1. Angela Lanfranchi, M.D., F.A.C.S.
President
Breast Cancer Prevention Institute
Clinical Assistant Professor of Surgery
Robert Wood Johnson Medical School
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2.  Louise A. Brinton, Ph.D., M.P.H.
 Chief Hormonal and Reproductive
Epidemiology Branch
Senior Investigator
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3. Cancer Epidemiol Biomarkers Prev April 2009
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.”
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4. Cancer Epidemiol Biomarkers Prev April 2009
Louise A. Brinton
Induced abortion RR 1.4 CI (1.1 to 1.8)
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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."
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6.  From 1957 to 2012 there are 70
studies differentiating induced from
spontaneous abortion.
 55studies show a positive association
and 33 studies are statistically
significant to the 95th percentile.
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7.  In1964, 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.
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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
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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
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10. TIME October 15, 2007
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11. Journal of American Physicians and Surgeons Fall 2007
11

12. Journal of American Physicians and Surgeons Fall 2007
In 9 countries with computerized cancer
and abortion registries, abortion was the
greatest predictor of breast cancer rates.
12

13. It is the biology of the breast lobule
maturation that occurs during
pregnancy which accounts for the
abortion breast cancer link.
13

14. A woman has an unplanned first pregnancy.
 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.
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15. Lobular Structures in the Human Breast
90 Lob.1
Lob.2
% of Structures Lob.3
60
30
0
Before After
full-term Full-term
pregnancy pregnancy
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16. Types of Breast Lobules
Type 1 Lobule Type 2 Lobule Type 3 Lobule
(TDLUs) 10-15% of all
85% of all breast Cancer resistant
breast cancers
cancers arise
arise in Type 2
Type 1 Lobules Lobules (Lobular
(Ductal cancer) cancer)
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17. 17

18. 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
19

20. JournalEpidemiology and Community and Community Health 1996
Journal of
of Epidemiology 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 Overall, 30% increase
risk of breast cancer
17 Lexington Avenue
New York, NY 10010, USA
J Brind
Center for Biostatistics and Epidemiology and
20,000 breast cancer
Department of Pharmacology
Pennsylvania State University
The Milton S Hershey Medical Center
cases a year are
Hershey, PA 17033, USA
V M Chinchilli
W B Severs
J Summy-Long
Correspondence to:
attributable to abortion
Professor J Brind
Accepted for publication
April 1996
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