Breast cancer risk of hormonal contraception and hormone replacement therapy: how to counsel and reassure patients considering recent evidence. Lino Del Pup*, Angelamaria Becorpi# *Gynecology Oncology, National Cancer Institute, Aviano, PN, Italy # Multidisciplinary Group of Integrative Medicine for Postmenopause Women’s Health after Cancer -Careggi University Hospital Florence On Behalf of the Italian Society of Third Age Gynecology (SIGiTE) Objective - the recent study by Morch (N Engl J Med 2017;377:2228-39) current and recent users of hormonal contraception (HC) have a relative risk of breast cancer (BK) 1.20 (95% CI, 1.14 to 1.26). The absolute risk is 13 (95% CI, 10 to 16) per 100,000 person years: one extra BK for every 7690 women using HC for 1 year. This nationwide epidemiologic analysis of newer HC, were 1.8 million women who were followed on average for 10.9 years (a total of 19.6 million person-years), could induce the press and lay public to think that HC and hormonal replacement therapy (HRT) have very similar and high BK risk. Methods – Review - Result(s) In It is a duty of Scientific Societies to properly inform on the radical differences in composition and effect of HC and HRT and that the very different hormonal milieu where they act in pre e postmenopause. An objective exposure of the comparative absolute risks and adequate strategies of counseling should therefore be used to improve user compliance. - Conclusions Withholding HC or HRT , if there are not contraindications, with the only aim of reducing BK risk is useless and it could even be counter effective as these treatments have important beneficial effects, like a reduced risks of ovarian and endometrial cancer for HC and improved quality of life for HRT.