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Breast Cancer and Abortion: Is There a Link?
The statistics are cause for grave concern: according to the American Cancer Society, there are 182,000 cases of breast cancer diagnosed each year and 46,000 woman die annually of the disease. Why has there been such a high rate in the incidence of this type of cancer? And why especially in the United States? Since the cancer rates are higher among well-educated than among poor women, some have opined that the reason for this may well be lifestyle factors such as diet. Other studies seize upon another possibility; reproductive decisions.

Recent Studies

The catalyst for the spate of recent interest in the number one killer of American women was a recent study. "Risk of Breast Cancer among Young Women: Relationship to Induced Abortion" written by Janet Daling and appearing in the Journal of the National Cancer Institute 86 (1994), 1584-1592. While Daling's article may be the most recent, it is certainly not the first to study this purported link. In the medical literature, we find that as far back as 1957, researchers in Japan were discussing the increased risk from breast cancer following both spontaneous and induced abortions. Anyone who consults MEDLINE, an online bibliography, will see a steady stream of recent articles in medical journals ever since, including that of H.L. Howe et al., "Early Abortion and Breast Cancer Risk Among Women Under 40," International Journal of Epidemiology 18 (1989), 300-304.

Before Daling's 1994 article, perhaps the most famous and oft-cited was that of M.C. Pike et al., "Oral Contraceptives Use and Early Abortion as Risk for Breast Cancer in Young Women," British Journal of Cancer 43(1981), 72-76, which concluded that a first-trimester abortion before a woman has had her first full-term pregnancy was associated with a 2.4-fold increase in breast-cancer risk. What is important to note here is that the first pregnancy when taken to full-term affords a woman an appreciable measure of protection against breast cancer; an induced abortion of a first pregnancy places a woman at a much greater risk for the dread disease.

Studies on the link between the rise of breast cancer and the incidence of abortion have been so numerous and so persistent that in January of 1994, the Washington-based National Women's Health Network [NWHN] felt obliged enough to come out with an opposing fact sheet entitled "Abortion and Breast Cancer: The Unproven Link." However, the accumulating evidence supports the opposite assertion, viz., that there well may be a link, as we shall see.

How Abortion May Generate Breast Cancer

One of the most intriguing of the studies linking breast cancer and abortion is that by J. Russo and Carcinogenesis: Pregnancy Interruption as a Risk Factor," American Journal of Pathology 100 (1980), 497-512. Using rats in an experiment, the authors attempt to explain how the link between abortion and breast cancer comes about in a physiological sense.

The NWHN document referred to earlier is not unaware of the Russo study and what it may mean:

Biological evidence from animal studies demonstrates that there is a plausible explanation for an association between breast cancer and abortion. When a pregnancy is interrupted, as in abortion, the mammary glands contain some areas with completely differentiated structures and other areas of immature cells. (Russo, 1981). Thus the breast is more susceptible to the initiation or promotion of cancer. Studies to this effect in rats are useful since rats' breast tissue is similar to humans.

How does this link come about? Researchers are turning their gaze to the issue of cell growth to find an answer. In a recent article appearing in the Journal of the National Cancer Institute 85, no. 24 (December 15, 1993) "Does Abortion Increase Breast Cancer Risk?" Troy Parkins mentions the Daling study (which had not yet been published) as tending to the conclusion that there is a 50% to 90% increase in breast cancer risk for women who have had an abortion before the age of eighteen, and tries to explain the findings by putting forward a hypothesis by Leon Bradlow, M.D., Director of the Laboratory of Biochemical Endocrinology at the Strang-Cornell Cancer Research Laboratory in New York who said, in effect, that a full-term pregnancy confers a protective benefit upon women, helping them avoid breast cancer. Parkins paraphrases Bradlow's argumentation:

Numerous scientists believe the protective benefits of pregnancy arise from having differentiated breast cells because breast cancer arises in undifferentiated cells. During the first half of pregnancy, increased concentrations of estrogen stimulate the mother's breasts to grow. During the second half of pregnancy, breast cells differentiate to allow milk production. There is substantial scientific evidence that estrogen increases breast cancer risk. If a pregnancy is cut short by spontaneous or induced abortion, the woman experiences high estrogen concentrations without differentiation. Some doctors say this explains studies that show an increase in breast cancer risk among woman who have had a spontaneous or induced abortion. Bradlow feels strongly that these studies should be publicized.

Ideology Meets Science

What makes this issue so volatile, of course, is the abortion connection. The NWHN fact sheet, while aware of the pertinent scientific studies attempting to establish the link between breast cancer and abortion, especially of a first pregnancy before the age of eighteen, concludes: "There is currently no scientifically acceptable reason for women to factor an increased risk of breast cancer into their decision whether or not to continue a pregnancy." I find this statement odd because the very studies cited by NWHN lead to the opposite conclusion. What is going on here? Why such an incongruity when dealing with an issue of life and death for so many women? While conceding that women should have as much information as possible about all the factors which may contribute to breast cancer risk, the last paragraph of the NWHN may give the explanation: the group "supports all reproductive rights, including the right to abortion." Is this concern for women's health or is this feminist ideology at work?

Researchers like Daling, while they may be personally pro-choice, believe that this information should become part of the total package of women's right to know everything pertinent about their bodies and the possible harmful effects of the abortion procedure (See Daling's remarks in "Do Abortions Raise the Risk of Breast Cancer," Time Nov. 7, 1994, p.61).

The Sacred Cow Meets the Smoking Gun?

The NWHN may well be right in saying that the link between breast cancer and abortion of a first pregnancy has as yet not been established without any trace of scientific doubt. No researcher, as far as I can tell, is saying that abortion is the only factor responsible for the rapid rise in breast cancer rates among American women. It is one factor, nothing more, nothing less. When the NWHN and other groups take the ideological approach that they do, is it my imagination or are they, in fact, emulating the tactic employed by tobacco companies discounting the purported link between lung cancer and smoking? If abortion is not the smoking gun, neither should it be regarded as a sacred cow.

Feminist Adrienne Rich once wrote: "Abortion is violence: a deep desperate violence inflicted by a woman upon, first of all, herself" (Of Woman Born: Motherhood as Experience and Institution {New York: Bantam Books, 1977}, pp. 268-269). In the tortured prose of this passage, and in the light of the medical studies on the topic we have consulted, Rich may be saying much more than she knows.

MAY 1995

Germain Kopaczynski, O.F.M. Conv.
Director of Education
John Center