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DMPA and breast cancer history — DFSRH MCQ

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HardProgestogen-only methodsDMPA and breast cancer historyDFSRH

A 40-year-old treated for oestrogen receptor-positive breast cancer 3 years ago requests DMPA. She is on tamoxifen, has no evidence of recurrence and has heavy periods. What is the most appropriate contraceptive advice?

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Correct answer: B — Use a highly effective non-hormonal method such as Cu-IUD

Recent breast cancer makes hormonal contraception generally unsuitable, including progestogen-only methods, because of concern about hormone-sensitive recurrence. A copper IUD is highly effective and non-hormonal. Tamoxifen can cause bleeding problems, but contraception should not rely on progestogen exposure without specialist consideration.

Reference: FSRH UKMEC; FSRH Supporting Contraceptive Choices After Breast Cancer