Back to Home

Fighting breast cancer: Are we missing a major at-risk population?

Women are often urged to get screening mammograms even without having a family history of breast cancer because it is widely believed that 70% of women who get breast cancer have no known identifiable risk factors.

However, if findings from the published literature are carefully considered, reproductive history and exposure to estrogen1 can readily account for most of this 70%. One of these risks, termination of pregnancy (abortion), is almost never included in the list of risk factors despite the following data:

Full-term pregnancy protects rats from chemical mammary tumor induction, but surgical abortion increases tumor incidence even beyond levels of virgin rats51.

Breast cells of nulligravidas show minimal differentiation and are thus maximally susceptible to carcinogens52.

A 1994 study of almost 2,000 women in Washington State9 found that all twelve subjects who had aborted before age 18 and who had a positive family history—mother, sister, grandmother or aunt with breast cancer—were diagnosed with breast cancer by age 45!

Many physicians believe abortion is a safe procedure, which saves women’s lives from the risk of a septic "back-alley" abortion53. Some of us believe that termination is safer than full-term delivery53. Naturally, data showing greater risk with abortion are viewed as suspect.

Further Information on the topics of abortion and breast cancer may be obtained from:

Angela Lanfranchi, MD, FACS at 732-356-0770 or Joel Brind, PhD at 914-463-3728 or

Breast Cancer Prevention Institute, 9 Vassar St., Poughkeepsie, NY 12601 at 1-866-622-6237 (Toll-free) or

The Coalition on Abortion/Breast Cancer via the internet at www.abortionbreastcancer.com

(References on reverse)

REFERENCES

  1. Henderson BE, Ross R, Bernstein L. Estrogen is a cause of human cancer: The Richard and Hilda Rosenthal Foundation Award Lecture. Cancer Research 1988;48:246-53.
  2. Segi M, Fukushima I, Fujisaku S, et al. An Epidemiological study on cancer in Japan. GANN 1957;48(Suppl):1-63.
  3. Pike MC, Henderson BE, Casagrande JT, Rosario I, Gray GE. Oral contraceptive use and early abortion as risk factors for breast cancer in young women. Br J Cancer 1981;43:72-6.
  4. Brinton LA, Hoover R., Fraumeni JF Jr. Reproductive factors in the aetiology of breast cancer. Br J Cancer 1983;47:757-62.
  5. Rosenberg L, Palmer JR, Kaufman DW, Strom BL, Schottenfeld D, Shapiro S. Breast cancer in relation to the occurrence and time of induced and spontaneous abortion. Am J Epidemiol 1988;127:981-9.
  6. Howe HL, Senie RT, Bzduch H, Herzfeld P. Early abortion and breast cancer risk among women under age 40. Int J Epidemiol 1989;18:300-4.
  7. Laing AE, Demenais FM, Williams R, Kissling G, Chen VW, Bonney GE. Breast cancer risk factors in African-American women: The Howard University Tumor Registry experience. J Natl Med Assoc 1993;85:931-9.
  8. Laing AE, Bonney GE, Adams-Campbell L, et al. Reproductive and lifestyle factors for breast cancer in African-American women. Genet Epidemiol 1994;11:A300.
  9. Daling JR, Malone DE, Voigt LF, White E, Weiss NS. Risk of breast cancer among young women: relationship to induced abortion. J Natl Cancer Inst 1994;86:1584-92.
  10. Daling JR, Brinton LA, Voigt LF, et al. Risk of breast cancer among white women following induced abortion. Am J Epidemiol 1996;144:373-80.
  11. Newcomb PA, Storer BE, Longnecker MP, Mittendorf R, Greenberg ER, Willett WC. Pregnancy termination in relation to risk of breast cancer. JAMA 1996;275:283-7.
  12. Wu AH, Ziegler RG, Pike MC, et al. Menstrual and reproductive factors and risk of breast cancer in Asian-Americans. Br J Cancer 1996;73:680-6.
  13. Palmer JR, Rosenberg L, Sowmya Rao R, et al. Induced abortion in relation to risk of breast cancer (United States) Cancer Causes Control 1997;8:841-9.
  14. Moseson M, Koenig KL, Shore RE, Pasternak BS. The influence of medical conditions associated with hormones on the risk of breast cancer. Int J Epidemiol 1993;22:1000-9.
  15. Marcus PM, Baird DD, Millikan RC, Moorman PG, Qaquih B, Newman B. Adolescent reproductive events and subsequent breast cancer risk. Am J pub Health 1999;89:1244-7.
  16. Newcomb PA, Mandelson MT. A record-based study on induced abortion and risk of breast cancer. Cancer Causes Control 2000;11:777-81.
  17. Lazovich D, Thompson JA, Mink PJ, Sellers TA, Anderson KE. Induced abortion and breast cancer risk. Epidemiol 2000;11:76-80.
  18. Watanabe H, Hirayama T. Epidemiology and clinical aspects of breast cancer. Nippon Rinsho 1968;26:1853-9 (in Japanese).
  19. Dvoirin VV, Medvedev AB. Role of women’s reproductive status in the development of breast cancer. In: Methods and progress in breast cancer epidemiology research, Tallin, 1978. Moscow: Oncology Science Center of the USSR Academy of Sciences, 1978;53-63 (in Russian).
  20. Burany B. Gestational characteristics in women with breast cancer. Jugosl Ginekol Opstet 1979;19:237-47 (in Serbo-Croatian).
  21. Nishiyama F. The epidemiology of breast cancer in Tokushima prefecture. shikoku Ichi 1982;38:333-43 (in Japanese).
  22. Le M-G, Bachelot A, Doyon F, Kramar A, Hill C. Oral contraceptive use and breast or cervical cancer: Preliminary results of a French case-control study. In: Wolff J-P, Scott JS, eds. Hormones and sexual factors in human cancer aetiology. Amsterdam:Elsevier, 1984:139-47.
  23. Hirohata T, Shigematsu T, Nomura AMY, Nomura Y, Horie A, Hirohata I. Occurrence of breast cancer in relation to diet and reproductive history: A case-control study in Fukuoka, Japan. Natl Cancer Inst Monogr 1985;69;187-90.
  24. Ewertz M, Duffy SW. Risk of breast cancer in relation to reproductive factors in Denmark. Br J Cancer 1988;58:99-104.
  25. Adami H-O, Bergstrom R, Lund E, Meirik O. Absence of association between reproductive variables and the risk of breast cancer in young women in Sweden and Norway. Br J Cancer 1990;62:122-6.
  26. La Vecchia C, Negri E, Franceschi S, Parazzini F. Long-term impact of reproductive factors on cancer risk. Int J Epidemiol 1993;53:215-9.
  27. Andrieu N, Clavel F, Gairard B, et al. Familial risk of breast cancer and abortion. Cancer Detect Prev 1994;18:51-5.
  28. Lipworth L, Katsouyanni K, Ekbom A, Michels KB, Trichopoulos D. Abortion and the risk of breast cancer: a case-control study in Greece. Int J Cancer 1995;61:181-4.
  29. Rookus MA, van Leeuwen FE. Induced abortion and risk for breast cancer: Reporting (recall) bias in a Dutch case-control study. J Natl Cancer Inst 1996;88:1759-64.
  30. Bu L, Voigt L, Yu Z, Malone K, Daling J. Risk of breast cancer associated with induced abortion in a population at low risk of breast cancer. Am J Epidemiol 1995;141:S85 (abstract 337).
  31. Talamini R, Franceschi S, La Vecchia C, et al. The role of reproductive and menstrual factors in cancer of the breast before and after menopause. Eur J Cancer 1996;32A:303-10.
  32. Melbye M, Wohlfahrt J, Olsen JH, Frisch M, Westergaard T, Helweg-Larsen K, Andersen PK. Induced abortion and the risk of breast cancer. N Engl J Med 1997;336:81-5.
  33. Luporsi E, 1988, in Andrieu N, Duffy SW, Rohan TE, Le MG, Luporsi E, Gerber M, Renaud R, Zaridze DG, Lifanova Y, Day NE. Familial risk, abortion and their interactive effect on the risk of breast cancer—a combined analysis of six case-control studies. Br J Cancer 1995;72:744-51.
  34. Rohan TE, 1988, in #32 above.
  35. Zaridze DG, 1995, in #32 above.
  36. Sanderson M, Shu XO, Jin F, Dai Q, Wen WQ, Hui Y, Gao YT, Zheng W. Abortion history and breast cancer risk: results from the Shanghai breast cancer study. Am J Epidemiol 2000;151 (abstract only).
  37. White E, Daling JR, Norsted TL, Chu J. Rising incidence of breast cancer among young women in Washington State. J Natl Cancer Inst 1987;79:239-43.
  38. Krieger N. Exposure, susceptibility, and breast cancer risk: A hypothesis regarding exogenous carcinogens, breast tissue development, and social gradients, including black/white differences, in breast cancer incidence. Breast Cancer Res Treat 1990;13;205-223.
  39. Remennick LI. Reproductive patterns and cancer incidence in women: A population-based correlation study in the USSR. Int J Epidemiol 1989;18:498-510.
  40. Harris B-ML, Eklund G, Meirik O, Rutqvist LE, Wiklund K. Risk of cancer of the breast after legal abortion during first trimester: a Swedish register study. BMJ 1989;299:1430-2.
  41. Brind J, Chinchilli VM. letter re: Induced abortion and the risk of breast cancer. N Engl J Med 1997;336:1834.
  42. Brind J, Chinchilli VM, Severs WB, Summy-Long J. letter re: Induced abortion and risk for breast cancer: Reporting (recall) bias in a Dutch case-control study. J Natl Cancer Inst 1997;89:588-9.
  43. Harris JR, Lippman ME, Veronesi U, Willett W. Breast cancer (first of three parts). N Engl J Med 1992;327:319-28.
  44. Stewart DR, Overstreet JW, Nakajima ST, Lasley BL. Enhanced ovarian steroid secretion before implantation in early human pregnancy. J Clin Endocrinol Metab 1993;76:1470-6.
  45. Kunz J, Keller PJ. HCG, HPL, oestradiol, progesterone and AFP in serum in patients with threatened abortion. Br J Obstet Gynaecol 1976;83:640-4.
  46. Witt BR, Wolf GC, Wainwright CJ, Johnston PD, Thorneycroft IH. Relaxin, CA-125, progesterone, estradiol, Schwangerschaft protein, and human chorionic gonadotropin as predictors of outcome in threatened and non-threatened pregnancies. Fertil Steril 1990;53:1029-36.
  47. MacMahon B, Cole P, Lin TM, et al. Age at first birth and breast cancer risk. Bull Wld Hlth Org 1970;43:209-21.
  48. Norman RJ, McLoughlin JW, Borthwick GM, Yohkaichiya T, Matthews CD, MacLennan AH, de Kretser DM. Inhibin and relaxin concentrations in early singleton, multiple, and failing pregnancy: relationship to gonadotropin and steroid profiles. Fertil Steril 1993;59:130-7.
  49. Brind J, Chinchilli VM, Severs WB, Summy-Long J. Induced abortion as an independent risk factor for breast cancer: a comprehensive review and meta-analysis. J Epidemiol Community Health 1996;50:481-96.
  50. Melbye M, et al. Preterm delivery and risk of breast cancer. Brit J Cancer 1999;80:609.
  51. Russo J, Russo IH. Susceptibility of the mammary gland to carcinogenesis II. Pregnancy interruption as a risk factor in tumor incidence. Am J Pathol 1980;100:497-512.
  52. Russo J, Rivera R, Russo IH. Influence of age and parity on the development of the human breast. Breast Cancer Res Treat 1992;23:211-18.
  53. Rosenberg L. Induced abortion and breast cancer: more scientific data are needed (editorial). J Natl Cancer Inst 1994;86:1569-70.
  54. Weed DL, Kramer BS. Induced abortion, bias, and breast cancer: why epidemiology hasn’t reached its limit (editorial). J Natl Cancer Inst 1996;88:1698-1700.
  55. Hartge P. Abortion, breast cancer, and epidemiology (editorial). N Engl J Med 1997;336:127-8.
  56. Meirik O, Adami H-O, Eklund G. letter re: Relation between induced abortion and breast cancer. J Epidemiol Community Health 1998;52:209.
  57. Brind J, Chinchilli VM, Severs WB, Summy-Long J. reply to letter re: Relation between induced abortion and breast cancer. J Epidemiol Community Health 1998;52:209-11.
  58. Fisher B, Constantino JB, Wickerham DL, et al. Tamoxifen for prevention of breast cancer: Report of the NSABBP P-1 study. J Natl Cancer Inst 1998;90:1371-88
  59. Position statement on abortion and access to comprehensive reproductive health services, American Medical Women’s Association (AMWA), November 1999.
  60. Bland, KI, Copeland, EM. The Breast: Comprehensive management of benign and malignant diseases, 2nd ed, Saunders, Phila, NY 1997;v1:523.
  61. Dixon JM, Sainsbury JRC, Masterton G, Pugh R. Handbook of Diseases of the Breast, 2nd ed, Harcourt Brace and Co, London 1998;97.