Carcinoma occuring with oc pill consumption

Ans. is b i.e. Ca breast

OCP’s are protective against Benign Breast diseases, but as far as Carcinoma breast is concerned their role is controversial. OCP’s are considered in the etiology of Ca breast.

“The most credible metanalysis of oral contraceptive use suggest that these agents cause little if any increased risk of breast cancer. By contrast, oral contraceptives offer a substantial protective effect against ovarian epithelial tumors and endometrial cancer.”

Ans. is a and b i.e. Endometrium; and Ovary

Ans. is b and c i.e. Increased risk of fibroadenosis; and Increased risk of fibroadenoma.

Non contraceptive benefits of OCPs:

• Cycle stabilization
• Cure of menstrual disorder- useful in menorrhagia & polymenorrhea
• Prevents anemia.
• Reduces the incidence of ectopic pregnancy.
• Protection against cancer – Ovarian ,Endometrial
• Protection against :Benign tumour – Benign breast disease, Ovarian functional cyst, Fibromyoma uterus
• Protects – PID, Anemia, Endometriosis, PCOD, Acne, hirsutism, Rheumatoid arthritis, Osteoporosis

Ans. is C. i.e. Endometrial cancer

According to the National Cancer Institute (NCI) , using birth control pills may slightly lower your risk for endometrial and ovarian cancers. 

Long-term use may slightly increase your risk for breast, liver, and cervical cancers.

Breast cancer

• Improvement of acne
• Prevention of atherogenesis
• Inhibition of hirsutism progression
• Decreases risk of ectopic pregnancy
• Decreases activity of rheumatoid arthritis
• Improves dysmenorrhea from endometriosis
• Decreases risk of endometrial and ovarian cancer
• Reduces various benign breast diseases
• Reduces menstrual blood loss and anemia
• Decreases the incidence and severity of acute salpingitis

Oral contraceptives are useful in preventing endometrial cancer, ovarian and colorectal cancer. But it increases the risk of development of breast cancer in carriers of BRCA1 and possible BRCA2.

Other noncontraceptive benefits includes its use in reduction of dysmenorrhea, menorrhagia, mittleschmerz syndrome, PID, ectopic pregnancy, endometriosis , fibroid uterus, rheumatoid arthritis and autoimmune disorders of thyroid.

Ref: Reproductive Health and Cancer in Adolescents and Young Adults By Gwendolyn P. Quinn, page 45; Harrison’s Principles of Internal Medicine 18th edition, chapter 347;  Textbook of Gynecology by D C Dutta 4th edition  Page 446-7.

Ans. A i.e. Hepatic adenoma

OCP’s administration may result in hepatic adenoma.

Oral contraceptive pills
Protects against:

– Uterine Ca,

– Ovarian Ca,

– RA,

– Endometriosis etc.

Ans. C i.e. Ectopic pregnancy

OCP reduces the incidence of ectopic pregnancy because of suppression of ovulation, and reduction in PID

Ans. C: Ovarian tumor

Combined oral contraceptives are generally accepted to be contraindicated in women with pre-existing cardiovascular disease, in women who have a familial tendency to form blood clots (such as familial Factor V Leiden), women with severe obesity and/or high cholesterol level), and in smokers over age 40.

COC are also contraindicated for women with Liver tumors, hepatic adenoma or severe cirrhosis of the liver, and for those with known or suspected breast cancer. (WHO category 4).

Ans. is ‘a’ i.e., Estrogen

Hepatotoxicity with oral contraceptive pills

• While early formulations of OCPs were associated with frequent serum enzyme elevations, current formulations and hormonal replacement therapy have not been linked to ALT or alkaline phosphatase elevations at rates any higher than occur with placebo.
• Estrogens in OCPs can cause mild inhibition of bilirubin excretion leading to jaundice in patients with inherited forms of bilirubin metabolism such as the Dubin Johnson syndrome.
• It can induce a clinically apparent cholestatic liver injury which typically arises during the first few cycles of therapy, and rarely after the six months.
• It has also been linked to hepatic tumors, both benign and malignant.

Ans:A.)OCP

Carcinoma shown: Breast cancer

Risk factors for the development of invasive breast cancer include:

• Female gender: The incidence of breast cancer in women exceeds that in men.
• Age: Risk increases with age between the third and eighth decades.
• Age at birth of first child: If aged 30 years or older, relative risk is 2 times that of patients who gave birth when younger
  than 20 years.So first child at early age is protective. Nulliparous women is more prone for breast carcinoma.
• Personal history of breast cancer: This factor depends on patient age at time of diagnosis. Risk is increased for younger women.
• Noninvasive carcinoma (ductal carcinoma in situ (DCIS)/lobular carcinoma in situ (LCIS)) on previous biopsy: This also is a marker for development of invasive lesions.
• Benign proliferative changes with atypical hyperplasia: These may increase relative risk by 4 times.
• Early menarche and late menopause: These also are associated weakly with increased relative risk of breast cancer.
• Menopausal hormone replacement therapy: the combination use of estrogen with progestin has been associated with an greater risk of breast cancer, particularly of lobular carcinoma. Increased risk is also related to increased duration of use; this risk can be reduced over time, following the termination of hormone replacement therapy.
• Family history: Degree of relativity of the family member with breast cancer affects individual risk.
• Genetic predisposition: Approximately 5-10% of breast cancer cases are primarily attributable to inherited factors. The risk of breast cancer in carriers of BRCA1 mutation is estimated to be 36-87%.