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WHY CAN'T WE LOVE THEM BOTH
by Dr. and Mrs. J.C. Willke
CHAPTER 23
BREAST CANCER
There is an ominous relationship between the
abortion of your first pregnancy and later development of breast cancer.
Is this proven?
No, but there is a very close correlation that has been demonstrated
in a large number of scientific studies. If further studies continue to demonstrate this
and no other definitive cause is found, it is highly likely that this will some day be
seen as a cause and effect.
Is breast cancer increasing?
According to the American Cancer Society. In 1962 there were 63,000
cases.
In 1972, 90,000 In 1982, 120,000 In 1992, 180,000
Perhaps some of the above is attributable to better diagnoses with mammograms, etc. Even
so, the increase is dramatic. In 1960, one women in fourteen developed breast cancer.
Today, it is nearing one in eight.
There are certain other risk factors, are there not?
Major risk factors that are well recognized are:
- family history in first degree relatives
- early onset and late cessation of menstruation
- being female (male breast cancer, while rare, has not increased)
- nulliparity, i.e., not being pregnant.
There are other
suspected risk factors?
Yes, diet is one. It is postulated that a high fat diet may
contribute. Toxic chemicals, pesticides and pollutants have been suggested, as have lack
of antioxidants in the diet. Alcohol, smoking and drugs may be implicated. Electromagnetic
fields, such as living under high-tension wires or being exposed to electronic display
boards have been suspected. Certain genes may predispose. None of these, however, have
been proven.
Contraceptive pills have been implicated. While nothing has been
proven, it would seem that the use of the pill before twenty years of age, or the
continuing use of pills for more than 10 years might be a causative factor.
In the overall, however, 60% to 70% of all breast cancer occurs in
women who do not have any of the classic risk factors.
Does pregnancy protect?
Yes, definitely. Women who have never been pregnant
have twice the risk of breast cancer compared to those who have had children. Women who
delay their first pregnancy into their thirties have almost a doubled risk of breast
cancer compared to those who have babies in their late teens or early twenties. It is also
possible that breast-feeding may add another protective affect, but there is no real proof
for this. B. MacMahon, et al., 1970 Bull. Wld.
Halth. Org., 43:20921
When was
abortion first suspected as a cause?
Dr. M. C. Pike, at the University of Southern California in l981,
published the first serious scientific study that demonstrated a direct association of
induced abortion with later breast cancer. He studied 163 women who developed breast
cancer before age 33, and compared them with 272 controls. He showed that if a woman had aborted her first pregnancy, her chance for
developing breast cancer was increased by a factor of 2.4 times. Pike MC, Henderson BE, Casagrande JT, Rosario I, Gray CE (1981) Brit. J.
Cancer, 43:726.
Give me other
definitive studies.
Certainly one of the definitive studies was
by H. L. Howe. Her study was done in upstate New York using official statistics from the
New York State Health Department. This was an excellent study by epidemiologic standards
and was not subject to any kind of recall memory bias from people asked in questionnaires.
It used only hard data. She investigated all the women in this area who developed breast
cancer under age 40 and checked to see whether or not they had had abortions. The
conclusion was that women who had aborted their first pregnancy had a 1.7 times increased
risk of breast cancer. Those who had gone on to abort their second and/or third pregnancy
had a 4.0 times increased risk. Howe HL, Senie RT,
Bzduch H, Herzfeld P (1989) et al., Int. J. Epidemiol. 18:3004.
Another was in Washington State: Few studies on this issue
receive media attention. This went worldwide and broke the defacto embargo on reporting
the abortionbreast cancer link. Janet Daling did a very professional study that could not
be discounted. It found:
- An induced abortion raises a womans chance of getting breast
cancer before age 45 by 50%. If done before age 18, it increases 150%; if after age 30,
its up 110%.
- A woman with a family member with breast cancer who had her first
abortion after 30 years increased her risk 270%.
- All 12 women in the
study with a family history of breast cancer, who aborted before age 18 all 12
got breast cancer before age 45. J. Daling, Risk of
Breast Cancer Among Young Women, J. Nat. Ca. Inst., Vol. 86, No. 21, 11/2/94, pg. 1584
Other studies done since then include: Greece: An
overall increased risk of 51% was reported in women who had abortions, compared to those
who did not. It involved 850 patients in Athens. L.
Lipworth, Int. J. of Cancer, April 95 U.S.A.:
A statistically significant increased risk of 23% of
breast cancer was shown to be attributable to induced abortion. For women over 60 years,
the risk was 80%. P. Newcomb et al., Preg.
Termination & Risk of Breast Cancer, JAMA 1/24/96, Vol. 275, No. 4, pg. 283
For a thorough explanation of the Newcomb study
above, see Natl. RTL News, 2/6/96, by J. Brind. Paris: "Having at least
two abortions if associated with an increased breast cancer risk" of 2.1 times. N. Andrieu, Role of Genetic & Repro. Factors in Br. Ca., Genetic
Spidem. 11 (3): 285, 1994
There are, in addition, many competent studies done in the last 20
years which also confirm this linkage. See: Before You Choose, The Link Between
Abortion & Breast Cancer; And: Legalized Abortion and the Sudden Increase of Breast
Cancer, both by Scott Somerville, P.O. Box 159, Paeonian Springs, VA 22129.
These are comprehensive analyses citing 74 studies.
Has anyone investigated recurrences of previously treated breast cancer?
Yes, Dr. H. Ownby did this in 1983. This was a study
of women who had breast cancer that had been treated and gone into remission. Ownby
studied how many of these developed a recurrence of their cancer. His research showed that
among women who had carried their first pregnancy to term, 10% had a recurrence of their
cancer within three years. Of those women who had aborted their first pregnancy 20% had a
recurrence. Among those who had aborted their second and/or third pregnancy also, 30% had
recurrences. H. Ownby, Interrupted Pregnancy Poor
Prognosis . . . in Breast Cancer, 1983 Breast Cancer Res. Treat. 3:339344
How about the
aggressiveness of the tumor?
In 1991 H. Olsson studied the aggressiveness of, and the propensity
to metastasize of diagnosed breast cancer. His study showed, if she had aborted her first
pregnancy and later developed breast cancer, that her cancer was more aggressive and more
quickly lethal than cancers among women who had carried their first pregnancy to term.
A marker gene associated with breast cancer, 1NT2,
was shown to be eighteen times higher than the normal rate among those who had aborted. H. Olsson et al., Cancer 67:128590.
Are there ethnic
differences?
Two studies have investigated this. In 1978, Choi in the U.S. and
Israel, investigated the difference between groups of Protestant and Catholic women in
Canada and found that the Protestant women had more breast cancer. Helmrich, in 1981,
investigated the difference between Jewish and Catholic women and found that there was
more breast cancer among the Jews.
Does this mean a difference due to ethnicity? Or
could it be that the Catholic women had fewer abortions? Certainly no conclusions can be
drawn, but this may be a bit of circumstantial evidence. N. Choi, An Epidem. Study of Br. Ca., Am. J. Epidemal. 107:510, 1978
S. Helmrich, Risk Factors for Br. Ca., Am. J. Epidemal. 117, 3545
Are there
differences in economic classes?
There were two studies done in the state of Washington that are
suggestive but again offer no hard proof.
That state legalized abortion in 1969 by state referendum. For the
first 5 years it did not pay for welfare abortions, then in 1974, the state began to pay
for welfare abortions. Bearing this in mind, the following has been shown. Women of higher
social economic status had an increase in breast cancer during those first 5 years which
then leveled off. Poor women did not experience a similar rise in breast cancer until
after 1974 when their incidence rose up to the plateau earlier achieved by the rich.
There was a similar study by Krieger in 1990 in
California showing similar results. Choi 78,
Denesa 80, Kelsey 81, Lowe 70, Krieger 90
If induced abortion is a problem, does spontaneous loss carry the same risk?
Early on, some thought yes, but more recent studies have shown
dramatically lower levels of female hormone in those who miscarried. Among these studies
were ones by B. Witt, Tulane Med. Sch. in 1990; a study in the Br. J. OBGyn. in 1976; one
by D. Stewart, U. of CA Davis in 1993; one by A. Guilloume in NY City, and the well known
one by Janet Daling in 94. All have shown that miscarriages are not associated with
an increased risk.
What
about the contraceptive pill? Certainly many who take the pill also get abortions.
Could it be that the pill causes the cancer and not the abortion?
Good question! Many have asked it. At this time in history there is
no definitive answer and the pill remains suspect. There are, however, a number of studies
relevant here which seem to implicate abortion as a causative factor rather than the pill.
There are three major studies, from Russia, Estonia,
and Soviet Georgia that were done prior to Russias opening to the West. During those
years there were almost no contraceptive pills used in those nations. During those years
abortion was the method of birth control. And what happened to breast cancer? It increased
by approximately 300 percent. L. Remennick, Reprod .
. . & Cancer Incidence in USSR, Intl. J. Epidemal., 18:498512, 1989
Incidentally, the above reasoning, such as it is, would also apply
to the suggestion that food additives and street drugs are part of the cause of the
increase in breast cancer. Prior to the lowering of the Iron Curtain, there were
essentially no food additives used in the Soviet Union and neither were there many street
drugs. The breast cancer rate however, as noted, skyrocketed in these countries. This
would seem to implicate abortion as a cause and to see such additives as only aggravating
factors, if indeed they are implicated at all.
What of breast feeding? If pregnancy is protective, does it add further
protection?
It would seem logical that this would be so. If
maturation of the breast is what causes the protection, and if lactation in any way
completes the maturing of the milk glands, then logically breast-feeding should be an
additive protective factor. In fact, sufficient studies have not been done on this, and so
we cannot draw any firm conclusions. Newcomb, however, in the January 1994 New England
Journal of Medicine, did find a decreased risk of premenopausal cancer among mothers who
had nursed, but not among postmenopausal women. One such study, ambivalent as it is, is
not enough to draw any conclusions.
What about differences between the black and white races?
There have been two studies out of Howard University
in Washington, DC that have addressed this issue. They are the first ones to compare
races. Laing, in her study, found that those with abortions had an increased incidence of
breast cancer among black women, the increase centering largely among black women who were
over 50 years old. He also found an increase in breast cancer among black women who used
birth control pills. She found an increase in breast cancer after induced abortion, but
not after spontaneous miscarriage, which was called a "protective factor." A. Laing, Br. Ca. Risk Factors in AfricanAmerican Women, J.
Nat. Med. Assn., Dec. 93, Vol. 85, No. 12, pg. 931
Is this a genetic ethnic difference, or might there be another
explanation? It is difficult to ignore the fact that black women in the United States,
where this study was done, have three abortions for every one that their white
counterparts have. A high percent of these abortions cluster in the teen years which, by
definition, means many of them are first pregnancies. If abortion is a causative factor,
and if black women, particularly young black women, have three times as many abortions as
white women, then it would seem logical that they should have a higher incidence of breast
cancer, which in fact they do.
Sadly, black women die almost twice as often from
breast cancer as whites. Eley et al., Racial
Differences in Survival, JAMA 9/28/94, Vol. 272, No. 12, pg. 947
This study found a relatively increased risk of 50% up to age 40,
increasing during the 40s to 180%, and to 370% to women over 50 years of age.
What about diet? It has been suggested as a causative factor.
Yes it has. Time magazine, in 1994, devoted the major subject
matter of one issue to this, strongly suggesting that a high intake of fat and red meat
might increase the incidence of breast cancer. It is a fact that the female hormone
implicated in breast cancer, estrogen, is stored in fatty tissue. Therefore, obese women
may be at greater risk. The concern, however, is not about obesity as such, but rather
about dietary intake.
Again, there is no proof. But it is interesting to note that the
breast cancer rate in Japan has gone up sharply and it has been suggested that, with their
increased standard of living, it is due to their increasing consumption of red meat and
fatty foods. In the U.S. the breast cancer rate has also gone up sharply, and this has
continued during the last decade or two during which time the intake of red meat and fat
has decreased sharply. We could compare to a third nation, the Soviet Union before its
opening to the West. There the abortion rate rose even faster, but there the intake of red
meat and of fat was minimal. To draw a conclusion is unscientific, as other factors
undoubtedly play a part. But, if fat is causative one might surmise that it has gone up in
Japan because they have increased such dietary intake; that it has gone up in the U.S.
because of a decrease in this dietary intake, and that it went up even higher in the
former Soviet Union because of a near deficiency of these dietary factors.
Can stress cause breast
cancer?
Investigators at the University of Wisconsin have found no link at
all. "Although women with breast cancer often attribute it to stress or depression,
we found no evidence of such an
association." They followed without and 258 with cancer for 5 years. P. Carbone, Relationship . . . Refuted, Primary Care &
Cancer, July 96, Vol. 16, No. 7, p. ll
These studies
on the association of abortion with breast cancer are rather convincing. But if they are
true, how do you explain the mechanism of the development of this cancer?
This is best understood by looking at the female breast in three
different phases of maturity: Immature Phase: This is the 5 year old girl whose breast,
under the microscope, is indistinguishable from that of her 6 year old brother. Her
brothers breast never matures. Hers will.
Nulliparous Adult Stage: During adolescence there is a flood of
female hormone which causes her breast to grow in size and shape. To external appearances
her breast is mature but it can not yet produce milk, and the internal structure remains
relatively undeveloped. Parous Breast: This is the third stage, the breast after being
pregnant. Most women who have been pregnant remember that their breasts became swollen and
tender very soon after missing their period. Also, by about 3 months, they no longer felt
this very much. What happened was the last phase of growth and maturation of her breasts.
During this phase the internal milk glands completed their development and readied her to
produce milk.
So what has this to do with later cancer?
Perhaps a lot. We dont know all the causes that trigger the
growth of cancer but we call such causes carcinogenic agents. We know that the immature
breast cells are relatively resistant to such agents. We know that after the first phase
of growth the cells are more susceptible and that after a pregnancy and full maturation
the cells are again more resistant. In early pregnancy there is a rapid growth and change
of these cells. If this is suddenly interrupted, the breast is left with many transitional
cells in a state of change, half way between immature and mature, cells in intermediate
stages. It is thought that these cells are more unstable and less resistant to
carcinogenic insult to the triggering of cancer.
What if she has a baby and then aborts the next one?
According to this reasoning this should not increase the risk. In
fact, some studies do show a further increase in risk.
If all of this is true, how many women will actually die of breast cancer?
There are approximately 1.5 million induced abortions annually in
the United States. Over half, or 800,000 of these, are first pregnancies. At a
conservative estimate one in ten of these women will get breast cancer. This is 80,000
cases. About onefourth of those who develop breast cancer, thats 20,000 women, will
die from the disease. If in fact, abortion of her first pregnancy increases her chance of
breast cancer from 1.0 to 1.5 then we should see, not 80,000 but 120,000 cases of cancer
among this target population. If the death rate among them remains at 25 percent, (and it
could be higher), then not 20,000, but 30,000 women will die. Among this group, however,
if instead of aborting their first pregnancy, these 800,000 women would have carried to
term and delivered. They would have reduced their chance for breast cancer from 1.0 to
.75. Accordingly, the 80,000 expected cases would be reduced to three-fourths of that or
60,000 cases, and the 20,000 deaths would have been reduced to 15,000 deaths.
Continuing this comparison we see that, if abortion is in fact
causative, then it is responsible for 10,000, plus 5,000, or a total of 15,000 deaths
annually from breast cancer that would not have occurred if the women, who had aborted
their first pregnancies, had instead carried those pregnancies to term.
A major study that refutes your thesis is the Lindeford Harris study from
Sweden. What of it?
It is poorly done from a scientific standpoint, and its
authors conclusions do not accurately reflect some of its actual findings. Dr.
Brind, mentioned above, has called it the "Swedish data massage." It compared
Swedish women with breast cancer, to the entire Swedish population, which contains all of
the same Swedish women who have breast cancer. Therefore, this comparison to the control
group is invalid. Even in this study however, there is proof of the very thing its authors
deny. In their articles conclusion, the authors state that there is no overall risk
of breast cancer from abortion. However, within the report, a table of results shows that
women who aborted after having a live birth had 58% of the average risk of breast
cancer, while women who aborted before their first live birth had 109% of the
average risk. This is an 88% increase in breast cancer, and it is clearly shown in the
heart of this study, a study that is routinely held up as proving exactly the opposite.
But there are many other studies that tend to disprove your claims.
So they claim, but, with few exceptions, these were
flawed by: inappropriately crude age matching or adjusting of controls (the main problem);
interpreting as statistically insignificant some retrospective case controls with low
statistical power; minimizing the actual results obtained in their conclusions; and
attributing results to patients "recall bias," even though a close exam
refutes such a claim. 178 B. M. LindeforsHarris et al.,
Response Bias. . . . Abortions. . . . Two Swedish Studies, Am. J. Epidemal. 1991,
Vol. 134, No. 9, Pg. 1003
But I havent seen such criticisms in any public reports.
There has been a true conspiracy of silence by the
media and also by many researchers who, like the Swedish study, bury actual findings and
conclude otherwise, e.g., editorials in journals, listing exhaustively multiple possible
causes of breast cancer and never even listing abortion, e.g., JAMA, July 21, 1993,
and New England Journal of Medicine, Jan. 1994, as well as Time magazine on
Jan. 14, 1991. Dr. Remennick concluded "an initial attitude of researchers toward
abortion usually determines the way they interpret results." 10 Remennick LI (1989) Int. J. Epidemiol. 18:498510.
Has anyone compared all the studies?
Yes, happily a comprehensive metaanalysis examined
61 published studies and subjected them to critical comparative analysis. Its conclusion
was: "The results support the inclusion of induced abortion among significant
independent risk factors for breast cancer,
regardless of parity or timing of abortion relative to the first term pregnancy. Although
the increase in risk was relatively low, the high incidence of both breast cancer and
induced abortion suggest a substantial impact of thousands of excess cases per year
currently, and a potentially much greater impact in the next century, as the first cohort
of women exposed to legal induced abortion continues to age." J.
Brind et al., "Induced abortion as an independent risk factor for breast cancer: a
comprehensive review and meta-analysis," Hershey Med. Center, J. Epidemol.
Community Health, 1996
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