NEW DELHI, January 3, 2014 ( – Women who have had an abortion are 6.26 times more likely to develop breast cancer than women who have no such history, a new study in India has found.

A report published in the current issue of the Indian Journal of Cancer suggests that abortion makes the breast's glandular tissue (epithelium) more likely to act as a cancer-producing agent. “It has been suggested that abortions leave the breast epithelium in a proliferative state with an increased susceptibility to carcinogenesis,” it says.

Perhaps more unnerving, that was not the greatest cancer risk facing women.


Women who consume oral contraceptive pills have a 9.5 times higher rate of breast cancer than women who do not use the drugs, researchers said.

“We found long-term use of oral contraceptive pills (OCP) higher among those suffering from breast cancer compared to healthy individuals,” said lead researcher Dr. Umesh Kapil of the department of gastroenterology and human nutrition at the All India Institute of Medical Sciences (AIIMS) in New Delhi.

In the report, Dr. Kapil explained that cancer is a hormonally mediated disease and that breast cancer is caused by repeated exposure of breast cells to circulating ovarian hormones.

He said long-term use of OCPs, which contain estrogen and progesterone, may be increasing the risk of breast cancer by causing a hormonal imbalance. His research suggests a strong relationship between use of oral contraceptive pills and the disease.

The study also looked into the association of other reproductive factors that affect the prevalence of breast cancer, and found that early onset of menstruation, higher age at marriage, higher age at first and last child birth, lower duration of breastfeeding, higher number of abortions, history of oral contraceptive pill use, and a family history of breast cancer are all associated with a significant increase in breast cancer occurrence.

The researchers found that mean age at first menstruation in cancer patients was about 13 years, as compared to about 14.5 years in the healthy controls. They observed that this difference was statistically significant.

The report noted that first pregnancy “induces irreversible changes that either render the breast tissue itself less susceptible to induction of cancer or reduced the carcinogenic stimulus to the breast.”

The researchers found that women who had an age of marriage more than 20 years old had an almost three times higher risk of breast cancer, while the age at first childbirth was found to be associated with a twofold higher risk in women who had their first child after the age of 21.

Age at last childbirth of more than 27 years resulted in a 329 percent higher incidence of breast cancer.

“Lactation also has a direct physical effect on the breast, such as changes in breast ductal epithelial cells leading to mechanical 'flushing-out' of carcinogens,” the researchers said.

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The study found that the risk of breast cancer increased 14.9 times in women having mean duration of breastfeeding of less than 13 months. The average duration of breastfeeding in cancer cases was about 11 months, while in controls it was about 21 months.

The study was a hospital-based survey conducted in the tertiary care hospital in New Delhi. Three hundred and twenty newly diagnosed breast cancer cases in the AIIMS departments of Surgery/Surgical Oncology were matched with an equal number of healthy individuals, which constituted the control group.

The average age of the women was 45.5 years. A majority of the participants lived in urban areas. All the women were married, and the majority of both groups were housewives. About 46 percent of the cases and 36 percent of the controls belonged to lower-middle socioeconomic status.

The AIIMS research team concluded that, “the results of the present study reveal a strong association of reproductive factors with breast cancer in the Indian population.”

The full text of the AIIMS study titled “Reproductive factors and breast cancer: A case-control study in tertiary care hospital of North India” is available here.