Breast Cancer Doc Angela Lanfranchi Says
Abortion Link is Real

The following is a testimony before the Massachusetts Joint Health Care Committee on June 11, 2003 by Angela Lanfranchi, M.D.

I, Angela Lanfranchi, M.D., testified on June 11, 2003 before this Committee in support of H.R. 2960 an Act Relative to Patient's Rights about the scientific and medical data regarding the link between breast cancer and abortion. My testimony is summarized herein for the benefit of those Committee members absent from the hearing.

In May, 1975, I received my M.D. from the Georgetown Medical School in Washington D.C. I became Board Certified in General Surgery in 1983 and was recertified in 1993. I am a fellow of the American College of Surgeons. I have been in practice with Surgical Associates of Central New Jersey for 18 years. I have held an appointment as Clinical Assistant Professor of Surgery at Robert Wood Johnson University Medical School since 1986. I teach Family Practice residents surgery at my primary hospital, Somerset Medical Center. I am a member of an Expert Advisory Panel for the New Jersey Board of Medical Examiners.

I am co-director of the Breast Center at Somerset Medical Center.  I have limited my elective practice of surgery to breast diseases, including breast cancer, for approximately the past 8 years. I see approximately 1200-1300 patients with breast problems a year and perform over 500 breast surgeries a year. I regularly give Grand Rounds lectures on breast topics to the Departments of Medicine and Family Practice at Somerset Medical Center and speak to breast cancer survivor groups and volunteers of the local chapter of the American Cancer Society. I have lectured to lay and professional groups both nationally and internationally on breast cancer risks and prevention and on the abortion breast cancer link. A local non-profit organization, Women's Health and Counseling Center, has recognized me, for my contributions to women's health in my local community.

It is my professional opinion, based upon my professional training, experience, and my study of the relevant peer-reviewed medical literature, that an overwhelming preponderance of the evidence indicates that induced abortion increases risk of breast
cancer. In short, interrupting a normal pregnancy with abortion leaves a woman with an increase in the number of undifferentiated breast cells [the Type 1 and 2 lobules] that are more susceptible to carcinogens. These carcinogens include estrogen, a type of
hormone found in hormone replacement therapy and birth control pills. Abortion of a first pregnancy is especially harmful and most damaging to teenagers. Many times teenagers will hide their pregnancy and undergo late term abortions which are even more damaging to them. The longer one is pregnant before an abortion, the higher the breast cancer risk. Women considering abortion have a right to be informed about this evidence prior to
consenting to the procedure.

Therefore, I give all of my new patients an intake form which requests information about, among other things, reproductive history, including number of abortions and age at first abortion. The abortion breast cancer link is acknowledged in authoritative textbooks that I use in my practice. The Breast, by Bland and Copeland (1991 and 1998 editions), clearly states that "first trimester abortion increases risk" of breast cancer.

Often when I have asked leaders in the field of breast cancer why they don't talk about the abortion breast cancer link at their meetings they have said, "It's too political." I have come to believe that what is meant by "too political" is the growing influence of major womens' medical organizations. Now that very soon over half of the physicians in this country will be women, they will have a major influence in medicine. Just one example of
this is the American Medical Women's Association. This organization and its foundation, the AMWA Foundation, had over 1 million dollars in revenue in the year 2000. Its corporate sponsors include major pharmaceutical companies.

The AMWA has as its mission to provide and develop leadership to advance women in medicine and improve women's health. This is an admirable goal and they have helped many women to achieve these goals. However, I believe they are so committed to reproductive rights and the protection of Roe v. Wade, as their position paper on Abortion and Access to Comprehensive Reproductive Health Services clearly states on their web site www.amwa-doc.org, that it has clouded good medical judgment. They openly state they oppose bills such as this one. And it would seem that allowing
the information that studies clearly show an increase risk of breast cancer with abortion to be discussed in open medical forums, is perceived as endangering the Roe v. Wade ruling. These studies are kept buried in the literature. When someone such as myself discusses them, instead of debating the issue with me and other colleagues in the field, I am dismissed as a fearmonger.

An example of these extremist positions is the AMWA's position paper on Breast Cancer Prevention adopted in November 1993. It states that women who have their first full term pregnancy (FFTP) before the age of 18 have a 75% reduced breast cancer risk compared to those who have their FFTP after age 30. Instead of making this fact widely known to women considering abortion of their FFTP, they state in this same paper, "Clearly reproductive choice is a high priority in our society. If oral contraceptives can be developed to prevent an unwanted pregnancy, a hormonal equivalent of pregnancy could be developed that would confer protection in women who choose to delay pregnancy." In other words, you would not need to have a child to get the protective effect of a full-term pregnancy. You could just take a pill.  It's clear to me why major drug manufacturers support their ideas.  But what about those young women who are already pregnant?  Shouldn't they be told of the risk reduction benefits when considering abortion?

The AMWA is so concerned that abortion rights are not eroded that they oppose parental notification and support the D&X or partial birth abortion procedure as again they show on their web site. In other words, these are women physicians who support taking a 13-year-old child for a partial birth abortion without their mother's consent or knowledge. This despite the fact that it is major gynecologic surgery which can result in permanent damage to this child's reproductive organs and future fertility, not to mention her death. Children need their mother's support when having an appendectomy, much less an abortion such as a D& X procedure. I think most mothers here today would agree with me on that.

Instances of resistance to new information are not uncommon in the history of medicine, especially when the new information questions the safety of a practice long accepted by physicians themselves. I am convinced that similar biases, rather than the actual scientific facts, account for the failure of the medical community at large to inform its members and patients about the overwhelming body of evidence linking induced abortion with increased breast cancer risk.

The most well-known example of this resistance to new information is the case of Vienna obstetrician Dr. Ignaz Semmelweis and "childbed fever."

In the 1840's, Dr. Semmelweis noticed that the death rates were 10 times higher on the doctor 's maternity wards than the midwives' wards and that the midwives washed their hands frequently, as compared to the doctors, who did not. Semmelweis felt it was lack of hand washing by doctors that caused the deaths. Semmelweis' superiors posed all sorts of other theories besides lack of hand washing as a cause (including overcrowding,
rough exams by medical students, and psychological causes). An experiment was done wherein the doctors washed their hands in chlorinated water and the death rate fell dramatically. Instead of being honored for his contribution to women's health, Semmelweis was ridiculed, his privileges were reduced, and he was forced to leave the hospital. Only after his death was he acknowledged to be correct.

Practical Use of the Recognition of the Abortion Breast Cancer Link

It is my practice to counsel regarding the link between abortion and breast cancer every one of my patients who indicates a history of induced abortion on her intake form and who, after a biopsy, is not diagnosed with cancer, or who asks about breast cancer risks. I have thus counseled thousands of my patients about the evidence linking abortion with increased breast cancer risk over the last four years. I do this because there is a critical need for women at a higher risk of breast cancer to be informed of their higher risk so that they can have better and more frequent screening, leading to earlier diagnosis, which will increase their survival should they actually develop breast cancer. Many patients perceive themselves to be at low risk because they have no known family history of breast cancer.  I point out that 85% of all breast cancer patients have no family history of breast cancer. Pointing out to women that they are at higher risk encourages more regular screening mammograms which can find small, more curable breast cancers thus increasing their survival. These women also need to know that taking birth control pills after an abortion will increase their risk even more. They can use non-hormonal contraception instead. They should also be advised that there is some evidence in one National Cancer
Institute commissioned study that having a child within 5 years of an abortion will decrease their risk.

I have counseled pregnant patients with this information. Some have had abortions aware that they will be at higher risk, prepared to have early screenings and aware of risk reduction strategies. Some have decided not to have an abortion based upon this information.

This information can also be reassuring to patients with close family members with breast cancer. For instance, I recently took care of identical twin sisters. One had a history of several abortions and no children. This twin developed breast cancer at the age of 35. The other twin had a child and no abortions. She had a benign breast biopsy a year later at the age of 36. She was relieved of her fear of breast cancer by knowing that she and her twin had very different risks despite the fact they shared identical genes.

As a physician, and an as a woman who lost her mother to breast cancer, I take this information very seriously. As the mother of a preteen in a state that has no parental consent law, I worry that a misguided, misinformed guidance counselor could arrange for my daughter to have an abortion without my knowledge almost guaranteeing she will develop breast cancer by the age of 45.  Mothers need this information to protect their teenagers who may react to an unplanned pregnancy rashly, without thought of future, life threatening medical complications.

I fully support the goal of the proposed legislation, H.B. 2960, which is to inform all women considering an abortion that there may be an increased risk of breast cancer among women who have had abortions. In my mind, there is no may be. Abortion does
increase the risk of breast cancer. This fact is borne out by 29 out of 39 epidemiological studies done over the past 45 years, experimental animal models, and well-known breast physiology. It is no coincidence, that 30% of my patients with breast cancer who are in their thirties do not have a family history of breast cancer but they have had an abortion.

Background on the Abortion - Breast Cancer Link

Breast Cancer Prevention Institute - http://www.BCPInstitute.org
Coalition on Abortion/Breast Cancer - http://www.AbortionBreastCancer.com
Polycarp Research Institute - http://www.polycarp.org

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