Hormonal Contraceptives and Breast Cancer Risk: What Pharmacists Should Know Amid Rising Misinformation

New observational evidence has renewed public concern about how hormonal contraceptives may be related to breast cancer risk. Although the topic is not new, viral social media narratives have amplified confusion, often overstating risk and overlooking important clinical nuance. For pharmacists, who are increasingly central to patient education on contraception, understanding the latest data is essential to provide balanced, evidence-based counseling.

An extensive Swedish nationwide cohort study of more than 2 million adolescent girls and premenopausal women revealed that the use of any hormonal contraceptive at any time was linked with a breast cancer hazard ratio (HR) of 1.24 as compared to the non-use group, meaning it accounts for an additional breast cancer case for every 7752 users annually.¹ Risk, according to the study, varied by product: progestin-only methods had a hazard ratio of 1.21, whereas combined estrogen-progestin methods had a hazard ratio of 1.12.¹ The study indicated that the risk associated with the use of a formulation containing desogestrel or its metabolite etonogestrel was slightly higher than that of levonorgestrel-containing options.¹

The 2023 meta-analysis of 22 observational studies had similar findings to those discussed before. Hormonal contraception users at any time had a combined odds ratio (OR) of 1.33 for breast cancer in comparison to non-users.² The risk was elevated in premenopausal women (OR 1.48) only. However, the authors pointed out the substantial heterogeneity and the limitations of observational study designs in their paper.² The increased risk was primarily seen in current or recent users, with the risk going back to normal after stopping the use of hormonal contraception, thus indicating a temporary, reversible effect rather than a sustained long-term increase.²

Putting Relative Risk of Breast Cancer Into Clinical Context

Although a 20% to 30% relative increase in breast cancer risk may appear significant, absolute risk remains low for younger and premenopausal individuals. The Swedish cohort estimated approximately 13 additional breast cancer cases per 100,000 person-years among hormonal contraceptive users.¹ For a typical woman in her teens or twenties, whose baseline breast cancer risk is already very low, this translates to a small numerical increase.

Health policy has been the pillar of these analyses, which emphasized the importance of putting the data into the right context. A journalistic review that summarizes the comments of the experts states that the findings do not show a significant risk for most users and that they should be considered alongside the firmly proven advantages of hormonal contraception, such as the prevention of pregnancy, improved menstrual regulation, treatment of endometriosis, and lowered risk of ovarian and endometrial cancers.³

Contraception Formulation and Duration Considerations

Various lines of evidence indicate that the kind of contraception as well as the length of its use may influence risk magnitude. It seems that progestin-only pills, implants, and hormonal intrauterine devices are associated with small but detectable risks; however, there is some variation depending on the specific progestins.¹ The risk is greatest during the period of active use, decreases with discontinued use, and appears to come back to normal level about 10 years after discontinuation.¹^,²

For pharmacists, this underscores the great significance of personalized contraceptive counseling. Patients having an increased risk of breast cancer at the beginning. For example, those with a strong family history, breast cancer gene mutations, or previous chest irradiation may be more comfortable after a conversation about safer forms or non-hormonal alternatives. However, in the case of a majority of patients, the small rise in absolute risk is not sufficient to put aside the benefits of effective contraception and menstrual health management.

Addressing Misconceptions in the Social Media Era

Misinformation on social media often misrepresents observational findings as definitive causation, minimizes confounding variables, or presents rare risks as common outcomes.³ Pharmacists are well-positioned to counter misinformation by providing context, outlining absolute versus relative risk, and emphasizing that hormonal contraceptives remain safe and effective for the majority of users.

Conclusion

There is a modest, temporary increase in breast cancer risk that is linked to the use of hormonal contraceptives, especially with some progestin-only units and current or recent use. Although this is the case, the absolute increase in risk is very small, and the advantages of contraception, among which is the prevention of cancer, are still very beneficial. While falsehoods spread on the internet, pharmacists are patients' most reliable allies in deciphering scientific data correctly, deciding on suitable contraceptive methods, and arriving at informed, personalized choices.

REFERENCES

1. Hadizadeh F, Koteci A, Karlsson T, Ek WE, Johansson Å. Hormonal Contraceptive Formulations and Breast Cancer Risk in Adolescents and Premenopausal Women. JAMA Oncol. Published October 30, 2025. Accessed November 19, 2025. doi:10.1001/jamaoncol.2025.4480

2. Torres-de la Roche LA, Acevedo-Mesa A, Lizarazo IL, et al. Hormonal Contraception and the Risk of Breast Cancer in Women of Reproductive Age: A Meta-Analysis. Cancers (Basel). 2023;15(23):5624. Published 2023 Nov 28. doi:10.3390/cancers15235624

3. Gounder C. Breast Cancer and Birth Control: A Huge New Study Shows How Science Can Be Distorted - KFF Health News. KFF Health News. Published November 18, 2025.