How do you counsel a woman regarding her previous hormonal contraception and the risks with her newly diagnosed invasive breast cancer?

I believe the risk of breast cancer from the use of hormonal contraception is very small, in the absence of other contributing risk factors such as family history.

A recent 2017 NEJM article (Morch et al) assessed the associations in a large cohort of 1.8 million women in Denmark followed for > 10 years. Compared to women who had not used hormonal contraceptives, the overall absolute increase in breast cancers diagnosed among current and recent users of any hormonal contraceptive was very small 13 per 100,000 person-years, or approximately 1 extra breast cancer for every 7690 women using hormonal contraception for 1 year.

The study did not adjust for age at menarche, breast-feeding, alcohol consumption, or physical activity, and information o...