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To the Editor.—
The letter from Drs. Kovi and Viola in The Journal (223:802, 1973) emphasizes our limited knowledge on the effects of long-term oral contraceptive hormone (OCH) therapy on the breast. The suggestion that the lobular sclerosis in their case reflected a premature menopausal alteration stimulated me to review eight cases of cancer in women 35 years of age or younger in whom the breast was removed prior to the oral contraceptive era. Lobular sclerosis identical to the type illustrated in their letter was seen in one, and focal sclerosis was seen in two others. It is possible that young patients with breast cancer who have a long history of OCH ingestion may have even a greater frequency of lobular sclerosis but this will require more than one case to prove, and there should be proper controls. Parenthetically, one previously reported case of breast cancer in a 28-year-old woman
Fechner RE. Oral Contraceptive Effects on the Breast. JAMA. 1973;224(2):249-250. doi:10.1001/jama.1973.03220150057029