Health of the Russian Federation. Clinical guidelines. Breast cancer. 2021. (in Russian)

3. Sukhikh GT, Prilepskaya VN, ed. National medical acceptance criteria for contraceptive methods. Adapted from WHO Medical Acceptance Criteria for Contraceptive Use, 5th Edition, 2015. Moscow; 2023. (in Russian)

4. Burkman RT. Oral contraceptives: Current status. Clin Obstet Gynecol. 2001. doi: https://doi.org/10.1097/00003081-200103000-00010

5. Schindler AE. Non-contraceptive benefits of oral hormonal contraceptives. Int. J. Endocrinol. Metab. 2013;11(1):41-7. doi: https://doi.org/10.5812/ijem.4158

6. Royal College of General Practitioners’ Oral Contraception Study. Effect on hypertension and benign breast disease of progestogen component in combined oral contraceptives. Effect on hypertension and benign breast disease of progestogen component in combined oral contraceptives. Lancet. 1977; 1(8012):624

7. Brinton LA, Vessey MP, Flavel R, Yeates D. Risk factors for benign breast disease. Am. J. Epidemiol. 1981;113(3):203-14. doi: https://doi.org/10.1093/oxfordjournals.aje.a113089

8. Leonidova TN, Mikova VN. Hormonal contraception and risks for breast disorders. Doctor.Ru. 2016; 3(120):15-7. (in Russian).

9. Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and hormonal contraceptives: collaborative reanalysis of individual data on 53297 women with breast cancer and 100 239 women without breast cancer from 54 epidemiological studies. Lancet. 1996; 347(9017): 1713-27. doi: https://dx.doi.org/10.1016/s0140-6736(96)90806-5

10. Iversen L, Sivasubramaniam S, Lee .J, Fielding S, Hannaford PC. Lifetime cancer risk and combined oral contraceptives: the Royal College of General Practitioners’ Oral Contraception Study. Am. J. Obstet. Gynecol. 2017;216(6):580.e1-580.e9. doi: https://dx.doi.org/10.1016/j.ajog.2017.02.002

11. Barańska A, Błaszczuk A, Kanadys W, Malm M, Drop K, Polz-Dacewicz M. Oral contraceptive use and breast cancer risk assessment: a systematic review and meta-analysis of case-control studies, 2009-2020. Cancers (Basel). 2021;13(22):5654. doi: https://dx.doi.org/10.3390/cancers13225654

12. Adamyan LV, Kotova EG, Rodionov VV, Protasova AE, Sheshko EL. The role of the gynecologist in the detection of breast pathology and coexisting hyperproliferative diseases. Russian Journal of Human Reproduction. 2023;29(5):6-17. (in Russian). doi: https://dx.doi.org/10.17116/repro2023290516

13. Gallez A, Dias Da Silva I, Wuidar V, Foidart JM, Pequeux C. Estetrol and mammary gland: friends or foes? J. Mammary Gland Biol. Neoplasia. 2021;26(3):297-308. doi: https://dx.doi.org/10.1007/s10911-021-09497-0

14. Schmidt M, Lenhard H, Hoenig A, Zimmerman Y, Krijgh J, Jansen M, et al. Tumor suppression, dose-limiting toxicity and wellbeing with the fetal estrogen estetrol in patients with advanced breast cancer. J. Cancer Res. Clin. Oncol. 2021;147(6):1833-42. doi: https://dx.doi.org/10.1007/s00432-020-03472-8.

15. Singer CF, Bennink HJ, Natter C, Steurer S, Rudas M, Moinfar F, et al. Antiestrogenic effects of the fetal estrogen estetrol in women with estrogenreceptor positive early breast cancer. Carcinogenesis. 2014; 35(11): 2447-51. doi: https://dx.doi.org/10.1093/carcin/bgu144

16. Instructions for medical use of Esteretta. (in Russian)

17. Łukasiewicz S, Czeczelewski M, Forma A, Baj J, Sitarz R, Stanisławek A. Breast cancer-epidemiology, risk factors, classification, prognostic markers, and current treatment strategies-an updated review. Cancers (Basel). 2021;13(17):4287. doi: https://dx.doi.org/10.3390/cancers13174287.

18. Tamimi RM, Spiegelman D, Smith-Warner SA, Wang M, Pazaris M, Willett WC, et al. Population Attributable Risk of modifiable and nonmodifiable breast cancer risk factors in postmenopausal breast cancer. Am. J. Epidemiol. 2016;184(12):884-93. doi: https://dx.doi.org/10.1093/aje/kww145

19. WHO. Preventing cancer. https://www.who.int/activities/preventing-cancer (last access May, 2024)

20. Stewart BW, Bray F, Forman D, Ohgaki H, Straif K, Ullrich A, et al. Cancer prevention as part of precision medicine: ‘plenty to be done’. Carcinogenesis. 2016;37(1):2-9. doi: https://dx.doi.org/10.1093/carcin/bgv166.

21. Smetnik AA, Rodionov VV, Kometova VV, Burmenskaya OV, Dardyk MV, et al. The breast and sex hormones. Obstetrics and Gynecology. 2021;(12):58-66. (in Russian). doi: https://dx.doi.org/10.18565/aig.2021.12.58-66