TWO RISKS

The Two (2) Breast Cancer Risks of elective induced abortion                           
(Brent Rooney)

Breast Cancer researcher Nancy Krieger  wrote, "Conversely,  early age  at  FFTP [first full-term pregnancy] consistently has emerged as the  strongest  protective [against breast cancer]  factor".4  It has been strongly suspected since the 17th century that 'something' about birth reduces breast cancer risk for the mother, since it was noted that nuns had a relatively high breast cancer risk; strict nuns do not deliver newborn. Was it the number of children, the duration of breast feeding, the age at last delivery, age at first birth, or something else that conferred BC risk reduction? The answer was delivered dramatically by Dr. Brian MacMahon (Harvard) and colleagues in 1970: age at first first full-term birth was the dominant BC reduction factor; note that it was not just pregnancy, but full-term pregnancies that conferred risk reduction.6  MacMahon et al. reported that women with a FFTP before age 20 years had 1/3 the BC risk as women with a FFTP after age 35.6 The  younger  the  age  at FFTP, the lower the breast cancer risk.6 It  is  not  productive  when  medical  science  issues  become highly politicized. For almost a decade there has been a U.S. public debate whether there is an 'ABC' (Abortion-Breast-Cancer)  risk. As the question is framed, it is assumed by many that one and only one independent ABC risk is being claimed. This assumption is false. The debate is whether there is a 'second' independent abortion breast cancer risk ("interrupted pregnancy").  What is well accepted is that there is a 'first' abortion-breast-cancer risk: medically postponed first full-term birth. Consider the following statement published in the Journal of the National Cancer Institute:

    "Scientists agree that a full-term pregnancy at a young age     protects against breast cancer." (Troy Parkins (NCI employee),     JNCI, 1993;85:1987).

Each one year delay in FFTP increases BC risk

   In  1983  Brian MacMahon  et al. (via  re-analyzing their 1970 data) reported that each one year delay in FFTP increased relative breast cancer  risk by 3.5 percent (compounded).1  How much breast cancer protection does an early first full-term birth provide? Compare a woman with a first full-term birth at age 20, versus women with later first full-term births (using the 'MacMahon' 3.5% figure):

   Age at first  Increase in relative birth breast cancer risk (vs. first birth at age 20)

       20         0
       25         18.7%
       30         41.0%
       35         67.3%
       40         98.8%

What is the connection between an early first birth and elective   induced abortion?

Consider a childless twenty year old 'Alice' who is pregnant and chooses to have an induced abortion (U.S. consent forms will not tell her that postponing her first birth increases her breast cancer risk).  If 'Alice' waits until age 30 to have her first birth, her relative breast cancer risk is 41% higher than if she had a full-term birth at age 20.  If the induced abortion had the side- effect of sterilizing her, 'Alice' will have no children and her relative breast cancer risk is about 90% higher compared to having a full-term birth at age 20.7  She also doubles her risk of ovarian cancer.9

What is the 'ABC' debate about?    That there is one abortion breast cancer risk (postponed first full-term birth) is not  debatable.  If medical researchers  are at least 95 percent confident of increased risk, they have obtained what is termed "statistical significance".  This can be called the 'gold standard' of  medical  science.  For  the  second  abortion breast cancer risk ("interrupted pregnancy"), there  have been seventeen (17) studies that have achieved "statistical significance". Sixteen (i.e. over 94%) of the seventeen studies found that an induced abortion increases breast cancer risk. How much breast cancer risk increase would there be for a young (under age 25) childless woman who has an induced abortion?  There is the postponed first full-term birth breast cancer risk mentioned above and the second risk ("interrupted pregnancy").  In 1996 a "meta-analysis" reported that this second risk yielded an increased relative risk of breast cancer of 50 per cent for an induced abortion before a first full-term pregnancy; this 50 per cent does not include the independent BC effect of postponing a first full-term birth.2 The total relative breast cancer risk increase for a young childless pregnant woman of age 20 years who has an elective induced abortion:

Age at first   Total increase     full-term in relative BC birth risk

 25 years       68.7% (18.7% + 50%)   
 30 years       91.0% (41%   + 50%)   
 35 years      118.3% (67.3% + 50%)

ABC risk for women carrying to full-term a first pregnancy

The 1996 'Brind' ABC meta-analysis analyzed twenty-three 'ABC' studies.2  This meta-analysis excluded the independent effect of postponing a first full-term birth via induced abortion.  The researchers reported an overall significantly increased relative risk of breast cancer of 30% from any induced abortions; it must be repeated that this 30% does not include the BC risk increase from a postponed first full-term birth.  'Brind' estimated an excess of 5,000 U.S. women contracting breast cancer annually from induced abortion exposure.  However, as the 'Roe v Wade' generation of women enters menopause, the annual U.S. breast cancer toll may climb much higher. 5,000 utterly dwarfs the infamous Tuskegee study that involved 412 black men with prior syphilus.  These 412 men were not told that they had syphilus, nor were they given therapies for their syphilus for many years.  However, the doctors conducting the Tuskegee study did nothing to cause any cases of syphilus.  For the ABC risk the number of patients is  much greater and the doctors performing 'pregnancy terminations' caused an increase in the risk of breast cancer! As of August 2001, no U.S. abortion clinic informs women of either the accepted ABC risk or the second independent ABC risk ('interrupted pregnancy') validated by the 1996 'Brind' meta-analysis. This failure to disclose a "material risk" for an elective medical treatment violates a doctor's legal duty to inform a prospective patient of "material" risks.  A doctor also has a legal duty (in the U.S. and Canada) not to perform any treatment that is not in a patient's best interests.10  Exposing a patient to an elective procedure with an increased breast cancer risk can not be considered to be in a patient's best interests.10  The Hippocratic dictum of "First, do no harm" is being violated.

The etiology of the Abortion-Breast-Cancer Risk

   Dr. Charles E. Simone explained the etiology of Abortion-Breast- Cancer thus:

"When conception occurs, hormonal changes influence the breast.       The milk  duct  network  grows  quickly  to form other networks       that  will  ultimately  produce  milk.  During  this  period of       tremendous  growth  and  development,  breast  cells are under-       going  great  change  and  are  immature or 'undifferentiated';       hence,  they  are  more  susceptible  to carcinogens.  But when       a first full-term  pregnancy  is  completed,  hormonal  changes       occur  that  permanently  alter  the breast network  to greatly       reduce  the  risk  of  outside  carcinogen  influence.  When  a       termination  occurs  in  the  first  trimester,  there  are  no       protective  effects,  and  many of the rapidly  dividing  cells       of  the  breast  are  left  in  transitional  states......   It       is  in  these  transitional  states  of  high proliferation and       undifferentiation  that  these cells can undergo transformation       to cancer cells."8

Summary

1 Breast Cancer researcher Nancy Krieger  wrote, "Conversely,  early   age at FFTP [first full-term pregnancy] consistently has emerged as   the strongest  protective [against breast cancer]  factor".4 A   postponed first full-term birth via an induced abortion is the   'first' independent ABC risk and is not debatable.4,5,6,7

2 There is very strong evidence for the 'second' independent ABC risk   ("interrupted pregnancy").2,3,8  Sixteen of seventeen significant   studies reported increased breast cancer risk from prior induced   abortions.

3 All U.S. and Canadian abortion clinic consent forms fail to inform   women of either the accepted ABC risk (postponed first full-term   pregnancy)  or the second very probable ABC risk.  A medical doctor   is legally prohibited from performing a medical treatment that the   doctor knows, or ought to know, is not in a patient's best interests.   10 .........................................................................

 References

  1 B MacMahon, D Trichopolous, et al.  Age at any Birth and Breast     Cancer Risk. International J Cancer 1983;31:701-704

  2 Brind J, et al. Induced abortion as an indepdendent risk factor     for breast cancer: a comprehensive review and meta-analysis. J     Epidemiology & Community Health  1996;50:481-496

  3 Daling J, et al. Risk of Breast Cancer Among Young Women: Relationship     of Induced Abortion, Journal of the National Cancer Institute     1994;86;1584-1592

  4 Krieger N. Exposure, susceptibility, and breast cancer risk.     Breast Cancer Research  and Treatment 1989;13:205-223

  5 A Decarli, et al.  Age at any Birth and Breast Cancer in Italy.     International J Cancer 1996;67:187-189

  6 B MacMahon, et al. Age at First Birth and Breast Cancer Risk.     Bull WHO 1970;43:209-221

  7 White E.  Projected Changes in Breast Cancer Incidence due to the     Trend toward Delayed Childbearing. Amer J Public Health     1987;77:495-497

  8 [book] Simone C. Breast Health. Avery Pub. Group, Garden City     Park, N.Y.    1995 (p. 147)

Ovarian Cancer

  9 A Whittemore A, et al.  Characteristics Relating to Ovarian Cancer     Risk: Collaborative Analysis of 12 United States Case-Control     Studies. American Journal of Epidemiology  1992;136:1184-1203

A Doctor's Legal Duty to Protect a Patient's Health

 10 [book] Picard E, Robertson G. Legal Liabilities of Doctors and     Hospitals in Canada.  1996 (pp. 264-265)