Not during my years in medical school, nor after I graduated, was I able to convince my mother to get an annual mammogram. It took me more than a few years afterwards to finally persuade her to get one every year. It sounds crazy (and is) but some people operate on the proposition “if I don’t see it, and they can’t find it, it ain’t there.” To a small degree, this was Mom. She never got breast cancer, but then again, she was the mother of seven, and as a result possessed one of the most resistant factors against getting breast cancer -- birthing multiple children.
By now, if you’re a woman having kept up with the latest health changes, you’re probably confused as to whether you should continue getting your mammograms on a yearly basis or not. A recent article in the New England Journal of Medicine slung another salvo in the “mammography wars” and affirmed that mammography screening should be discontinued, that it in effect does more harm than good. Something hard to believe. It claimed current debates are based on outdated trials and that treatment for breast cancer has advanced so much -- so much so -- that it essentially has wiped out the modest gains and benefits that mammography screening was purported to confer. Furthermore, a Canadian study found that 22% of mammograms were overdiagnosed, resulting in unneeded surgery, radiation, or chemotherapy, and that mammograms in and of themselves do not reduce mortality. This usually grates women the wrong way as surveys show that women tend to grossly overestimate the benefits of mammography screening as well as overestimating the lives saved as a result of mammography screening. This supposedly is the most accurate medical information that researchers can provide women. Everyone agrees that women deserve the most accurate information available, especially if it is information that can curb the incident rate of a medical problem germane to women -- unless, that is, it flies in the face of left-leaning politics or ideological medicine. A meta-analysis is a review and analysis of all results occurring from multiple research studies. A 1996 meta-analysis and a Chinese 2012 meta-analysis (36 trials) study reviewed the association, if any, of breast cancer in women who had abortions. And they found an interesting thing. These meta-analysis studies found that a woman who had an induced abortion had, respectively, a 30% and a 44% chance of incurring breast cancer. This means if the risk is 10%, then having an induced abortion increases one’s chance to 14.4%. But two additional facts became clear and were discovered. In the same way that the chance of incurring a side-effect of a medication increases with the dose, so too does the risk of incurring breast cancer with multiple abortions. The risk increased to 76% in women who had two induced abortions, and to 89% in women who had three. Not only is this association validated by statistics, and ‘dose-dependency,’ it is also confirmed physiologically. During the early phases of pregnancy a woman is exposed to massive amounts of estrogen, which in turn proliferates breast lobules, in preparation for breast feeding. But the lobules (Type 1 and 2) are also most susceptible to cancer. But in the later phases of pregnancy other hormones kick in and make the susceptible lobules more mature and cancer-resistant (Type 3 and 4). A woman who delivers prematurely (prior to 32 weeks) has twice the risk of breast cancer. A woman who has a spontaneous miscarriage has no additional risk of breast cancer. But, however, the woman who decides, in the early stages of pregnancy, to have sucked out whatever she wants to call what is in there, thus experiences a dangerous spike in estrogen without acquiring the protective tissues that emerge only by bringing a child to term -- leaving herself at higher risk for breast-cancer. She is left with unopposed amounts of estrogen as well as the cancer-vulnerable Type 1 and 2 breast lobules. In other words, giving birth is protective, terminating it incurs risk. Now this is not to say this association between induced abortions and breast disease has been without controversy, with various special interest groups opposing the increasingly strengthened research-validated proof. This is not unlike Big Tobacco opposing the clinically-proven association between smoking and lung cancer. But it’s difficult to deny the vast majority of studies dating back to 1957 that reveal an association between breast cancer and induced abortions. In every study in which there is a statistically significant result, the association is a direct and positive association; in every study in which there is NO statistical significance of results there is a negative association. I really doubt that a woman intent on not carrying a “fetus” would factor in the risk of having breast cancer far into the future. There are too many emotionally in-your-face issues she must consider in that moment. The woman wanting to have a child calls it a ’baby’; the woman who does not calls it a ’fetus’. And I doubt women or many physicians will stop any time soon ordering and asking for mammograms, for concerned, prudent, neurotic, or CYA reasons. As a physician, whenever I hear new medical information come out like this that encourages physicians to do something less or monitor something less frequently, I can’t help but wonder what influence the forces who wish to restrict medical encounters and events in the interest of saving money (for something else or someone else) have on the outcomes. I know it sounds like paranoid thinking. But there’s a lot of ‘influencing’ going on these days. To the extent you, the mother or grandmother, or husband, or father, have influence over a young mother in your family who might be considering an abortion, if you are fortuitous in time enough to come into such information, you may want to provide her with this factual piece of information regarding the increased risk of breast cancer with induced abortions. Otherwise, she may escape an inconvenience for now only to face a fatal one later.
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