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Missing the link?

National | HEALTH: Abortionists do not want to tell women about the likely connection between abortion and breast cancer, but as Breast Cancer Awareness Month arrives, some states are making sure that pregnant women are informed

Issue: "Terror on trial," Oct. 18, 2003

IN FEBRUARY 2002, CHARNETTE Messe found something many women search for but hope never to find: a lump under her arm. The Groton, Conn., mother of a preschooler quickly consulted her doctor. But because Mrs. Messe was only 30, and had no immediate family history of breast cancer, the doctor at first said a mammogram was unnecessary.

Mrs. Messe did not agree. In the past, she'd used Depo-Provera, a birth-control medication that elevates the risk of breast cancer. Also, at age 20, before marrying, she had had an abortion.

"I knew about the abortionÐbreast cancer link," said Mrs. Messe. "I demanded a mammogram." It was during the test, administered a month later, that she first knew something was profoundly wrong: "I was joking around with the technician, and the next thing I know, she's not smiling anymore."

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After the test, a new doctor sat down with the Messes and broke the news: Mrs. Messe had breast cancer. She remembers how the conversation went after that: "I said to the doctor, 'I have a 3-year-old daughter at home. Am I going to get to see her grow up?' He looked at me and said, 'Possibly not.'"

This year, an estimated 211,000 women will be diagnosed with breast cancer. Apart from skin cancer, the disease is the most common type of cancer among American women, a fact cancer-researchers, clinicians, and survivors will emphasize during October, National Breast Cancer Awareness Month. Risk factors for breast cancer include smoking, genetics, late childbearing, and estrogen overexposure. Mrs. Messe believes estrogen overexposure, both from Depo-Provera and abortion, caused her cancer.

Dozens of medical research studies say she may be right. But leading cancer groups, including the National Cancer Institute (NCI) and the American Cancer Society, say there is no abortionÐbreast cancer link. The NCI, a division of the National Institutes of Health, states categorically on its website that "induced abortion is not associated with an increase in breast cancer risk."

That statement is the latest strike in what researcher Joel Brind calls a "cataclysmic battle" over women's right to accurate medical information about the risks of abortion, and the abortion industry's interest in keeping some information quiet. The NCI posted the statement following a February 2003 "consensus workshop" on the abortionÐ breast cancer (ABC) link. But it is a topic on which the "consensus" seems to lean in the other direction.

Researchers first tied abortion to breast cancer in 1957. The medical explanation for the link centers on the interruption of the hormonal flow that occurs in women's breast cells after an abortion. During pregnancy, a surge of estrogen-a known cancer-inducing substance-begins to differentiate breast cells to prepare them for lactation. During the second and third trimester, the differentiation becomes permanent. ABC link proponents believe that an abortion interrupts this breast maturation process, leaving countless cells in an "in-between" state in which they are more susceptible to cancer formation.

The 1957 study found that women who had induced abortions doubled their risk of breast cancer. Since then, 29 of 38 epidemiological studies, including 13 of 15 American studies, exploring an independent ABC link have reported elevated risks ranging from slight to-in the case of women with previous family history of the disease who aborted a first pregnancy before age 18-extremely high.

It is widely acknowledged that a full-term first pregnancy lowers a woman's risk of breast cancer, and that any premature birth before 32 weeks more than doubles breast cancer risk. But many cancer researchers refuse to acknowledge that this same biologic mechanism could link breast cancer with abortion.

That became acutely clear in 1996, when Mr. Brind, a professor of biochemistry at the City University of New York, completed a landmark comparison of all existing literature on the ABC link. He concluded that, overall, previous research showed that women who had an abortion before their first full-term pregnancy increased by 50 percent their risk of developing breast cancer. Women who had an abortion after their first full-term pregnancy had a 30 percent increased risk.

Coming as it did just when pro-life activists seemed to be turning the tide of public opinion on abortion, Mr. Brind's study touched off a political war. In one camp: clinicians, cancer survivors, and pro-life groups anxious to spread the news about what some call the single most avoidable breast cancer risk. In the other: pro-abortion groups, their media friends, and establishment cancer groups anxious to preserve the culture of "choice." Women's health was caught in the crossfire.

NCI's February 2003 "consensus workshop" shows how. That event evolved after a dust-up between NCI, ABC-link proponents, Health and Human Services Secretary Tommy Thompson, and a confab of pro-abortion legislators led by U.S. Rep. Henry Waxman (D-Calif.). The problem: NCI's website, which in March 2002 stated: "The current body of scientific evidence suggests that women who have had either induced or spontaneous abortions have the same risk as other women for developing breast cancer." (NCI and others say studies that show an ABC link often have a "recall bias"-that women with cancer, seeking a cause for their illness, will be more likely than healthy women to admit to past abortions.)

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