Queensland MP Freya Ostapovitch has claimed abortion increases the risk of breast cancer.
The member for Stretton rose to speak on a matter of public interest just before midday on Tuesday, when most parliamentary reporters were in the budget lock up.
Ms Stretton said her mother’s breast cancer diagnosis had prompted her to research the condition and said she was “alarmed” to find “many of the risks that increase breast cancer are not public knowledge”.
While also mentioning smoking, obesity, the pill and alcohol, Ms Ostapovitch focused on abortion, quoting from Chinese researchers, saying “the more induced abortions a woman had, the greater her risk of breast cancer”.
“Another six studies have emerged from India and Bangladesh, confirming that induced abortion increases breast cancer risk,” she said.
“Why are women not informed of these basic facts so that they can avoid induced abortions and thus lower this risk of breast cancer, the major cause of death other than road accidents for premenopausal women and the third major cause of death for postmenopausal women?
“I know that some of these choices will be unpopular or inconvenient, but women have a right to know.
“A woman has no choice at all if she does not know the choices in the first place. Let women decide if they want to make lifestyle choices that decrease or increase the risk of contracting cancer. I hope that this speech will raise awareness and get the conversation started about some real ways a woman can prevent contracting breast cancer.”
Kate Marsh, public liaison officer for Children by Choice said the link between breast cancer and abortion was “often raised by anti-choice lobbyists or people who might be ideologically opposed to abortion”, but was not stacked up by evidence.
“It is one of the risks, along with infertility and mental illness that is often used as a way to try and frighten women away from seeking a termination,” Ms Marsh said.
“It is not something that is backed up by the evidence though, along with those other two issues. It is something that has been debunked by the World Health Organisation, the National Cancer Institute in the US and there are also bodies here in Australia, like the Australian Cancer Council, which don’t actually recognise induced or spontaneous abortion as a risk for breast cancer.”
A quick Google search brings up many studies which have debunked the claim, including Denmark research from the 1990s, which used medical records to study 1.5 million women born between 1935 and 1978 and found “no overall effect on the risk of breast cancer” and abortion.
Cancer Council Queensland reported that nine out of 10 women who developed breast cancer have no other risk factors.
In Queensland, 2911 residents were diagnosed with breast cancer in 2010, which is when the most recent statistics were available. Twenty-four of those diagnosed, were men.
Of the 473 people who died from breast cancer in 2010, 469 were women and four were men. The risk for developing breast cancer increases with age – in Queensland, around three-quarters of those diagnosed are over 50.
Risk increases for women who have a family history of breast cancer, but hereditary breast cancer accounts for less than five per cent of all breast cancers diagnosed.
Cancer Council Queensland info:
Detection and symptoms:
If the cancer is found and treated early, there is an increased chance of surviving the disease.
There are a number of breast changes that women should look out for. Women should consult their GP about the following:
•A persistent lump, lumpiness or thickening;
•Changes to the nipple such as crusting, ulceration, redness or drawing in of the nipple;
•Discharge from the nipple;
•Any change of the shape, feel, size or colour of the breast;
•Dimpling or puckering of the skin; and
•Unusual breast pain which is not associated with a monthly menstrual cycle.
Who is at risk
•Being a woman is the main risk factor for developing breast cancer. While men can be diagnosed with breast cancer, it is approximately 100 times more common in women.
•The risk for developing breast cancer increases with age. In Queensland, around three-quarters of women diagnosed are over the age of 50.2
•Nine out of 10 women who develop breast cancer have no other risk factors.
•The risk increases for women who have a family history of breast cancer, but hereditary breast cancer accounts for less than five per cent of all breast cancers diagnosed.
•Women who have already had breast cancer have an increased risk of developing a second breast cancer.
Cancer Council Queensland’s Breast Cancer Support Service is a free and confidential service where trained volunteers who are breast cancer survivors provide information and support to women with breast cancer.
The Breast Cancer Support Service is an opportunity for women with breast cancer to speak to someone who has had a similar experience. Where possible, women are matched with a volunteer according to age and type of treatment.
To be matched with a Breast Cancer Support volunteer, or for more information about breast cancer, please call the Cancer Council Helpline on 13 11 20.
Breast Cancer and Abortion
Why is it hard to talk about abortion and breast cancer?
Abortion and breast cancer are both topics that can bring out strong feelings in people. The issue of abortion is often linked to personal and political viewpoints – even without a possible disease connection. Breast cancer is the most common cancer in women (aside from skin cancer), and it’s the second leading cancer killer in women. Because it can be a deadly disease, it’s one that many women fear.
Linking these topics creates a great deal of emotion and debate. But scientific research studies have not found a cause-and-effect relationship between abortion and breast cancer.
How do hormones affect the breasts?
A woman’s risk for some types of breast cancer is related to hormone levels in the body. Breast cells normally grow and divide in response to hormones like estrogen, progesterone, and prolactin. Levels of these hormones change throughout a woman’s life, but they typically change a lot during pregnancy. When a woman is pregnant, her body gets ready for breast-feeding by altering the levels of these hormones. This causes changes in the breast tissue.
Does abortion affect hormones during pregnancy?
Concern about a possible link between abortion and breast cancer has been raised because abortion is thought to interrupt the normal cycle of hormones during pregnancy. Some believe that this interruption might increase a woman’s risk of developing breast cancer.
There are different types of abortion:
• Spontaneous abortion, which most people refer to as a miscarriage, is the loss of a fetus before 5 months (20 weeks) into the pregnancy. It is often caused by problems with the fetus or with the maternal environment in which it is growing.
• Stillborn birth (stillbirth) is usually considered to be the death of a fetus after 5 months’ gestation while still in the uterus (womb).
• Induced abortion is a medical procedure done to end a pregnancy. It is what most people think of when they hear “abortion.”
All of these have been studied to see what effect they may have on a woman’s risk of developing breast cancer later in life.
Research on abortion and breast cancer
Research study problems
Many studies have looked at a possible link between abortions and an increased risk of breast cancer. But because of the nature of the topic, these studies have been hard to do. This may help explain why study findings vary.
Before 1973, induced abortions were illegal in much of the United States. So when researchers asked a woman about past pregnancies, she may not have felt safe saying that she had an illegal abortion. Even though abortion is now legal, it is still a very personal, private matter that many women do not like to talk about.
Studies have also shown that healthy women are less likely to report that they have had induced abortions. In contrast, women with breast cancer are more likely to accurately report their reproductive histories. This may be because they are searching their memories for anything that may be linked to the cancer.
The likelihood that women who have breast cancer will give a more complete account of their abortions than women who do not have breast cancer is an example of recall bias. Recall bias like this can sometimes cause studies to find links that may not exist.
Research study design
Most early studies of abortion and breast cancer used a case-control study design. This study design is very prone to recall bias (see above). In these studies, women with and without breast cancer were asked about past abortions. The researchers then compared the frequency of abortions in women with breast cancer (the cases) to those in women without breast cancer (the controls).
Higher rates of reported abortions in breast cancer cases (versus the controls) were seen in some of these studies, but it is likely that these were not true findings because of recall bias. Studies that ask women about abortion before breast cancer is diagnosed (prospective studies) do not seem to find this link.
A prospective study design is stronger and less prone to bias. In this type of study, a group of women who are cancer-free are asked about their past abortions and then are watched over a period of time to see if a new cancer occurs. In this type of study all of the women are cancer-free at the start, so there is no chance that having cancer will influence their memory of past abortions or their willingness to report past abortions.
Some prospective studies have further addressed the problem of recall bias by using new ways to find out about past induced abortions. For example, one study used birth certificate information of children born to women with breast cancer to identify women who had had induced abortions. (The number of previous abortions was listed in the birth certificate registry information.) This study found no increase in breast cancer risk in women who had an abortion followed by a live birth.
Research has confirmed that study type is likely to play a role in what is found. A review of the previous studies on this issue (see the next paragraph), covering tens of thousands of women, showed that women followed in prospective studies (which are less prone to recall bias) had no increased breast cancer risk if they had had an abortion. Case-control studies, which are prone to recall bias, pointed to a slight increase in risk.
Results from major prospective studies
The largest, and probably the most reliable, study on this topic was done during the 1990s in Denmark, a country with very detailed medical records on all its citizens. In this study, all Danish women born between 1935 and 1978 (a total of 1.5 million women) were linked with the National Registry of Induced Abortions and with the Danish Cancer Registry. All of the information about their abortions and their breast cancer came from registries – it was very complete and was not influenced by recall bias.
After adjusting for known breast cancer risk factors, the researchers found that induced abortion(s) had no overall effect on the risk of breast cancer. The size of this study and the manner in which it was done provide good evidence that induced abortion does not affect a woman’s risk of developing breast cancer.
Another large, prospective study was reported on by Harvard researchers in 2007. This study included more than 100,000 women who were between the ages of 29 and 46 at the start of the study in 1993. These women were followed until 2003.
Again, because they were asked about childbirths and abortions at the start of the study, recall bias was unlikely to be a problem. After adjusting for known breast cancer risk factors, the researchers found no link between either spontaneous or induced abortions and breast cancer.
The California Teachers Study also reported on more than 100,000 women in 2008. Researchers asked the women in 1995 about past induced and spontaneous abortions. While the women were being followed in the study, more than 3,300 developed invasive breast cancer. There was no difference in breast cancer risk between the group who had either spontaneous or induced abortions and those who had not had an abortion.
What do the experts say?
In February 2003, the US National Cancer Institute (NCI) held a workshop of more than 100 of the world’s leading experts who study pregnancy and breast cancer risk. The experts reviewed human and animal studies that looked at the link between pregnancy and breast cancer risk, including studies of induced and spontaneous abortions. Some of their findings were:
• Breast cancer risk is increased for a short time after a full-term pregnancy (that is, a pregnancy that results in the birth of a living child).
• Induced abortion is not linked to an increase in breast cancer risk.
• Spontaneous abortion is not linked to an increase in breast cancer risk.
The level of scientific evidence for these findings was considered to be “well established” (the highest level).
The American College of Obstetricians and Gynecologists (ACOG) Committee on Gynecologic Practice also reviewed the available evidence in 2003 and again in 2009. ACOG published its most recent findings in June 2009. At that time, the Committee said, “Early studies of the relationship between prior induced abortion and breast cancer risk were methodologically flawed. More rigorous recent studies demonstrate no causal relationship between induced abortion and a subsequent increase in breast cancer risk.”
In 2004, the Collaborative Group on Hormonal Factors in Breast Cancer, based out of Oxford University in England, put together the results from 53 separate studies done in 16 different countries. These studies included about 83,000 women with breast cancer. After combining and reviewing the results from these studies, the researchers concluded that “the totality of worldwide epidemiological evidence indicates that pregnancies ending as either spontaneous or induced abortions do not have adverse effects on women’s subsequent risk of developing breast cancer.” These experts did not find that abortions (either induced or spontaneous) cause a higher breast cancer risk.
Conclusion
The topic of abortion and breast cancer highlights many of the most challenging aspects of studies of people and how those studies do or do not translate into public health guidelines. The issue of abortion generates passionate viewpoints in many people. Breast cancer is the most common cancer in women aside from skin cancer; and breast cancer is the second leading cancer killer in women. Still, the public is not well-served by false alarms. At this time, the scientific evidence does not support the notion that abortion of any kind raises the risk of breast cancer or any other type of cancer.
References
American College of Obstetricians and Gynecologists (ACOG) Committee on Gynecologic Practice. ACOG Committee Opinion. No. 434: Induced Abortion and Breast Cancer Risk. Obstet Gynecol. 2009;113:1417-1418.
Beral V, Bull D, Doll R, et al. Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and abortion: Collaborative reanalysis of data from 53 epidemiological studies, including 83,000 women with breast cancer from 16 countries. Lancet. 2004;363:1007-1016.
Henderson KD, Sullivan-Halley J, Reynolds P, et al. Incomplete pregnancy is not associated with breast cancer risk: The California Teachers Study. Contraception. 2008;77:391-396.
Kitchen AJ, Trivedi P, Ng D, Mokbel K. Is there a link between breast cancer and abortion: a review of the literature. Int J Fertil Womens Med. 2005;50(6):267-71.
Melbye M, Wohlfahrt J, Olsen JH, et al. Induced abortion and the risk of breast cancer. N Engl J Med. 1997;336:81-85.
Michels KB, Xue F, Colditz GA, Willett WC. Induced and spontaneous abortion and incidence of breast cancer among young women. Arch Intern Med. 2007;167:814-820.
National Cancer Institute. Abortion, Miscarriage, and Breast Cancer Risk. Accessed at www.cancer.gov/cancertopics/factsheet/Risk/abortion-miscarriage on February 18, 2013.
National Cancer Institute. Breast Cancer Prevention. Accessed at http://www.cancer.gov/cancertopics/pdq/prevention/breast/HealthProfessional/page2#Section_280 On February 18, 2013.
National Cancer Institute. Reproductive History and Breast Cancer Risk. Accessed at www.cancer.gov/cancertopics/factsheet/Risk/reproductive-history on February 18, 2013.
National Cancer Institute. Summary Report: Early Reproductive Events and Breast Cancer Workshop. Accessed at www.cancer.gov/cancerinfo/ere-workshop-report on February 18, 2013.
Source: The Age, American Cancer Society