Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor
To the Editor: The findings of Ms Grabrick and colleagues1 strengthen the results of previous studies showing that women who have used OCs and have a family history (first degree female relative) of breast cancer may be at higher risk of developing breast cancer themselves. However, because recall bias is inevitable with such a long follow-up (>35 years), I do not agree with the authors that the reliability of the data was greater than 90%. Surveillance bias may have similarly limited the study's validity. Also, concomitant smoking and OC use may have exerted confounding effects. A recent report shows an increased breast cancer risk in patients with a history of both active and passive smoking.2 Another study also suggests a modest increase in breast cancer risk associated with adolescent smoking.3
Aslam F, Rashid H. Oral Contraceptives and Risk of Breast Cancer in Women With a Family History of Breast Cancer. JAMA. 2001;285(1):39–40. doi:10.1001/jama.285.1.39
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