Dozens of studies have shown that the greater the number of abortions, the higher the incidence of breast cancer. Three states require physicians to disclose to patients seeking abortion that the procedure may increase the risk of breast cancer; 3 other states have more general disclosure requirements in connection with abortion.
There is a legal obligation of informed consent for any medical procedure. With the majority of studies showing that abortion increases the breast cancer risk, and even the minority studies reinforcing the well-established principle that childbirth is protective against breast cancer, patients seeking abortion have an obvious right to this information.
The patient who received an abortion and later develops breast cancer may have a valid claim against the provider. Already there has been at least one settlement in a lawsuit brought for such failure to disclose.
Unfortunately, misinformation has circulated in the media by virtue of an article published last year in the Lancet medical journal. That article did not deny that increased abortions result in greater incidence of breast cancer. Rather, the article merely claimed that abortion does not increase the risk of breast cancer compared to someone who delayed pregnancy altogether. The Lancet article and its published data are consistent with the prevailing medical view that the more abortions in a society, the greater the number of breast cancer cases.
Failure to diagnose this higher incidence of breast cancer has now become the most common type of malpractice case. While only a small percentage of physicians perform abortions in their practices, most physicians will encounter a patient who has an abortion in her medical history. The overall rate in the United States of a patient contracting breast cancer is 1 in 7.5 and tragically continues to rise.
The likelihood of a patient developing breast cancer may be higher if there is an abortion in the patients medical history and physicians may be held accountable for a heightened duty to screen that patient for cancer.
There is also a public policy issue about who should pay for the enormous costs of increased breast cancer cases. Tobacco companies have ultimately been held liable for health care costs imposed by the increased risk of cancer from smoking. Attorney Generals of various states have sued to obtain enormous settlements from the tobacco industry. Should the logic be any different for abortion providers?
Informed Consent Laws. There is a general duty at common law for physicians to procure informed consent from a patient before an operation. Failure to do so can result in criminal battery or, at a minimum, malpractice. Consent is plainly not meaningful if not fully informed. Consent to an operation based on an understanding of no long-term adverse effects is invalid if the operation does increase a risk of a long-term condition and the patient was not informed of this fact.
The lack of completely informed consent by a patient can impose liability on the physician. Courts in New York have held that even emotional distress brought on by misinformation about abortions serves as the basis for a valid claim and the acting physician can thereby be held liable. In 1987, the New York Court of Appeals allowed recovery by a patient because she had received incorrect information resulting in an abortion that caused emotional distress.
In 2004, a trial court in New York upheld a claim of medical malpractice where a breach of duty by a physician and misinformation caused emotional distress. The mother had been told that her condition of fibroid tumors rendered it unlikely that she could carry her pregnancy to term. She then submitted to a chemical abortion, but it failed to be completed successfully. The patient ultimately decided to give birth. Her child was then born with severe defects, which were caused by the attempted chemical abortion. If the patient had been correctly informed, she would have chosen to continue her pregnancy and given birth to a healthy child.
Lawsuits may be filed against abortion providers who fail to disclose that the procedure might increase the chance of breast cancer. One such suit, in Pennsylvania, has already settled on confidential terms.
Pennsylvania does not have a law expressly requiring that abortion providers disclose a connection with breast cancer, but the common law imposes a duty of informed consent nationwide.
Three states do expressly require that abortion providers inform their patients that the operation may increase the risk of breast cancer: Texas, Mississippi and Minnesota.
Minnesota mandates this disclosure but the Department of Health has added a disclaimer to its publications as described below. A fourth state, Kansas provides the information through state publications including its website.
Two other states, Alabama and Louisiana, have backed away from disclosing the possibility of an increased risk. Neither Alabama nor Louisiana, however, has altered the common law duty to provide all relevant information to a patient in procuring consent.
Texas, the second most populous state, has a statutory mandate that informed consent be given 24 hours prior to an abortion. Texas law expressly establishes that consent is informed only if the physician who is to perform the abortion informs the woman [of] the possibility of increased risk of breast cancer following an induced abortion and the natural protective effect of a completed pregnancy in avoiding breast cancer . Additionally, the woman to receive an abortion must certify in writing that she has been informed of this increased risk. This law was enacted in 2003 and its effect on abortions in that state is not yet known.
Mississippi law requires that women preparing to receive an abortion sign a form indicating they have been specifically told about a possible link between abortion and breast cancer.
Effective beginning in 1996, this requirement and others have had a dramatic affect on the numbers of women obtaining abortions in that state. In response to the requirements, abortions have fallen by more than 50 percent in Mississippi. In 1991 the number of abortions performed was 8,814; in 2002, the latest year for which data is available, this number had dropped to 3,605, representing a decline of 59%.
Minnesota law requires informed consent and disclosure of the abortion/breast cancer link at least 24 hours prior to an abortion. According to Minnesota law, no abortion shall be performed unless the female is told of the particular medical risks associated with the abortion procedure to be employed including the risk of breast cancer.
Additionally, the Minnesota Department of Healths Report of Informed Consent for Induced Abortion lists the risk of breast cancer associated with abortion. Although the state mandates this disclosure and the Department does claim the risk exists, they also add a disclaimer: two recent studies claim there is no link, adding that [w]omen who have a strong family history of cancer or who have clinical findings of breast disease should seek medical advice from a physician regardless of their decision to become pregnant or have an abortion.
Kansas law expressly requires that women be informed of a description of risks related to the proposed abortion method, and the state-mandated pamphlet which is handed out to potential patients warns: [s]everal studies have found no overall increase in risk of developing breast cancer after an induced abortion, while several studies do show an increas
isk However, Kansas does not specifically require informing patients of abortion and its related increased risk of breast cancer.
In Louisiana, a state-mandated brochure and its Department of Health and Hospitals had been informing women of the potential risks of the abortion procedure, voluntarily including information on the increased risk of breast cancer.
Under pressure from media representations about an article that appeared in Lancet, discussed in greater detail below, Louisiana hastily removed the abortion/breast cancer link information.
In June of 2004, a United States District Court judge approved a settlement involving a challenge to the 2002 Alabama Womens Right to Know Act. The constitutionality of the law, which required disclosure of the effects of abortion on the body, the risks involved and the alternatives available, was well established. But the court-approved settlement specifically stated that the warning of the increased risk of breast cancer due to an abortion was to be removed from the state-mandated brochures. Apparently abortion providers oppose informing patients about the increased risk of breast cancer more than other disclosure requirements.
The Flawed Lancet Article. In March 2004, the medical journal Lancet published an article that was widely and inaccurately portrayed as disproving the link between abortion and breast cancer.
Not even the article itself denied that more abortions increase breast cancer incidence, a fact observed by the vast majority of studies and by changes in breast cancer rates worldwide in response to changes in abortion rates. Delaying or avoiding childbirth elevates the risk of breast cancer, and abortion has that adverse effect.
According to most studies, abortion also causes additional risk.
The Lancet article did claim that [p]regnancies that end as a spontaneous or induced abortion do not increase womans risk of developing breast cancer.16 This was the strongest assertion in the article, but it does not deny that abortion increases the risk of breast cancer.
Instead, this assertion compares the risk of breast cancer from an abortion to a hypothetical case when no pregnancy occurred in the first place. Once a pregnancy occurs, aborting that pregnancy does increase the risk of breast cancer for that individual. For society as a whole, more abortions do cause greater incidence of breast cancer in the future. Not even the Lancet article doubts this.
Ignored in the media reports is that the Lancet article relies entirely on a purely hypothetical comparison between (i) pregnancy followed by abortion and (ii) no pregnancy at all. But neither the patient, nor the abortion provider, nor the government has the option of turning back the clock and undoing a pregnancy after it occurs, and childbirth is beneficial to health.
The only intentional alternatives are between childbirth and abortion, and the Lancet article tacitly concedes that the latter increases the risk of breast cancer with respect to the former. Nearly all studies have concluded likewise. The medical consensus is that carrying a pregnancy to term is healthier than terminating it by abortion. Women consenting to an abortion need this information in order for their consent to be informed.
This effect of abortion is illustrated by countries that have banned or restricted abortion. Under two decades of rule by Nicolae Ceausescu, Romania prohibited abortion and enjoyed one of the lowest breast cancer rates in the entire world during that time, far lower than comparable Western countries. Romanias breast cancer rate was an astounding one-sixth the rate of the United States.
But after the execution of Ceausescu on Christmas Day, 1989, Romania has taken the entirely opposite approach, embracing abortion to the point where Romania now has one of the highest abortion rates in the world.
Science predicts that breast cancer rates will rise as the women having abortions reach ages susceptible to the disease. Indeed, that is exactly what is happening, with the worse still ahead as women who had abortions as teenagers and in their twenties in the 1990s reach ages more susceptible to breast cancer.
Similar observations of cause-and-effect are evident in Poland and Ireland: Poland limits abortion and now enjoys one of the lowest breast cancer rates in Europe, despite a high rate of cancer in men, while Ireland prohibits abortion and benefits from a breast cancer rate of only 1 in 13, nearly half of the United States rate.
Even in the Far East, where breast cancer rates have historically been much lower than the West, increased abortions have apparently caused alarming increases in breast cancer incidence.
In Taiwan, for example, abortion was traditionally rare but Taiwan has followed its pervasive practice in the West. A sharp increase in abortions in Taiwan would predictably lead to relatively higher breast cancer incidence among the younger age group affected by the change.
This has indeed occurred, as breast cancer patients younger than 40 years of age account for only 6 percent of total breast cancer victims in West European countries, but the ratio reaches a high of 29 percent in Taiwan. No plausible explanation for this phenomenon (other than abortion) has been advanced.
The data republished in the Lancet article do show an increased risk among breast cancer victims asked if they had obtained an abortion. Specifically, the article reveals that about 33 out of 39 large studies of breast cancer patients had an increased risk of breast cancer from abortion beyond the affect of avoiding a pregnancy.16
The Lancet article disingenuously excludes the studies showing the highest correlation and includes dubious studies, but even then its data still illustrate a clear correlation. Its tables show studies in France, Greece, Australia and Germany displaying relative risks of breast cancer of 1.35 or above for abortion compared to no pregnancy at all.
The risk of breast cancer from abortion compared to childbirth, which is the real alternative, is of course far higher given the protective benefits of childbirth.
The Lancet article errs, however, in emphasizing small prospective studies that rely on self-reporting of abortion by patients who do not have cancer and may not even be sick. In contrast to the cancer patients, who have every incentive to disclose a medical history of abortion, women who are not ill have an incentive to keep that personal information entirely private. The only healthy women who have reason to disclose a prior abortion are those preparing for childbirth, which has beneficial effects that mask the health impact of the abortion.
By effect if not design, the Lancet article relied on samples consisting of the least likely breast cancer victims among women who had abortions. For the small prospective studies used by the Lancet article, [o]n average, the age of the women with breast cancer was 50.4 years and they had 2.4 births.16
But about 80% of breast cancer victims are over 50, and the typical breast cancer patient has had fewer than 2.4 births. The obvious disincentives for healthy women to report their own abortions, and the masking effect of the large average number of childbirths, negate any effect of abortion in this sample.
It is no surprise that the effects of abortion are offset by other factors in this unrepresentative group. There are many additional flaws to the Lancet article, already explained elsewhere
The Lancet article contains political language favoring abortion, such as the phrase that certain women have been at risk of illegal abortion for part of their reproductive lives.16 The authors apparently picked studies advancing their agenda, and admitted to excluding studies showing higher correlations between abortion and breast cancer.27 They also excluded older women, who are most likely to contract breast cancer, by an irrational elimination of studies predating the full legalization of abortion in many countries.
The article cannot accomplish its purported goal of surveying other studies by selectively excluding studies that do not serve its conclusion. Moreover, the article failed to include details about how the prospective studies were really performed.
Regional variations in breast cancer rates among similar ethnic groups confirm the link between abortion and breast cancer. In Great Britain, for example, the rate of breast cancer decreases steadily as one travels from England, where abortion has been common, to Northern Ireland, where abortion has been uncommon, to Ireland, where it has been prohibited.
In the United States, similar relationships between abortion and breast cancer can be observed. The San Francisco Bay Area, including Berkeley, is known for its longstanding acceptance of abortion and it has a breast cancer rate 9% higher than the rest of the state, according to information from the state Department of Finance and the state Office of Vital Records.
Long Island has suffered from a high rate of breast cancer that politicians have blamed on the environment. But the boroughs of New York and Long Island have long had a thriving abortion industry, dating back to 1970 when the State legalized the procedure even before Roe v. Wade (1973), and many of the earliest and busiest abortion clinics in the United States have been on Long Island. In contrast, Wyoming has the lowest abortion rate among states. Though its smoking rate is higher than 30 other states and its typical diet is far from ideal, Wyoming has one of the lowest breast cancer rates among women nationwide.
Malpractice and Failure to Diagnose. The alarming increase in breast cancer in the wake of abortion has been well documented. But this issue has not yet been addressed: who is paying the costs?
Physicians are. Not the small percentage that perform abortions, but the large percentage that do not.
The physicians bearing the costs here are those sued for failure to diagnose breast cancer, and the other physicians who have endured rising malpractice premiums.
The most common type of malpractice case is now failure to diagnose breast cancer.
This type of lawsuit now surpasses all other suits against physicians. The average payout for these failures to diagnose cases is substantial: about $200,000 apiece. Added to that are substantial costs of defense, lost time and income for the defendant physician, and significant administrative costs.
These malpractice costs are borne by all physicians in the form of rising premiums. The over 50% increase in breast cancer in America since Roe v. Wade has likely caused a greater than 50% increase in lawsuits for failure to diagnose it, as lawyers develop practices specializing in this particular type of action. Even when detected, a failure to diagnose lawsuit can be filed for not detecting sooner. (Abortions and breast cancer both increased before Roe v. Wade also.)
About 5% of breast cancer is inherited, and thus delineated in a routine medical history that documents parental illness, but a physician faces a difficult task of defending against a failure to diagnose claim in everyone else.
About 80% of women with breast cancer are the first in their families to be stricken by the disease. Even a proper diagnosis can lead to a malpractice lawsuit, if the attorney wants to argue that the breast cancer should have been detected sooner.
With abortion recognized as a risk factor for breast cancer by consensus in the medical literature and by several state laws, physicians should be aware of the likelihood of being sued for failure to diagnose breast cancer in a patient who had an abortion.
A physician can save lives and protect himself against lawsuits by being vigilant for the possibility of breast cancer in patients with a medical history of abortion.
The Alan Guttmacher Institute estimates that about 1 in 3 American women will have had an abortion by the time she reaches the age of 45 years. Accordingly, physicians can expect that roughly a third of their patients around that age will have had an abortion, though this can vary widely due to location and demographics.
It is helpful to know what percentage of those patients will ultimately develop breast cancer, in order to screen for it early and save lives. The overall rate is 1 in 7.5 in the United States. But more abortions mean more breast cancers under the prevailing medical view, thereby implying a higher rate of breast cancer among women who have had an abortion.37 How much higher?
About 80% of breast cancer victims are over the age of 50, but that population was already past the teenage years when abortion rates increased sharply after the national legalization of abortion.
Half of all abortions are by women aged 24 or younger, and the numbers of abortions in the United States did not reach its highest levels until many years after Roe v. Wade.
The vast majority of abortions performed in the United States (and the world) occurred after 1980, and a woman aged 24 or less then is still shy of 50 years today. Any increase in breast cancer by abortion already witnessed would be merely the beginning of much greater increases in breast cancer in the future. The largest expense to physicians and society from the effect of abortion on breast cancer lies ahead.
While ultimately a third of American women will have abortions by the age of 45, far fewer women had abortions in the 1960s and 1970s than in the 1980s and 1990s. Among women who have reached 50 years today (and thus were already 25 years or older by 1980), perhaps only about a fifth of that group has had abortions.
If the 50% rise in breast cancer rates since abortion became legal nationwide is primarily attributable to this fifth, then that implies a 3.5-fold increase in relative risk for it.
Given that the overall lifetime risk of breast cancer has risen to 1 in 7.5, a relative lifetime risk of 3.5 for breast cancer by the fifth who have reached 50 years and have had an abortion translates into an absolute lifetime risk for them of about 1 in 3. The risk would be even higher when all types of cancer are included.
The United States has not yet felt the full impact of the abortions performed on over twenty million young women since 1980. The vast majority are well under 50 years old; many millions of them have not yet reached 30 years.
If 1 in 3 of these younger women develops breast cancer, or even half that rate for 1 in 6, the costs in terms of lives lost, medical expenses, failure to diagnose lawsuits, and forgone opportunities are staggering. Studies show that breast cancer deprives a woman who dies from it of 20 years of her life, and those who survive also lose a great deal.31
Ultimately the tobacco companies have been held liable for the costs they impose on individuals and society. Will the same occur for the abortion ind
r will those costs continue to be borne by other physicians in the form of malpractice premiums and by society at large?
Are we currently in a period of denial similar to what happened for decades in connection with tobacco?
The States of Mississippi and Texas, and the countries of Ireland and Poland, have adopted abortion policies that will minimize the occurrence of breast cancer in the future. Meanwhile, the country of Romania is changing from having among the lowest incidence of breast cancer to having the highest.
The liberalization of abortions in Romania in 1990, the significant increase of the number of abortions at relatively short intervals, determined a raise in the incidence of breast and uterine cervix cancer in my country. Its population faces increasing breast cancer for the next few decades, cutting short many womens lives and devastating its health system.
Less than 20 years after Roe v. Wade, the rate of breast cancer in the United States had risen to 1 in 10, and Time Magazine sounded a national alarm with a cover story describing it as the puzzling plague. Yet the article did not mention abortion even once. Now the breast cancer rate has risen further to 1 in 7.5, but articles about causation have vanished from the established media. Most of the women who had uninformed abortions in the 1980s and 1990s have not yet reached ages most vulnerable to breast cancer.
The full impact of abortion on health is yet to come.
Conclusion. Consent to any operation is meaningless unless fully informed. The overwhelming consensus in the medical literature is that abortion does increase the incidence of breast cancer.
This information is of obvious significance to women who may consider having an abortion, and their consent without it is legally deficient. Failure to diagnose breast cancer has become the most popular type of malpractice lawsuit.
To save lives and guard against possible lawsuit, physicians would be well-advised to warn of the link prior to the operation and to be vigilant looking for breast cancer in patients having a medical history of abortion.
The costs to individuals and society from withholding or ignoring this information about abortion and breast cancer are enormous. In contrast to the tobacco industry, the abortion industry pays nothing to offset the substantial costs to society of increased cancer. States and countries, already strained to their breaking point in their health budgets, face a rising tide of costly breast cancer cases. Disseminating information is the best way to save lives and scarce resources. [Andrew L. Schlafly, Esq.]
1. Natanson v. Kline, 186 Kan. 393, 406-407, clarified by, 187 Kan. 186 (1960).
2. Martinez v. Long Island Jewish Hillside Medical Center, 70 N.Y.2d 697, 699 (1987).
3. Sheppard-Mobley v. King, 10 A.D.3d 70 (2004).
4. United States Representative Patrick Toomey to Address Over 1,500 at the Wyndham Franklin. Business Wire, 22Nov03.
5. Chipping away at abortion. The Washington Times, 29Oct03, p. A20.
6. Tex. Health & Safety Code § 171.012.
7. Miss. Code Ann. § 41-41-33.
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9. Minn. Stat. § 145.4242.
11. K.S.A. § 65-6709.
12. If You Are Pregnant, published by the Kansas Department of Health and Environment.
13. Meckler L. Some women considering abortion are wrongly told it could increase breast cancer risk. Associated Press, November 10, 2004, Wednesday, BC Cycle.
14. Abortion; Corrections being made to Louisiana abortion brochure. Oncology Business Week, 12Dec 04.
15. Johnson B. Court approves distribution of materials before an abortion. The Associated Press State & Local Wire, June 28, 2004, Monday, BC Cycle.
16. Breast cancer and abortion: collaborative reanalysis of data from 53 epidemiological studies, including 83 000 women with breast cancer from 16 countries. Lancet, March 27, 2004, Vol. 363, p. 1007.
17.Breast Cancer: Pregnancies ending in abortion do not increase breast cancer risk. Oncology Business Week, 18Apr04, p. 16.
18.Study: No Abortion, Breast Cancer Link, The Commercial Appeal (Memphis, TN), March 28, 2004, A5.
19.Corrections being made to Louisiana abortion brochure. Patient Care Law Weekly, December 12, 2004, p. 21.
20.Corrections being made to Louisiana abortion brochure. Healthcare Mergers, Acquisitions & Ventures Week, December 11, 2004, p. 18.
21. Corrections being made to Louisiana abortion brochure. MD Week, December 10, 2004, p. 7.
22. Corrections being made to Louisiana abortion brochure. Medical Verdicts & Law Weekly, 9Dec04, p. 19.
23.Khan A. The Role of Fat in Breast Cancer. The Independent, May 18, 1998.
24. Abdullaev N. Russians Are Quickest to Marry and Divorce. Moscow Times, December 8, 2004.
25. OFlaherty K, Oakley R. Self-checks useless in breast cancer fight. Sunday Tribune (Ireland), 6Oct02, p. 8.
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28. Furton E. The Corruption of Science by Ideology. Ethics and Medics, December 2004, Vol. 29, No. 12.
29. Lanfranchi A. The Abortion-Breast Cancer Link Revisited. Ethics & Medics, November 2004, Vol. 29, No. 11.
30. O’Reilly R. New Weapon in War Against Breast Cancer. The Press Association Limited, Dec. 17, 1998.
31. With BC-Portugal-Abortion Referendum. Associated Press Worldstream, June 27, 1998.
32. Environmental Contributors to Breast Cancer: What Does the Science Say? Field Hearing of the House Subcommittee on Environment, Technology, and Standards, Committee on Science, 22June02, Serial No. 107-74.
33. Wyoming ranks 16th for health, well-being of women. The Associated Press State & Local Wire, November 27, 2004, Saturday, BC Cycle.
34. Malec K. The Abortion-Breast Cancer Link: How Politics Trumped Science and Informed Consent. Journal of American Physicians and Surgeons, Summer 2003, Vol. 8, No. 2, pp. 41-45.
35.Church E. Legal trends in imaging; CE Directed Reading. Radiologic Technology, September 1, 2004, Vol. 76, No. 1, p. 31.
36. International Breast Cancer Fact Sheet, Women’s Environment and Development Organization (WEDO), September 1997, Vol. 10, No. 2.
38.Probability of Breast Cancer in American Women, Cancer Facts, National Cancer Institute, Dec. 23, 2004, http://cis.nci.nih.gov/fact/5_6.htm.
39.Fournier R, Schmid R. Elizabeth Edwards has breast cancer. Associated Press, Nov. 04, 2004.
40.Womens Environment and Development Organization (WEDO) World Conference on Breast Cancer-July 1997-Information Packet.
41.A Puzzling Plague; What is it about the American way of life that causes breast cancer? Time Magazine, Jan. 14, 1991, p. 48.
[In PDF file below:
urnal of American Physicians and Surgeons ^_
[Spring 2005 Journal of American Physicians and Surgeons, Volume 10 Number 1
http://www.jpands.org/vol10no1/aschlafly.pdf, Andrew L. Schlafly, Esq. 
Posted on 06/03/2005]