Date post: | 25-Jun-2015 |
Category: |
Health & Medicine |
Upload: | tjfjustice |
View: | 1,710 times |
Download: | 2 times |
Angela Lanfranchi, M.D., F.A.C.S. President
Breast Cancer Prevention Institute
Clinical Assistant Professor of Surgery
Robert Wood Johnson Medical School
1
Louise A. Brinton, Ph.D., M.P.H.
Chief Hormonal and Reproductive Epidemiology Branch Senior Investigator
2
3
Results “In analyses of all 897 breast cancer cases (subtypes combined): the multivariate-adjusted odds ratios for examined risk factors were consistent with the affects observed in previous
studies on younger women. Specifically, older age, family history of breast cancer, earlier menarche age, induced abortion and oral contraceptive use were associated with increased risk for breast cancer.”
Cancer Epidemiol Biomarkers Prev April 2009
4
Louise A. Brinton
Induced abortion RR 1.4 CI (1.1 to 1.8)
Cancer Epidemiol Biomarkers Prev April 2009
5
The Globe and Mail January 8, 2010
An e-mail to Dr. Brinton on Friday was returned by an Institute spokesman named Michael Miller who said: "NCI has no comment on this study. Our statement and other information on this issue can be found at: http://www.cancer.gov/cancertopics/ere."
From 1957 to 2012 there are 70 studies differentiating induced from spontaneous abortion.
55 studies show a positive association and 33 studies are statistically significant to the 95th percentile.
6
In 1964, the US Surgeon General applied the newly developed Bradford Hill criteria for causality to the cigarette lung cancer link epidemiologic studies to warn the public.
These same criteria have been fulfilled by the world’s epidemiologic studies of the abortion breast cancer link.
7
8
9 Criteria for drawing a causal inference
from an epidemiological association
1. Timing: The patient must be exposed to the risk before the cancer
2. Similar findings in many studies
55/70 studies worldwide; 18/24 in the US associate abortion and breast cancer
3. Statistically significant increases in risk
33 studies worldwide; 9 US are statistically significant
4. Dose effect: The risk should become higher with more
exposure to the risk
The longer the pregnancy before abortion, or the more abortions, the
higher the risk, e.g. 1994 Daling Study, 1997 Melbye Study
5. A large effect observed (RR>3)
e.g. 1994 Daling Study for subgroups of teens, over 30, and family history
9
9 Criteria for drawing a causal inference
from an epidemiological association
6. Causal association is biologically plausible
Elevated estrogen levels in pregnancy leaves the breast with
increased numbers of Type 1 and 2 lobules where cancers form
without the benefit of full maturation to cancer resistant Type 3 lobules
7. Experimental studies
1980 Russo and Russo study on virgin, aborted and parous rats
8. Coherence natural history and biology of breast cancer
Breast cancers caused by abortion are found after 8 to 10 years and
average cancer cell growth takes 8 to 10 years to be clinically
detectable
9. Analogy – similar exposures associated with similar effects
Premature delivery before 32 weeks doubles breast cancer risk
10
TIME October 15, 2007
11
Journal of American Physicians and Surgeons Fall 2007
12
In 9 countries with computerized cancer and abortion registries, abortion was the greatest predictor of breast cancer rates.
Journal of American Physicians and Surgeons Fall 2007
It is the biology of the breast lobule maturation that occurs during pregnancy which accounts for the abortion breast cancer link.
13
If she chooses to continue her pregnancy and has a full-term pregnancy, or one that lasts at least 32 weeks, she will lower her risk of breast cancer.
OR If she chooses to end her pregnancy with an induced
abortion, she will necessarily have an increased risk of breast cancer because: 1. She will lose the benefit of a full-term pregnancy.
2. She will delay a full-term pregnancy or have no or fewer full-term pregnancies.
3. She may have a premature delivery before 32 weeks of another pregnancy.
14
A woman has an unplanned first pregnancy.
15
0
30
60
90 Lob.1 Lob.2 Lob.3
Lobular Structures in the Human Breast
% o
f S
tru
ctu
res
After
Full-term
pregnancy
Before
full-term
pregnancy
16
Type 1 Lobule (TDLUs)
85% of all breast
cancers arise
Type 1 Lobules
(Ductal cancer)
Type 2 Lobule
10-15% of all
breast cancers
arise in Type 2
Lobules (Lobular
cancer)
Type 3 Lobule
Cancer resistant
Types of Breast Lobules
17
Induced abortion leaves the breast with more places for cancers to start.
18
19
Age-adjusted SEER Incidence Rates by Year, Race, Age
1975 <50 3.78
Age-adjusted SEER Incidence Rates by Year, Race, Age
2007 <50 13.98
20
Journal of Epidemiology and Community Health 1996;50:481-496
Induced abortion as an independent risk factor
for breast cancer: a comprehensive review and
meta-analysis
Joel Brind, Vernon M Chinchilli, Walter B Severs, Joan Summy-Long
Department of Natural Science, Baruch College
The City University of New York
17 Lexington Avenue
New York, NY 10010, USA
J Brind
Center for Biostatistics and Epidemiology and
Department of Pharmacology
Pennsylvania State University
The Milton S Hershey Medical Center
Hershey, PA 17033, USA
V M Chinchilli
W B Severs
J Summy-Long
Correspondence to:
Professor J Brind
Accepted for publication
April 1996
Journal of Epidemiology and Community Health 1996
Overall, 30% increase risk of breast cancer
20,000 breast cancer cases a year are
attributable to abortion
21
Copyright 2012, all rights reserved.
1-866-622-6237
(1-86 NO CANCER)
www.bcpinstitute.org