ENDEAVOUR FORUM NEWSLETTER No. 112, NOVEMBER 2003

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Angela Lanfranchi, MD, FACS, a breast cancer surgeon and Clinical Assistant Professor of Surgery at Robert Wood Johnson University Medical School in New Jersey, testified before the Massachusetts Joint Health Care Committee on June 11, 2003 in support of informed consent legislation. The bill in question would require physicians to inform abortion-bound women about the increased risk of breast cancer.  Dr. Lanfranchi is a critic of the American Women’s Medical Association because of its commitment to “reproductive rights”.  Angela’s testimony:                        

“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.

Personal Conversations

“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 increased 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 fear monger. 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:

Dr. Angela Lanfranchi,MD FACS

"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 her 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 more an abortion such as a D&X procedure. I think most mothers here today would agree with me on that ..... 

 Practical Implications of Recognizing ABC

“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 counselled 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 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 counselled 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 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 counsellor 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. Women have a right to know”.

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