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To view a printer friendly version of this document, click here. Abortion - A Preventable Risk Factor Two Ways That Abortion Raises Breast Cancer Risk
Expert Testimony From the Center For Reproductive Law and Policy Medical Authorities Acknowledge Link Privately, Not Publicly World’s First Known Abortion-Breast Cancer Settlement
ABORTION-BREAST CANCER SUMMARY The coalition was organized in 1999 by a group which includes cancer survivors, women who’ve had abortions and others whose family members have had the disease. We came together because of our deep concern that women haven’t been informed about strong biological evidence and epidemiological research published since 1957 which provide overwhelming support for a cause and effect relationship between abortion and breast cancer. More than two dozen peer-reviewed studies conducted in different parts of the world report increased risk. Most of these studies were conducted by scientists describing themselves as abortion supporters. Many physicians, however, are unaware of the research because they’ve not been educated by the “gatekeepers” in organized medicine. Other physicians may be aware of the research, but refuse to acknowledge the preponderance of the evidence because of personal ideology or their own involvement in performing or referring patients for abortions. Regardless of personally ideology, physicians who fail to inform their abortion-bound patients of the breast cancer risk, violate their legal duty to obtain informed consent and expose themselves to the risk of medical malpractice lawsuits. Only a few decades ago, breast cancer was known to be a grandmother’s disease. Because of abortion, it has become a young woman’s disease, and breast cancer rates have skyrocketed over 40% since the surgical procedure was legalized in the U.S. in 1973. Observing that breast cancer has emerged as a young woman’s illness only in recent decades, New Jersey breast cancer surgeon, Angela Lanfranchi, M.D., F.A.C.S., declared under oath in a California lawsuit that she has discussed the research with many physicians and encouraged them to get reproductive histories from their patients. Among the doctors who have obtained these histories, they’ve “found as I did that ... cases of breast cancer in young women are associated with an abortion history.” [[Agnes Bernardo, Pamela Colip, and Saundra Duffy-Hawkins v. Planned Parenthood Federation of America and Planned Parenthood of San Diego and Riverside Counties; Superior Court of the State of California, County of San Diego, August 15, 2001] Our purpose is to educate women about abortion as a risk factor for breast cancer, help preserve their health and save lives. Women have the exclusive right to be decision makers where their own health care is concerned. This is why we’ve provided a comprehensive listing all of the research in order to give women the opportunity to review it and decide for themselves whether or not abortion causes breast cancer. ABORTION -- A PREVENTABLE RISK FACTOR It is not true that all women who have breast cancer have had abortions. It’s also untrue that all women who’ve had abortions will get breast cancer. Induced abortion is only one of the risk factors for the illness. However, it is the most preventable risk factor for breast cancer. TWO WAYS THAT ABORTION RAISES BREAST CANCER RISK There are two ways that abortion raises a woman’s risk for breast cancer. The first way is not debated. It’s called the "protective effect of childbearing," and scientists have acknowledged this effect for centuries. The second way is debated, and scientists have studied this effect - known as the "independent link" - since 1957. It has to do with this question: Does an abortion leave a woman with more cancer-vulnerable breast tissue than she had before she became pregnant? Scientists first observed in the 17th century that women’s reproductive histories impacted their risk for breast cancer when it was noticed that nuns were at high risk for the disease. Scientists surmised that childbearing provides women with increased protection. Today’s medical experts agree that the best way women can reduce their lifetime risk for breast cancer is by: 1) Having an early first full term pregnancy (FFTP) starting before age 24; 2) Bearing more children; and 3) Breastfeeding for a longer lifetime duration. It’s undeniable that abortion causes women to change their childbearing patterns. It leads them to forego the protective effects of early FFTP, increased childbearing and breastfeeding. Consequently, scientists do not debate that it increases breast cancer risk in this first of two ways. Despite these truths, there is not one cancer fundraising business that uses the phrase, "Abortion raises breast cancer risk." Not one of them has ever denounced Planned Parenthood for depriving women of the protective effect of childbearing or acknowledged that abortion contributes to the nation’s breast cancer rates at least in this way. If childbearing reduces breast cancer risk, then choosing not to have that child means a greater breast cancer risk for the woman. Therefore, there is no debate among scientists that the woman who aborts has a greater breast cancer risk than does the woman who has a baby (assuming that her pregnancy lasts at least 32 weeks). The Strongest Protective Factor Medical experts have universally recognized since the publication of a landmark Harvard study in 1970 that the earlier a woman has her first full term pregnancy (FFTP), the lower her risk for breast cancer is. [MacMahon et al. (1970) Bulletin of the World Health Org 43:209-21] Anti-cancer groups tell women that late FFTP (30 years of age or older) increases risk, but this is a half truth. A late FFTP is at age 24 or older. Each year that a woman delays her FFTP, her risk climbs markedly. A subsequent Harvard study reported that for each one year delay of a first full term pregnancy, risk is elevated 3.5%. [Trichopolous D, Hsieh Cc, MacMahon B, Lin T, et al. Age at Any Birth and Breast Cancer Risk. International J Cancer (1983) 31:701-704] Nancy Krieger, PhD, wrote in 1989 that early FFTP had “emerged as the strongest protective factor” against the disease. [Breast Cancer Research and Treatment, 13:205-223] Joel Brind, PhD, the lead author of the only comprehensive review and meta-analysis of the abortion-breast cancer research, stated in an affidavit in a California lawsuit that a single year’s delay of a FFTP impacts a woman’s risk of dying from breast cancer so greatly that it is about 10 times more than her risk of dying in childbirth. [Lawsuit referenced above] For this reason, we encourage married women not to delay their FFTPs. We do, however, encourage abstinence before marriage. Increased Childbearing and Breastfeeding Scientists have long considered breastfeeding a likely protective factor, but this wasn’t confirmed until recently. In July 2002, a large meta-analysis of 47 epidemiological studies conducted in 30 countries and published in the British medical journal, Lancet, determined that women can reduce their relative risk of the disease by 4.3% for every 12 months of breastfeeding and 7.0% for each birth. It was concluded that skyrocketing breast cancer rates in the developed nations could be reduced by more than one-half if only women would bear more children and breastfeed for longer duration. [Beral, V (July 20, 2002) Lancet 360:187-95] Second Way - The Independent Link: An Increase in Cancer-Vulnerable Breast Tissue Abortion has been implicated with breast cancer in yet another way, however, and estrogen overexposure is the explanation for it. There is staggering evidence of an independent link between abortion and breast cancer. What this means is that a woman who has an abortion is left with more cancer-vulnerable cells than she had before she ever became pregnant. Biological evidence and more than two dozen studies worldwide support a cause and effect relationship. Fifteen studies were conducted on American women, and 13 of them reported risk elevations. Seven found a more than a twofold elevation in risk. Seventeen are statistically significant, 16 of which demonstrated a positive association. The term “statistical significance” means that scientists are at least 95% certain that their findings are not due to chance or error. The evidence of a causal relationship between abortion and breast cancer isn’t only based on a statistical relationship either. Scientists also require biological evidence and a reasonable biological explanation before concluding that there’s a causal relationship. These requirements have been met. Researchers were able to demonstrate that 77.7% of a group of rats given abortions could be caused to develop breast cancers with the carcinogen DMBA. On the other hand, 0% of the rats allowed to have a full term pregnancy, but not allowed to nurse their pups, developed tumors when exposed to DMBA. Among a group of 9 rats allowed to have a full term pregnancy and nurse their pups, only one developed a tumor. Among two groups of virgin rats, 66.7% and 71.4% developed tumors after being exposed to the carcinogen. Rats with abortion histories were at the greatest risk of all 5 groups. The experiment demonstrated that an induced abortion resulted in close to a 80% risk elevation among rats. [Russo J, Russo IH (1980) Am J Pathol 100:497-512] Most of the risk factors associated with breast cancer involve estrogen overexposure. Women who experience more menstrual cycles are exposed to higher levels of estradiol, a form of estrogen, over the course of their lifetimes. Women who reach puberty at an early age or menopause at a late age or who have fewer or no children, experience more menstrual cycles. Ergo, they are known have a higher risk of breast cancer. Women who have more children and who nurse them, on the other hand, experience fewer menstrual cycles and reduce their risk of breast cancer by doing so. Similarly, a low fat diet and avoidance of alcohol reduce a woman’s exposure to estrogen. Estrogen is a secondary carcinogen. It promotes the growth of normal and abnormal tissue. In fact, estrogen replacement therapy, which is generally the same chemical form as the estrogen naturally produced by a woman’s ovaries, was included on our nation’s list of known carcinogens in 2001. For an exhaustive explanation of estrogen’s role in the promotion of breast cancer, see the Web Site for the Breast Cancer Prevention Institute at and click on “The Estrogen Connection,” www.BCPInstitue.org. Biological Explanation for the Link The explanation for the independent link makes good biological sense. It remains unrefuted and unchallenged by scientists because it is physiologically correct. A never-pregnant woman has a network of primitive, immature and cancer-vulnerable breast cells which make up her milk glands. It is only in the third trimester of pregnancy - after 32 weeks gestation - that her cells start to mature and are fashioned into milk producing tissue whose cells are cancer resistant. When a woman becomes pregnant, her breasts enlarge. This occurs because a hormone called estradiol, a type of estrogen, causes both the normal and pre-cancerous cells in the breast to multiply terrifically. This process is called “proliferation.” By 7 to 8 weeks gestation, the estradiol level has increased by 500% over what it was at the time of conception. If the pregnancy is carried to term, a second process called “differentiation” takes place. Differentiation is the shaping of cells into milk producing tissue. It shuts off the cell multiplication process. This takes place at approximately 32 weeks gestation. If the pregnancy is aborted, the woman is left with more undifferentiated -- and therefore cancer-vulnerable cells -- than she had before she was pregnant. On the other hand, a full term pregnancy leaves a woman with more milk producing differentiated cells, which means that she has fewer cancer-vulnerable cells in her breasts than she did before the pregnancy. In contrast, research has shown that most miscarriages do not raise breast cancer risk. This is due to a lack of estrogen overexposure. Miscarriages are frequently precipitated by a decline in the production of progesterone which is needed to maintain a pregnancy. Estrogen is made from progesterone, so the levels of each hormone rise and fall together during pregnancy. For a thorough biological explanation of the abortion-breast cancer link, see this second website for the Breast Cancer Prevention Institute, www.BCPInstitute.org and click on its online booklet, “Breast Cancer Risks and Prevention.” The first epidemiological study was reported in an English language journal in 1957. Researchers found a 160% elevation in risk among women who’d obtained abortions. [Segi M., et al. GANN (1957); 48 (Suppl): 1-63] The first study to examine the abortion-breast cancer link among American women was published in 1981 and reported that abortion “appears to cause a substantial increase in risk of subsequent breast cancer.” A 140% risk elevation was reported. [Pike MC et al., British Journal of Cancer (1981;43:72-6] Howe et al. 1989, the only statistically significant study conducted on American women in which medical records of abortion were used, not interviews after the fact, reported a 90% increased risk of breast cancer among women in New York who had chosen abortion. [Howe et al. (1989) Int J Epidemiol 18:300-4] Our bar graphs reveal the relative risk found for each epidemiological study. These graphs were developed for our website by Chris Kahlenborn, M.D., author of the book, Breast Cancer, Its Link to Abortion and the Birth Control Pill. World’s Only Comprehensive Review and Meta-Analysis In 1996, Professor Joel Brind of Baruch College in New York and his colleagues at Pennsylvania State Medical College conducted a review and meta-analysis of the studies. A meta-analysis pools together the data from the studies in an area of medicine - in this case, the abortion-breast cancer research - and comes up with an overall risk for a particular risk factor. The Brind team, half of whom included abortion supporters, found an overall 30% elevated risk among women choosing abortion after first full term pregnancy (FFTP) and a 50% elevated risk among women choosing abortion before FFTP. [Brind, et al. Jrnl of Epidemiol Community Health (1996);50:481-96] Number of Additional Breast Cancer Cases The average American woman already has a high lifetime risk of breast cancer - 12.5%. One in 8 women can be expected to be diagnosed with the disease in her lifetime. If this already high lifetime risk is increased by even a small percentage - 30% - then many thousands more women will develop breast cancer who would not otherwise have developed it. Using conservative figures, Dr. Brind has estimated that there are presently an additional 5,000 to 8,000 cases of breast cancer per year due to earlier abortions and that by the year 2020 there will be an additional 40,000 to 50,000 cases of breast cancer yearly. Royal College of Obstetricians and Gynecologists On March 13, 2000 the U.K.'s Royal College of Obstetricians and Gynecologists became the first medical organization to warn its abortion practitioners, saying that Dr. Brind's review was methodologically sound and that the abortion-breast cancer research "could not be disregarded." [“Evidence-based Guideline No. 7: The Care of Women Requesting Induced Abortion” (2000) RCOG Press, p. 29-30] Later that summer after the London press learned of the RCOG’s warning, the BBC and The Guardian strenuously objected. Angry, post-abortive women, who hadn’t been informed of the breast cancer risk, called their doctors to learn what they could do to reduce their risks and otherwise protect their health. After being intimidated by members of the press who don't respect human life, the RCOG put its tail between its legs and dutifully withdrew the warning. The incident reveals the cowardice of the RCOG’s leadership. It demonstrates what the medical group was willing to say when it thought it was politically safe to do so. Today, the RCOG says that the relationship between abortion and breast cancer is "inconclusive." The group repeats the falsehood that the abortion-breast cancer studies which relied on interviews, not medical records, contain a bias called "report bias." This hypothetical problem proposes that studies, which use interviews, are inherently flawed because there is allegedly a difference in the reporting levels between healthy women and unhealthy women. In other words, healthy women lie or underreport their abortions, but unhealthy women don’t. However, a far more reasonable hypothesis is that women, who don’t want to report their abortions to researchers truthfully, would refuse to participate in these studies in the first place. If the RCOG’s claim of report bias were true, then the findings of scientists who relied on interviews would be inaccurate and artificial. However, the RCOG provides no citations to support its claim because there are none. The RCOG expects women to accept its phantom theory as if it were a fact. Truth is, there are no scientists who presently claim to have found credible evidence of such a bias or difference in reporting levels. The RCOG says it relies on the supposed findings of an abortionist, David Grimes, who is affiliated with the population control group, Family Health International. Despite the fact that Grimes clearly does not respect human life, the RCOG repeats his unsupported assertion that the studies which relied on medical records are superior to those relying on interviews. One especially disturbing study on women was done by Dr. Janet Daling and her colleagues at Seattle’s Fred Hutchinson Cancer Research Center in 1994. Dr. Daling, an abortion supporter, found that “among women who had been pregnant at least once, the risk of breast cancer in those who had experienced an induced abortion was 50% higher than among other women.” Daling’s team found that teenagers under age 18 and women over 29 years of age who procure an abortion increase their breast cancer risk by more than 100%. Those with a family history of the disease increase their risk 80%. Daling’s most alarming finding was that teenagers with a family history of breast cancer who procure an abortion face a risk of breast cancer that is incalculably high. All 12 women in her study with this history were diagnosed with breast cancer by the age of 45. [Janet R. Daling et al., “Risk of Breast Cancer Among Young Women: Relationship to Induced Abortion,” 86 Journal of the National Cancer Institute; (1994);1584] The 1997 and 1999 Melbye Studies The abortion industry relies heavily upon Melbye et al. 1997, a study conducted on Danish women, to dispute the abortion-breast cancer link and dismiss more than two dozen studies finding risk elevations. However, even this study reported that “{w}ith each one-week increase in the gestational age of the fetus...there was a 3 percent increase in the risk of breast cancer.” The researchers, nevertheless, reported no overall positive association between abortion and breast cancer. [Melbye, et al. “Induced Abortion and the Risk of Breast Cancer,” New England Journal of Medicine (1997);336:81-5] The Brind team argued in a letter to the New England Journal of Medicine that serious errors of misclassification and data adjustment in the Melbye study likely masked a significant risk increase. For instance, 60,000 women whose abortions were recorded in the Danish Life Statistics between 1940 and 1973 were counted by Melbye et al. as not having had abortions, although a number of them developed breast cancer. Additionally, Melbye and colleagues started recording breast cancer cases in 1968, but recorded abortions starting in 1973. It is clearly unscientific to start counting cases of a disease before the proposed cause of that disease. [Joel Brind & Vernon Chinchilli, Letter, ” Induced Abortion and the Risk of Breast Cancer,” 336 New England Journal of Medicine (1997) 1834-35] In addition, Melbye and colleagues implicitly corrected these errors in a subsequent study in 1999. [Melbye M., Wohlfahrt J., Anderson A.M., Westergaard T., Andersen P.K., “Preterm Delivery and Risk of Breast Cancer,” British Journal of Cancer (1999);80:609-613] In February of 2000, the New England Journal of Medicine, possibly the world’s most influential medical journal, admitted evidence of an abortion-breast cancer link in the text of an article written by researchers at the University of Pennsylvania School of Medicine, in spite of having published the much criticized Melbye study three years earlier. In reviewing risk factors for breast cancer the article stated, "Other risk factors have been less consistently associated with breast cancer (such as diet, use of oral contraceptives, lactation, and abortion)." [Armstrong K., et al., “Assessing the Risk of Breast Cancer,”NEJM (2000);342:564-71] EXPERT TESTIMONY FROM THE CENTER FOR REPRODUCTIVE LAW AND POLICY Center for Reproductive Law and Policy expert, Dr. Lynn Rosenberg, a Boston University Medical School epidemiologist, testified in the fall of 1999 in a Florida case on the abortion-breast cancer link. When asked by an attorney whether a pregnant 15 year old who aborts her pregnancy has a higher risk of breast cancer than one who carries her pregnancy to term, Dr. Rosenberg answered, “Probably, yes." [Dr. Joel Brind, “ABC in the Courts: Dramatic ABC Testimony in Florida’s Parental Notification Appeal,” Abortion-Breast Cancer Quarterly Update, (Fall, 1999) Vol. 2, No. 3, p. 1]. In July 1998, Congressman Tom Coburn M.D., an obstetrician-gynecologist, questioned a representative from the National Cancer Institute (NCI), Dr. Edison Liu, during a Commerce Committee hearing on the State of Cancer Research. Congressman Coburn accused the NCI of misleading the public and "selectively releasing data" on the abortion-breast cancer link. Dr. Brind accused the NCI of publishing an “outright lie” about the research on its website. Its website in 1999 said, “The scientific rationale for an association between abortion and breast cancer is based on limited experimental data in rats and is not consistent with human data.” Commenting on this falsehood from the NCI, Dr. Brind said, “It is consistent with human data, and it is not just based upon limited data and rats. There is all the other biological evidence of what happens during pregnancy and what it is that makes breast cancer cells grow and what is the difference between a spontaneous and induced abortion. In other words, the whole biological story is consistent.” [Transcript of the talks by Professor Joel Brind and Professor Robert Burton at an Endeavour Forum Public Meeting on the 24th of August 1999, at Malvern, Vic. 3144, Australia] After Congressmen Coburn and Dave Weldon, M.D. and other members of Congress called for hearings into the NCI’s scientific misconduct, the NCI revised its web site in 1999 and removed its falsehood. Nevertheless, its web page discussing the abortion-breast cancer link, as well as its web pages later published, remained conspicuous for what they still did not tell women (i.e., the number of studies - worldwide and American - reporting increased risk; the number of studies reporting a more than twofold risk elevation; the number of statistically significant studies and the biological evidence). On June 7, 2002, twenty-eight members of Congress, including Congressmen Weldon and Coburn, sent a letter and petition with their own fact sheet to the Secretary of Health and Human Services, Tommy Thompson. They objected to the NCI’s reliance on Melbye et al. 1997, labeled it a “flawed study,” and called the NCI’s fact sheet “scientifically inaccurate and misleading to the public.” They pointed out that the NCI fact sheet erroneously stated, “The current body of scientific evidence suggests that women who have had either induced or spontaneous abortions have the same risk as other women for developing breast cancer.” Addressing this claim, the Congressmen asserted, “This glossing over of the weight of published scientific evidence does not provide the public with the information they deserve.” The Congressmen asked Secretary Thompson to have the fact sheet “reevaluated for accuracy and bias.” Later that month, the NCI web page was taken down. MEDICAL AUTHORITIES ACKNOWLEDGE LINK PRIVATELY, NOT PUBLICLY There is good reason to believe that medical authorities at the highest levels of organized medicine are aware that abortion causes breast cancer, but they will not speak of it publicly because it is political dynamite. Angela Lanfranchi, M.D., declared under oath in the lawsuit, Bernardo et al. v. Planned Parenthood, et al., that “Over the past three or four years, I have spoken with many authorities and people in a position to be well-informed. Some have been straightforward and said that they know it is a risk factor but felt it was ‘too political’ to speak about.” [Lawsuit referenced above] John Kindley, an attorney who authored an article for the Wisconsin Law Review in 1999, discussed the issues of informed consent and the abortion-breast cancer connection. Informed consent is a legal obligation requiring physicians to fully inform their patients of the risks associated with any surgical procedures recommended by them. Mr. Kindley argued that physicians who do not inform their patients of the breast cancer risk expose themselves to considerable legal liability and can be sued for medical malpractice. He represents a North Dakota woman in a false advertising suit against a clinic which was distributing a pamphlet denying the existence of studies reporting increased risk among women choosing abortion. Mr. Kindley explains how the increased risk of breast cancer resulting from an induced abortion impacts a woman’s lifetime risk: “The real significance of a relative risk increase depends upon the background risk which is increased. For example, although smoking increases the risk of lung cancer by a factor of 10.0, the background risk of lung cancer for nonsmokers is very low. By contrast, an average American woman’s lifetime risk of breast cancer is about twelve percent. A 1.3 relative risk increase from an induced abortion would therefore indicate about a four percent increase in absolute terms. Estimating a twenty-five percent mortality rate, this figure would suggest that about 1 out of 100 women who have had an induced abortion die from breast cancer attributable to the abortion.” www.johnkindley.com, “The Fit Between the Elements for an Informed Consent Cause of Action and the Scientific Evidence Linking Induced Abortion with Increased Breast Cancer Risk,” Wisconsin Law Review, (1999); Vol. 1998, No. 6; p. 1620] Congressman Dave Weldon M.D. sent a “Dear Colleague” letter and a copy of Mr. Kindley’s law review article to all members of the U.S. House of Representatives on August 24, 1999. He discussed the duty of physicians to properly inform patients of the risks associated with surgical procedures. Dr. Weldon called abortion a “significant health risk” and a “health care time-bomb” in his letter. WORLD’S FIRST KNOWN ABORTION-BREAST CANCER SETTLEMENT The world’s first known abortion-breast cancer settlement was reported in Australia in 2001. An Australian woman who’d obtained an abortion sued her physician for medical malpractice. She claimed he failed to inform her of the research linking abortion with breast cancer and the possibility of emotional damage which she might suffer as a result of her abortion. Although she hadn’t developed breast cancer, her attorney, Charles Francis, said she nevertheless received a significant sum. [Patrick Goodenough, “First Case Linking Abortion-Breast Cancer Settled,” Cybercast News Service, www.CNSNews.com, January 4, 2002] Women have the right to know about the abortion-breast cancer research. In fact, we find it paternalistic that women have been prevented from making informed choices about this women’s health issue. Public health authorities have been seriously remiss about educating women and their doctors about the weight of the research. These authorities include: the National Cancer Institute, research scientists and the nation’s anti-cancer organizations whose own web pages discussing the research, in some cases, cite irrelevant studies for which no abortion data were collected. Others contain much misinformation, omissions of most or all of the studies, half truths and even fabrications. Because of induced abortion, anti-cancer organizations guarantee themselves an ever increasing pool of donors who’ve been unwittingly victimized by this cover up - breast cancer patients, survivors and their family members. Many of these donors have become activists who’ve lobbied Congress for billions of dollars of taxpayer money to support increasingly more research into the causes of breast cancer and methods of prevention. We’re not opposed to research, but any anti-cancer organization which fails to truthfully inform women about what scientists have known for five decades and taxpayers and donors have paid for has no right to continually return to the wells of public or private money. We seek to reach women -- and those who love them -- with life-saving information, and our cause is extremely urgent. Will you help us to ensure that the public is finally told the truth about abortion? Please share this information with others and send us your donation now to help with our cause. Donations can be mailed to the Coalition on Abortion/Breast Cancer, P.O. Box 152, Palos Heights, Illinois 60463. Our coalition is recognized by the IRS as a 501(c)3 organization. |
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