Transcript Abortion Raises Breast Cancer Risk A Resource for Crisis

Abortion Raises
Breast Cancer Risk
A Resource for
Crisis Pregnancy Centers
Karen Malec, Coalition on Abortion/Breast Cancer,
www.AbortionBreastCancer.com
Angela Lanfranchi, MD, FACS, Breast Cancer Prevention Institute,
www.BCPInstitute.org
PART II
Table of Contents
PART II
Why the U.S. National Cancer Institute Isn’t Reliable: The Agency’s 2003
Workshop, “Early Reproductive Events and Breast Cancer”
Parallels to the Tobacco-Cancer Cover-Up
U.S. National Cancer Institute’s
2003 Workshop
“Early Reproductive Events
and Breast Cancer”
a political sham
One-hundred scientists attended a 3-day workshop on the abortion-breast
cancer link, “Early Reproductive Events and Breast Cancer,” in February of
2003.
They concluded: “Induced abortion is not associated with an increase in breast
cancer risk.”
Leaders of the NCI’s
sham Workshop
Dr. Andrew Von
Eschenbach
Director, U.S. National
Cancer Institute
in 2003
Dr. Andrew Von Eschenbach
falsely told
the New York Times that
scientists at the workshop had
conducted a comprehensive
review of the worldwide
research.
"A Conversation with Andrew Von Eschenbach; Director Tries to
Untangle Web of Cancer Controversies," New York Times, March
11, 2003.
The Truth
The NCI’s online videocast shows
that only studies showing no abortionbreast cancer link were reviewed.
Scientists were not invited to present
the opposing view that abortion raises
risk.
Video available at: http://www.videocast.nih.gov/PastEvents.asp
Leslie Bernstein, Ph.D.
leader/moderator of NCI’s workshop
Leading experts whose research
had reported an abortion-breast
cancer link (i.e. Janet Daling and
Joel Brind) were not invited to
present this view at the workshop.
But Leslie Bernstein, Ph.D.
(biostatistician and epidemiologist
with the City of Hope) was invited
to be the leading presenter on the
abortion-breast cancer link, even
though her area of expertise
centers on the effects of exercise
and obesity on breast cancer risk.
Leslie Bernstein, Ph.D.
leader/moderator of NCI’s workshop
After the workshop,
Dr. Bernstein Told A
Reporter at
CancerPage.com why
she didn’t want
women to know the
truth about the
abortion-breast cancer
link.
Leslie Bernstein, Ph.D.
Told Journalist Rachel Lowe
at CancerPage.com
"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."
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>.
Abortion Providers’ Paid Experts
Invited to the Workshop
The NCI invited two experts who had previously testified
on behalf of abortion providers in the most radical kind
of pro-abortion litigation brought against the states of
Florida and Alaska because their legislatures had
passed parental notice or consent laws.
Lynn Rosenberg, Ph.D. (Boston Medical School)
testified on behalf of Florida abortion providers
represented by the Center for Reproductive Law and
Policy and was compelled under oath to admit that the
15-year-old who has an abortion has a greater risk than
does the 15-year-old who has a baby.
This was an acknowledgment of the risk-reducing effect
of full term pregnancy only, not the independent link.
Rosenberg (1999) NW FL Women’s Health vs. State of FL, FL Circuit Ct.,
2nd circ., videotape deposition of 11/18/99, pp. 77-78
NCI Leaders Invited
Abortion Providers’ Paid Experts
to the Workshop
•
The NCI invited Julie Palmer, Ph.D. (Slone
Epidemiology Center, Boston University
School of Public Health) to participate as an
expert at the workshop.
•
Palmer had served as a paid expert on
behalf of abortion providers in a 2002 lawsuit
they brought against the State of Alaska
because its legislature had passed a parental
notice law. Videotape deposition of Dr. Julie Palmer,
Planned Parenthood et al. vs. State of Alaska, Superior
Court for the State of Alaska, 3rd Judicial District, Case
No. 3AN 97-6014 Civil
•
Both Palmer & Rosenberg have authored
research finding that abortion is linked to
increased breast cancer risk, independently
of the loss of the protective effect of full term
pregnancy (meaning abortion leaves the
breasts with more places for cancers to
start.) Palmer et al. Cancer Causes Control 1997;8:841849. Rosenberg et al. Am J Epidemiol 1988;127:981-989.
National Cancer Institute
Branch Chief
Louise Brinton, Ph.D.,
M.P.H., was the
chief organizer of the
NCI’s phony 2003
workshop.
But in 2009, Dr. Brinton co-authored a
study, led by Jessica Dolle, focusing on
the link between the pill and triplenegative breast cancer.
The authors reported a statistically
significant 40% increased risk among
women with abortions. Dolle et al. Cancer
Epidemiology Biomarkers and Prevention 2009;18(4)1157-1166
The following known and suspected breast cancer risk factors were examined separately
as potential confounders for the main effects of all other risk factors in age-adjusted models:
age (at reference), race, education, annual income, family history of breast cancer, body mass
index (BMI; kilogram per square meter) 1 year before reference, smoking history, alcohol
consumption, age at menarche, number of live births, age at first birth (still or live), lactation
history (among parous women), abortion history (among gravid women), and oral
contraceptive use (never/<1 y versus z (less than or equal to) 1 year, oral contraceptive
duration, age at first use, years since first use, and years since last use).
Text
Results
In analyses of all 897 breast cancer cases (subtypes combined), the multivariateadjusted odds ratios for examined risk factors were consistent with the effects
observed in previous studies on younger women (Table 1). Specifically, older age,
family history of breast cancer, earlier menarche age, induced abortion, and oral
contraceptive use were associated with an increased risk for breast cancer. Risk
was decreased in relation to greater number of births and younger age at first birth.
Text
What “They” - Dr. Brinton & the
National Cancer Institute - Said at the
2003 Workshop
•
One-hundred scientists attended a 3-day workshop on the abortion-breast
cancer link, “Early Reproductive Events and Breast Cancer,” in February of
2003.
•
They concluded: “Induced abortion is not associated with an increase in breast
cancer risk.”
•
One person - Professor Joel Brind - dissented. His minority report is available
at the Breast Cancer Prevention’s website at:
http://bcpinstitute.org/nci_minority_rpt.htm
•
For the first month after the February 24-26 workshop, visitors to the NCI's
website were led to believe that no dissent had taken place. There was no
indication whatsoever that dissent had occurred. The NCI's updated March 25,
2003 web page included bare minimal information that an unnamed
"participant" (Joel Brind, Ph.D.) had dissented. The dissenter's Minority Report
was excluded from the web page altogether. As a result, women were being
kept in the dark about the rationale behind his dissent.
The Truth
•
In the 1930's, 100 scientists wrote a collection of essays, which disparaged Albert
Einstein's theory of relativity. When a reporter asked the esteemed scientist for his
comment, Einstein cleverly replied, "Why 100? If I were wrong, one would have been
enough."
•
The workshop’s conclusions contradicted 46 years of epidemiological, biological and
experimental research. By the time of the workshop in February of 2003, 29 out of 38
epidemiological studies reported risk elevations. Thirteen of 15 American studies had
reported increased risk. Sixteen of 17 statistically significant studies found risk
elevations.
•
The NCI’s leaders provided a videocast of the workshop on its website showing that
NCI leaders welcomed only one viewpoint - that abortion does not raise risk. A
comprehensive review of the research was not performed. The only research that was
considered was research whose authors had concluded abortion did not raise risk. Video
available at: http://www.videocast.nih.gov/PastEvents.asp
The Truth
•
Invited scientists were not independent of the federal government. Their careers
depended on federal grants. Some scientists told Professor Joel Brind they feared the
loss of their government grants if they spoke in favor of an abortion-breast cancer link.
•
Three new studies were announced, but not given to scientists for an in-depth
evaluation before the start of the workshop. The studies were non-peer reviewed,
and their data were unpublished. Although scientists regularly share their data when
asked to do so, requests for it were denied to the workshop's participants. New studies
were presented on Day 2 of the workshop, the only day for which a videocast was not
made available on the NCI's website until long after media attention had waned.
What “They” - Dr. Brinton & the
National Cancer Institute - Said at the
2003 Workshop
•
They concluded that early first term birth, increased
childbearing and longer duration of breastfeeding
reduce risk.
•
But they contradicted themselves by stating,
“Induced abortion is not associated with an increase
in breast cancer risk.”
The Truth
•
Logically, Abortion Raises Breast Cancer Risk By
Causing the Mother to:
•
Lose the protective effect of full term pregnancy;
•
Have a smaller family or no full term pregnancies;
•
Delay a first full term pregnancy.
What “They” - Dr. Brinton & the
National Cancer Institute - Said at the
2003 Workshop
•
The workshop statement falsely labeled the
relationship between pre-term birth and increased
breast cancer risk as an "epidemiologic gap" in the
research.
The Truth
•
By the time of the workshop, three studies had provided ample support
for a link between premature birth and increased breast cancer risk. 1)
Melbye M, Wohlfahrt J, Andersen A-MN, Westergaard T, Andersen PK. Preterm delivery and risk of breast cancer. Br J
Cancer 1999;80:609-13. 2) Hsieh C-c, Wuu J, Lambe M, Trichopoulos D, Adami H-O, Ekbom A. Delivery of premature
newborns and maternal breast-cancer risk. Lancet 1999;353:1239. 3) Vatten LJ, et al. Pregnancy related protection
against breast cancer depends on length of gestation. Br J Cancer 2002;87:289-90.
•
Melbye et al. 1999 found a more than two-fold risk elevation among women
having pre-term births before 32 weeks gestation.
•
Because a pre-term birth is essentially the same biological event for a woman
as an abortion, these studies also provide support for the ABC link. Whether
the baby is dead or alive, the changes that take place in the mother’s breasts
during pregnancy are identical.
58
The Truth
★ As of 2011, four studies show that premature birth is
linked with increased breast cancer risk.
★
★
★
★
1) Melbye M, Wohlfahrt J, Andersen A-MN, Westergaard T, Andersen PK. Preterm delivery and risk of breast
cancer. Br J Cancer 1999;80:609-13.
2) Hsieh C-c, Wuu J, Lambe M, Trichopoulos D, Adami H-O, Ekbom A. Delivery of premature newborns and
maternal breast-cancer risk. Lancet 1999;353:1239.
3) Vatten LJ, et al. Pregnancy related protection against breast cancer depends on length of gestation. Br J
Cancer 2002;87:289-90.
4) Innes K and Byers T. First pregnancy characteristics and subsequent breast cancer risk among young women.
Int J Cancer 2004; 112:306-311.
What “They” - Dr. Brinton & the
National Cancer Institute - Said at the
2003 Workshop
★
Reporting Bias - They told women to ignore retrospective studies (showing an
abortion-breast cancer link) which relied on women’s self-reports of their
abortion histories.
★ Although scientists often use this study design where other controversial risk
factors are being examined, the NCI & Brinton pointed to an hypothetical
problem in the design of retrospective studies called “reporting bias” (also
called “response bias” or “recall bias”).
★ They falsely claimed the only reason why there are studies reporting an
abortion-breast cancer link is not because there really is such a link, but
because breast cancer patients are more likely to tell the truth about their past
abortions than are healthy women.
The Truth
★
★
★
Reporting Bias - One study, Howe et al. 1989, ruled out any possibility of
Reporting Bias because its researchers relied on medical records of past abortions,
not women’s reports of abortion histories. Howe et al. Int J Epidemiol 1989;18:300304.
Howe et al. 1989, a prospective study conducted on New York women, whose authors
matched fetal death records with patients’ medical records, reported a statistically
significant 90% increased risk for women with abortions. It avoided the problem of
reporting bias because its authors did not rely on women’s reports of their past
abortions. Howe et al. Int J Epidemiol 1989;18:300-304.
Since the 2003 workshop, a 2007 study on 8 European countries has also avoided any
chance of reporting bias by using national data from nations believed to have nearly
complete abortion counts. In his study, Patrick Carroll found that induced abortion
was the “best predictor” of future breast cancer rates. He proved he could
successfully predict future breast cancer rates for England and Wales for 2003 and
2004 with nearly 100% accuracy. Caroll P. J Am Phys Surg Vol. 12, No. 3 (Fall 2007)
72-78.
The Truth
★
★
★
★
★
★
★
Although reporting bias is a legitimate hypothesis, it has been
tested in many studies around the world. There are no
scientists at the present time who claim to have found credible
evidence of it.
Brind J. J Am Phys Surg 2005;10(4)105-110.
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.
Lipworth L, Katsouyanni K, Ekbom A, Michels KB, Trichopoulos D. Abortion and the risk of breast cancer: a casecontrol study in Greece. Int J Cancer 1995;61:181-4.
Lindefors-Harris BM, Eklund G, et al. Response bias in a case control study analysis utilizing comparative data
concerning legal abortions from two independent Swedish studies. Am J Epidemiol 1991; 134:1003-1008.
Meirik O, Adami H-O, Eklund G. Letter Re: Relation between induced abortion and breast cancer. J Epidemiol
Community Health 1998;52:209.
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.
Dr. Brinton
Showed She
Doesn’t Believe in
Reporting Bias
Either!
In their 2009 study, Louise
Brinton, Jessica Dolle and their
colleagues used data from two
1990s studies that Brinton and
the National Cancer Institute
had falsely claimed at the 2003
workshop were flawed because
of the supposed problem of
reporting bias.
The Truth
★
Two of the studies that Dr. Brinton and the NCI had claimed were flawed because of
Reporting Bias, were studies conducted in the 1990s by Dr. Janet Daling’s team.
Daling et al. J Natl Cancer Inst 1994;86:1584-1592. Daling, Brinton et al. Am J Epidemiol 1996;144:373-380.
★
★
★
★
The studies from the 1990s reported risk increases of between 20%-50% for women
with abortions. Brinton co-authored one of those studies⎯Daling et al. 1996.
In 2007, medical journals first described triple-negative breast cancer.
In their 2009 study on use of the birth control pill and triple-negative breast cancer,
Drs. Brinton, Dolle and their colleagues used the data from those supposedly flawed
1990s studies. By doing so, they relied on women’s self-reports of past abortions, not
medical records.
In their 2009 study, Brinton and Dolle’s team tested 897 specimens of cancerous breast tissue
that had been saved from study subjects participating in the 1990s studies. They tested the
tissue samples for triple-negative breast cancer. Then, they matched their results with the
study subjects’ reproductive history - including women’s self-reports of their abortion
histories.
Tell us the
truth,
Dr. Brinton!
If the studies relying on
women’s self-reports of
their past abortions are
flawed because of
“reporting bias,” as you
claimed at the 2003 NCI
workshop, then why did
you use data from two of
those studies published in
the 1990s?
What “They” - Dr. Brinton & the
National Cancer Institute - Said at the
2003 Workshop
“Breast cancer is transiently increased after a full
term pregnancy.”
The Truth
•
The NCI’s statement is a is a half-truth. A small, temporary increase in risk after a full
term pregnancy only exists among women who delayed their first full term pregnancies
until after age 25. The risk is not more than 18% for women delaying FFTP until after
age 25 and as much as 40% for women delaying FFTP until after age 30. The risk
lasts up to 10 years after birth. 1) Cummings et al. Br Med J 1994;308:1672-1674. 2) Vatten et al. Eur J Cancer
1992;28A:1148-1153. 3) Lambe et al. N Engl J Med 1994;331:5-9.
•
The transient increase in risk is eliminated almost completely among women with two
children. There is a non-significant risk increase of up to 16% among women who have
a second child after age 35. Lambe et al. N Engl J Med 1994;331:5-9.
•
Abortion causes many women to delay their first full term pregnancies and limit the
size of their families.
The Truth
•
The NCI misleads women into believing childbearing is unsafe in comparison to not
being pregnant.
•
The Truth - In comparison to the risk of remaining childless, having a full term
pregnancy always lowers lifetime breast cancer risk. The younger a woman is when
she has her first full term pregnancy, the lower her lifetime risk is. 1) MacMahon, B, Cole P, Lin TM, Lowe
CR, Mirra AP, Ravnihar B, Salber EJ, Valaoras VG, Yuasa S. Age at First Birth and Breast Cancer Risk. Bull WHO 1970;43:209-221. 2) Trichopoulos D, Hsieh C, MacMahon B, et al.
Age at any birth and breast cancer risk. Int J Cancer 1983;31:701-704.
•
The transient increase in risk that occurs among women who have late first full term
pregnancies is significantly less than the long term risk associated with having an
abortion.
The Truth
•
Biological Reasons for the Transient Increase in Risk:
•
The most cancer-vulnerable time in a woman’s life takes
place during period between the onset of menstruation
and first full term pregnancy - known as the “susceptibility
window” - when nearly all of the breast lobules are
immature and cancer-susceptible Type 1 and 2 lobules.
Breast lobule maturation
before and after first full term pregnancy
The Truth
•
Biological Reasons for the Transient Increase in Risk:
•
The longer the susceptibility window is prolonged by delaying a first full term
pregnancy, the more mutations she can accumulate due to the effects of cancercausing substances on her cancer-susceptible Type 1 and 2 lobules. During the “the
susceptibility window,” her estrogen stimulates her Type 1 and 2 lobules during every
monthly menstrual cycle. Estrogen causes her cells to multiply through cell division
and can directly damage DNA.
•
When she delays a FFTP, she extends the susceptibility window and can accumulate
more abnormal cells. When she does get pregnant, these cells may be provoked into
growing into cancer cells because of the influence of increased estrogen during
pregnancy.
•
But, full term pregnancy is always protective over the long term. The “differentiation”
process during the last months of a full term pregnancy protects the mother from
estrogen overexposure early in pregnancy and switches off the ability cells to divide. It
leaves her with fewer places in her breasts for cancers to start. 1) W. Boecker, et al., “The Normal
Breast,” in Preneoplasia of the Breast: A New Conceptual Approach to Proliferative Breast Disease, ed. W. Boecher (Munich: Elsevier Saunders,
2006), 1–28. 14) J. Russo et al., “Full-Term Pregnancy Induces a Specific Genomic Signature in the Human Breast,” Cancer Epidemiology
Biomarkers and Prevention 17 (2008): 51–66.
Parallels to the TobaccoCancer Cover-Up
•
Many parallels can be drawn between the abortion-breast cancer link and the tobacco-cancer link.
•
Although evidence of a tobacco-cancer link dated from 1928, the U.S. National Cancer Institute and
the American Cancer Society delayed acknowledging the risk until the 1960s.
•
According to journalist Richard Kluger’s 1996 book, Ashes to Ashes, the American Cancer
Society’s leaders “had long hesitated to antagonize millions of their contributors by denouncing
their cherished smoking habit as arrant folly,” and they were reluctant to “tangle with a major U.S.
industry, especially one with great influence over the media” through its purchase of cigarette
advertising. Ashes to Ashes: America’s Hundred-Year Cigarette War, the Public Health, and the
Unabashed Triumph of Philip Morris, Alfred A. Knopf, New York, 1996, p. 203.
•
Kluger wrote that tobacco-state Congressmen pressured National Cancer Institute’s leaders. He said,
“Jesse Steinfeld, deputy NCI director at the end of the Sixties, remembered accompanying NCI
director Kenneth M. Endicott to congressional appropriations sessions where they were confronted
by tobacco-state lawmakers who demanded to know just how much the institute - and the HEW
Department overall - was spending on ‘anti-smoking propaganda.’ To Steinfeld, ‘the covert, if not
overt, message was that if you wanted your budget passed, you’d better go easy on smoking and
health.’” p. 424-425.
Parallels to the TobaccoCancer Cover-Up
•
According to former FDA chief Dr. David Kessler, the Tobacco Institute hired
prominent scientist and American Cancer Society leader Clarence 'Pete' Little as the
first science director of the Council for Tobacco Research. Experts at the CTR
“were assigned specifically to find loopholes in arguments being advanced in
litigation. Researchers were pressured not to publish critical findings....” A Question
of Intent: A Great American Battle with a Deadly Industry, Public Affairs, New
York, 2001, p. 200-202.
•
Kessler said tobacco executives bought the silence of the American Medical
Association, Harvard, Sloan Kettering Medical Center, UCLA and others by giving
these organizations funds for research on the tobacco-cancer link. Tobacco
executives considered purchasing United Press International. Kessler said tobacco
industry funding purchased the silence of influential women's groups too. Kessler,
pp. 207-208, p. 275.
•
Unlike tobacco, however, abortion and its health risks are a doctors'
industry.
For More
Information
Contact:
Karen Malec, Coalition on Abortion/Breast Cancer,
www.AbortionBreastCancer.com
Angela Lanfranchi, MD, FACS, Breast Cancer Prevention Institute,
www.BCPInstitute.org