COMMENTARY ON THE STUDY,
DELELLIS HENDERSON ET AL. 2008
The study by Katherine DeLellis Henderson and her colleagues is a prospective study known as the California Teachers Study. [1] It was funded by several governmental agencies including the U.S. National Cancer Institute, the California Department of Health Services and the Centers for Disease Control and Prevention.
Biologic Plausibility
DeLellis Henderson's team acknowledged the plausibility of the biological reasons for an abortion-breast cancer (ABC) link. Research by Irma and Jose Russo provides biological evidence showing that childless women have immature cancer-susceptible breast lobules that multiply under the influence of an increased estrogen level early in a normal pregnancy, but not during an abnormal pregnancy (i.e., most first trimester miscarriages) because the estrogen level is not elevated. The breast lobules do not mature into fully cancer-resistant lobules until the last months of a full term pregnancy. [2,3]
This illustrates how abortion raises risk in two ways:
1) It denies women an opportunity to mature their breast tissue into cancer-resistant tissue at an early age (the protective effect of a full term pregnancy); and
2) It leaves women with more places for breast cancers to start (the "independent link").
Abortion can increase risk in a third way. The Institute of Medicine acknowledges that abortion puts women at risk for a subsequent premature birth. [4] Other research shows that a premature birth before 32 weeks gestation increases breast cancer risk. [5,6,7,8]
Flaws in the Study, DeLellis Henderson et al.
The study, DeLellis Henderson et al., includes a number of serious flaws that resulted in an underestimation of the breast cancer risk. Researchers claimed their data refuted two breast cancer risks associated with abortion - loss of the protective effect of a full term pregnancy (an accepted risk) plus the independent link (a contested risk).
First, DeLellis Henderson's team made a novel claim that women who have abortions and those who have full term pregnancies have a "similar risk" of breast cancer. Standard medical texts have acknowledged the risk-reducing effect of a full term pregnancy for decades. This team's claim runs counter to a half-century of evidence, so it's very unusual that the authors would fail to provide any data whatsoever to support it.
Instead of comparing the effects of having an abortion with having a full term pregnancy - which they PRETENDED to do - the researchers underestimated the risk by using an inappropriate comparison group that does not realistically reflect the choice that a pregnant woman makes: Instead of comparing women who aborted their first pregnancy to women who had carried their first pregnancy to term, they compared women who had aborted their first pregnancy to women who had never been pregnant!
The authors continued the charade of conflating induced abortion with spontaneous miscarriage, which, being a different sort of event entirely, does not raise breast cancer risk, as does induced abortion.
Second, DeLellis Henderson and her colleagues claimed abortion does not leave the breasts with more places for cancers to start. Nearly one in five of the women who developed breast cancer in the study - 708 women with in situ breast cancer - were counted as not having breast cancer. In other words, they were counted as controls.
An Outright Lie
DeLellis Henderson's team included an outright lie about the study, Howe et al. 1989, by misrepresenting it as a "retrospective case-control" study "with potential for reporting bias, inappropriate referent group selection and lack of differentiation between spontaneous and induced abortion."
On the contrary, in the introduction to their study, Howe and her colleagues described it as "a population-based record linkage study" - a prospective study. [9] They said, "underreporting and inconsistent reporting" of abortions "occurred similarly among the cases and the controls. That means reporting bias was not a defect in the study because the medical records proved that breast cancer patients (cases) underreported their abortions at a rate similar to that of healthy women (controls).
Howe et al. reported a statistically significant 90% risk increase among New York women who had abortions. Contrary to the claims of DeLellis Henderson's team, Howe's group also included appropriate referent group selection and differentiation between spontaneous and induced abortions.
Howe et al. is a stumbling block for scientists with an aversion to the ABC link. They will often either ignore the study altogether and pretend that it does not exist or else they will misrepresent it. Howe et al. is problematic for them because it conflicts with their party line - that "studies with prospectively collected data, which ameliorate the potential introduction of reporting bias, have shown no evidence for an association between...induced abortion and breast cancer risk." [1]
The Number of Controls That Had Abortions Is Unknown
DeLellis Henderson never showed in any of their tables how many controls had induced abortions, but not cancer. It is not possible for other scientists examining their work to calculate the raw relative risk without the data. It is not possible to determine what the magnitude of their adjustment was.
Protecting Big Abortion from a Tsunami of Medical Malpractice Lawsuits
Since the publication of the 1996 review and meta-analysis of the worldwide research by Brind and his Penn State colleagues [10], more than a dozen attempts have been made within the scientific community to shoot it down and protect Big Abortion from a tsunami of medical malpractice lawsuits. Brind and other experts have shown that a pattern exists wherein scientists have authored over a dozen studies dismissing the ABC link that were subsequently proven in medical journals to be severely flawed. [11-21]
Leslie Bernstein, Ph.D. and the U.S. National Cancer Institute
Leslie Bernstein is a senior author in the study, DeLellis Henderson et al. In 2003, Bernstein served as the lead moderator at the U.S. National Cancer Institute's workshop on the ABC link [22] - a political sham in which the public was falsely assured that researchers conducted a comprehensive review of the worldwide research when, in fact, they only examined a small body of research showing no ABC link. Anyone caring to know the truth can watch the NCI's videocast of the workshop online. [23]
After the workshop, Bernstein told a journalist with CancerPage.com the reasons for her antipathy towards the ABC link. She said, "The biggest bang for the buck is the first birth, and the younger you are, the better off you are. I would never be a proponent of going around and telling them that having babies is the way to reduce your risk. I don't want the issue relating to induced abortion to breast cancer risk to be part of the mix of the discussion of induced abortion, its legality, its continued availability." [24]
Leslie Bernstein's name is on an earlier ABC link study, Mahue-Giangreco et al. 2003. [25] Professor Brind sent a letter to the editor of the medical journal Cancer Epidemiology Biomarkers and Prevention that was critical of the authors' research; but even though Brind is an international expert in this field, the journal's politically correct inquisitors rejected it for publication - a shocking, new method of censoring any dissent on the ABC link. (See his letter and the Coalition on Abortion/Breast Cancer's press release at:
<http://www.abortionbreastcancer.com/press_releases/040817/index.htm>)
References:
1. DeLellis Henderson K, Sullivan-Halley J, Reynolds P, Horn-Ross P, Clarke C, et al. Incomplete pregnancy is not associated with breast cancer risk: the California Teachers Study. Contraception 2008;77:391-396.
2. Russo J, Reina D, Frederick J, et al. Expression of phenotypical changes by human breast epithelial cells treated with carcinogens in vitro. Cancer Res 1988;48:2837-2857.
3. Russo J, Russo IH. Development of the human mammary gland. In Neville MD, Daniel C (ed). The Mammary Gland, Plenum, NY 1987:67-93.
4. Preterm birth: Causes, Consequences and Prevention. Press Release. Institute of Medicine, July 13, 2006. Available at:
<http://www.iom.edu/CMS/3740/25471/35813.aspx>.
5. Vatten LJ, et al. Pregnancy related protection against breast cancer depends on length of gestation. Br J Cancer 2002;87:289-90.
6. Innes K and Byers T. First pregnancy characteristics and subsequent breast cancer risk among young women. Int J Cancer 2004; 112:306-311.
7. Melbye M, Wohlfahrt J, Andersen A-M N, Westergaard T, Andersen PK. Preterm delivery and risk of breast cancer. Bri J Cancer 1999;80:609-13.
8. Hsieh C-c, Wuu J, Lambe M, Trichopoulos D, et al Delivery of premature newborns and maternal breast-cancer risk. Lancet 1999;353-1239.
9. Howe HL, Senie RT, Bzduch H, Herzfeld P. Early abortion and breast cancer risk among women under age 40. Int J Epidemiol 1989;18:300-304.
10. Brind J, Chinchilli V, Severs W, Summy-Long J. Induced abortion as an independent risk factor for breast cancer: a comprehensive review and meta-analysis. J Epidemiol Community Health 1996;50:481-496.
11. Brind J. The abortion-breast cancer connection. National Catholic Bioethics Quarterly Summer 2005; p. 303-329.
<http://www.AbortionBreastCancer.com/Brind_NCBQ.PDF>.
12. Brind J. Induced abortion as an independent risk factor for breast cancer: A critical review of recent studies based on prospective data. J Am Phys Surg Vol. 10, No. 4 (Winter 2005) 105-110. Available at:
< http://www.jpands.org/vol10no4/brind.pdf>.
13. Lanfranchi A. The abortion-breast cancer link. Ethics and Medics (January 2003) Vol. 28, No. 1.
14. Lanfranchi A. The abortion-breast cancer link revisited. Ethics and Medics (November 2004) Vol. 29, No. 11, p. 1-4. Available at:
http://www.abortionbreastcancer.com/news/041120/index.htm
15. Furton E. Editorial. The corruption of science by ideology. Ethics and Medics (Dec. 2004) Vol. 29, No. 11, p. 1-2. Available at:
http://www.abortionbreastcancer.com/E+MDec2004-EFurtonarticle.PDF
16. Schlafly A. Legal implications of a link between abortion and breast cancer. J Am Phys Surgeons 2005;10:11-14. Available at:
http://www.jpands.org/vol10no1/aschlafly.pdf
17. Lanfranchi A. The science, studies and sociology of the abortion-breast cancer link. Research Bulletin 2005;18:1-8. Available at:
http://www.abortionbreastcancer.com/June2005.pdf
18. Lanfranchi A. The breast physiology and the epidemiology of the abortion breast cancer link. Imago Hominis 2005;12(3): 228-236.
http://www.abortionbreastcancer.com/Lanfranchi060201.pdf
19. Brind J. Induced Abortion and Breast Cancer Risk: A Critical Analysis of the Report of the Harvard Nurses Study II. Journal of American Physicians and Surgeons (Summer 2007) Vol. 12, No. 2, p. 38-39. Available at:
<http://www.jpands.org/vol12no2/brind.pdf>.
20. Brind J. Breast cancer in relation to abortion: results from the EPIC study. Int J Cancer. 2008 Feb 15;122(4):960-1.
21. Rooney B. Letter. Abortion and Breast Cancer. J Am Phys Surg (Fall 2007) Vol. 12, No. 3, p. 67. Available at:
<http://www.jpands.org/vol12no3/correspondence.pdf>.
22. "Early Reproductive Events and Breast Cancer," National Cancer Institute. (February 2003). A list of NCI resources for this topic is available at:
<http://www.cancer.gov/cancertopics/ere>.
23. "Early Reproductive Events and Breast Cancer," National Cancer Institute videocast. Archive video of this Webcast can be viewed at:
<http://videocast.nih.gov>.
24. Lowe RM, NCI scientific panel concludes abortion has no impact on breast cancer risk. CancerPage.com, March 3, 2003. Available at:
<http://www.cancerpage.com/news/article.asp?id=5601>. Accessed June 9, 2008.
25. Mahue-Giangreco M et al. (March 2003) Cancer Epidemiology Biomarkers and Prevention, Vol. 12, 209-214.
