Dear Editor,
I read with interest Eilis Nig Raollaigh's letter on Wednesday 19 December 2007 regarding the potential association between abortion and breast cancer. I agree that women who feel that they are at increased risk of breast cancer, whether real or perceived, should seek appropriate medical advice. I am concerned, however by the anxiety that might be generated by the letter among women who have had either a spontaneous abortion (miscarriage) or an induced abortion (termination).

The articles cited in the letter were written by the same, non medical author using information of uncertain quality. In fact, quite a number of studies in the medical literature have looked at the possible association between abortion and breast cancer. Most of these were poorly designed with inadequate statistical analysis and presented conflicting results.

In 2004 an excellent review of the most reliable data available was published in the Lancet, one of the oldest and most respected medical journals in the world. Data was taken from 53 studies undertaken in 16 countries, including a total of 44,000 women. The conclusion was that 'Pregnancies that end as a spontaneous or induced abortion do not increase a woman's risk of developing breast cancer.' Of note, one of the senior authors on this paper was Valerie Beral, the author of The Million Woman Study, which demonstrated the association between hormone replacement therapy (taken for five years or longer) and breast cancer. This eminent researcher has no agenda apart from scientific clarity on the affects of hormonal factors in breast cancer.

The majority of breast cancers are sporadic, without an obvious cause. Proactive surveillance with self examination and enrolment in the National Breast Screening Programme, which offers free mammography to all women between the age of 50 and 64, are the best methods of detecting cancers at an early (and therefore more treatable) stage. Intensive surveillance is primarily confined to that small group of women with a significant family history of breast and/or ovarian cancer. Neither spontaneous nor induced abortion are indications for intensive surveillance.

Yours sincerely,
Karl Sweeney

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