Breast cancer and hormonal contraception: Should we rethink our concepts?

Borges, João Bosco Ramos; Torresan, Renato Zocchio

doi:10.1590/1806-9282.64.03.201

Cited by 3 publications

(3 citation statements)

References 16 publications

(13 reference statements)

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“…The relationship between COCs and progestins with breast cancer has been controversial and mainly based on population-based epidemiologic studies [59][60][61][62] . The risk of breast cancer was shown to be similar between different COCs, and findings for different progestin-only formulations were inconsistent 57 .…”

Section: Breast Healthmentioning

confidence: 99%

Use of dienogest in endometriosis: a narrative literature review and expert commentary

Murji

Biberoğlu²,

Leng

et al. 2020

Current Medical Research and Opinion

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Objective: Endometriosis affects up to 10% of women of reproductive age, and the main goal of treatment is to relieve symptoms. Progestins have been the mainstay of endometriosis suppression, of which dienogest has become an important option in many parts of the world. This is an expert literature review, with recommendations on the use of dienogest in the context of various clinical considerations when treating endometriosis. Methods: A search of PubMed was conducted for papers published between 2007 and 2019 on the use of dienogest in endometriosis. Experts reviewed these and included those they considered most relevant in clinical practice, according to their own clinical experience. Results: Evidence regarding the long-term use (>15 months) of dienogest for the management of endometriosis is presented, with experts concluding that the efficacy of dienogest should be assessed primarily on its impact on pain and quality of life. Fertility preservation, the option to avoid or delay surgery, and managing bleeding irregularities that can occur with this treatment are also considered. Counseling women on potential bleeding risks before starting treatment may be helpful, and evidence suggests that few women discontinue treatment for this reason, with the benefits of treatment outweighing any impact of bleeding irregularities. Conclusions: Overall, the evidence demonstrates that dienogest offers an effective and tolerable alternative or adjunct to surgery and provides many advantages over combined hormonal contraceptives for the treatment of endometriosis. It is important that treatment guidelines are followed and care is tailored to the woman's individual needs and desires.

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Section: Breast Healthmentioning

confidence: 99%

Use of dienogest in endometriosis: a narrative literature review and expert commentary

Murji

Biberoğlu²,

Leng

et al. 2020

Current Medical Research and Opinion

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Section: Introductionmentioning

confidence: 99%

“…6 There are several conditions that predispose to its development, such as older age, female sex, genetic mutations, previous history of ductal carcinoma in situ, high body mass index (BMI), nulliparity or first pregnancy after 30 years of age, early menarche, history of BC or ovarian cancer in the family, late menopause, exposure to previous thoracic radiation therapy, and slightly elevated combined hormone replacement therapy in postmenopause women. 7,8 Advancements in the diagnosis and treatment of BC have resulted in a higher survival rate at 5 years (89% in the USA), which has led to an increase in the number of shoulder morbidity cases. [9][10][11] One of such morbidities is AC, 5,9 which according to Yang et al accounts for 10.3% of patients treated within a period of 13 to 18 months.…”

Section: Introductionmentioning

confidence: 99%

Immobilization, Lymphedema, and Obesity are Predictive Factors in the Development of Adhesive Capsulitis in Breast Cancer Patients

Fernandes,

Assis,

Spagnol

et al. 2023

Rev Bras Ginecol Obstet

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Objective Adhesive capsulitis is a condition characterized by shoulder pain and stiffness. Breast cancer treatment has been linked to the development of this condition, but its mechanisms are still little known. This study's objective was to identify predictors factors associated with the development of adhesive capsulitis in breast cancer patients. Methods A case control study was performed with women undergoing treatment for breast cancer in a single center. The sampling was nonprobabilistic and consecutive. Adhesive capsulitis was defined as constant pain associated with decreased active and passive shoulder movement in anterior elevation, external rotation at 0°/90° abduction, and internal rotation at 90° abduction. The study group consisted of patients with shoulder pain and range of motion limitations, while the control group consisted of women without any shoulder abnormalities. Sociodemographic and clinical variables were collected. A univariate logistic regression was used to assess the influence of variables on the studied outcome. For p < 0.20, a multivariate logistic regression was used. The probability of null hypothesis rejection was 5%. Results A total of 145 women were assessed, with 39 (26.9%) on the study group and 106 (73.1%) on the control group. The majority was under 60 years old. In the multivariate analysis, variables correlated to the outcome under study were shoulder immobilization (OR = 3.09; 95% CI: 1.33–7.18; p = 0.009), lymphedema (OR = 5.09; 95% CI: 1.81–14.35; p = 0.002), and obesity (OR = 3.91; 95% CI: 1.27–12.01; p = 0.017). Conclusion Lymphedema, postsurgery immobilization, and obesity are predictive factors for the development of adhesive capsulitis in breast cancer patients.

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Women's health, hormonal balance, and personal autonomy

2023

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Hormone-based contraception disrupts hormonal balance, creating artificial states of anovulation and threatening women's health. We reviewed its main adverse effects and mechanisms on accelerated ovarian aging, mental health (emotional disruptions, depression, and suicide), sexuality (reduced libido), cardiovascular (brain stroke, myocardial infarction, hypertension, and thrombosis), and oncological (breast, cervical, and endometrial cancers). Other “collateral damage” includes negative effects on communication, scientific mistrust, poor physician–patient relationships, increased patient burden, economic drain on the healthcare system, and environmental pollution. Hormone-sensitive tumors present a dilemma owing to their potential dual effects: preventing some cancers vs. higher risk for others remains controversial, with denial or dismissal as non-relevant adverse effects, information avoidance, and modification of scientific criteria. This lack of clinical assessment poses challenges to women's health and their right to autonomy. Overcoming these challenges requires an anthropological integration of sexuality, as the focus on genital bodily union alone fails to encompass the intimate relational expression of individuals, complete sexual satisfaction, and the intertwined feelings of trust, safety, tenderness, and endorsement of women's femininity.

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Breast cancer and hormonal contraception: Should we rethink our concepts?

Cited by 3 publications

References 16 publications

Use of dienogest in endometriosis: a narrative literature review and expert commentary

Use of dienogest in endometriosis: a narrative literature review and expert commentary

Immobilization, Lymphedema, and Obesity are Predictive Factors in the Development of Adhesive Capsulitis in Breast Cancer Patients

Women's health, hormonal balance, and personal autonomy

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