A 32-year-old woman, gravida 0, comes to your office for contraception counselling, specifically about insertion...

Comprehensive and Detailed Explanation:

The levonorgestrel-releasing intrauterine device (LNG-IUD) is generally contraindicated in current or recent breast cancer due to the progestin component, but may be considered in select patients on tamoxifen, especially if non-hormonal options are unsuitable. Consultation with the oncologist is required to evaluate risks and benefits.

Toronto Notes 2023 – Gynecology, “Contraception in Special Populations”:

“Levonorgestrel IUDs are generally avoided in patients with a history of hormone-sensitive cancers; however, decisions should be made collaboratively with oncology.”

MCCQE1 Objectives (Gynecology > 82-2: Contraception):

“Candidates must tailor contraceptive advice to patients with medical comorbidities, including cancer survivors.”

Irregular bleeding (A) is a common but not contraindicating side effect. No pre-procedure antibiotics (D) are typically needed. The IUD does not cause infertility (E). Risk of recurrence (C) is unconfirmed and must be individualized.

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