There was a very recent New York Times article that examined the a recently published study that looked at 78,595 women in Denmark between the ages of 15 to 49 years who used levonorgestrel IUDs (Mirena, Liletta, Kyleena, Skyla) and compared them to 78,595 women who did not use the devices but otherwise had similar profiles. This study found that the group using levonorgestrel IUDs had a 40 percent higher chance of developing breast cancer. I could not access this study but I was really interested in what other recent research has said, especially given my understanding of the benefits of IUDs and my experience in clinic with many contraception-hesitant patients.
The study in the article I chose was published in 2020 and it also aimed to assess the relationship between the use of the levonorgestrel intrauterine system (LNG-IUS) and the risk of breast cancer. I chose this article because it was of the highest level of evidence (the authors conducted a systematic review and meta-analysis of studies published between 1999 and 2019) and the results were as follows: 1) the meta-analysis – which included 7 studies; 3 case-control and 4 cohort – showed a modest increase in breast cancer risk among LNG-IUS users, particularly in women aged 50 and older; 2) 4 of the 8 studies included in the systematic review reported an increased risk of breast cancer in LNG-IUS users, particularly in postmenopausal women and with long-term use.
So clinically, the findings do suggest a potential link between LNG-IUS use and breast cancer risk, particularly for prolonged use in older women. But the authors did note that the variation in study designs, adjustments for breast cancer risk factors, and heterogeneity among the results suggest interpretation of these findings should be cautious. I think having this more recent research provides really great insight into how healthcare providers can discuss contraceptive options for patients for healthcare providers, especially those with concerns about breast cancer risk or who are close to perimenopause or older.
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