In general population samples, oral contraceptives (OCs) have been observed to be weakly associated with risk of breast cancer up to 10 years after a woman discontinues use.1 Much less is known, however, regarding this association among women with a familial predisposition to breast cancer; while some studies have shown a higher risk among women with a family history,2-6 others have found little or no such evidence.7-18 Observational studies have demonstrated a reduction in risk of ovarian cancer with OC use. As a result, women from high-risk breast-ovarian cancer families are often counseled to take OCs to reduce their ovarian cancer risk.19,20 However, a small study of Ashkenazi Jewish women with breast cancer suggests that OC use may increase the risk of breast cancer more in carriers of BRCA1 or BRCA2 mutations than in noncarriers.21