Skip to main content

Advertisement

SpringerLink
Log in

Association between abortion and breast cancer: an updated systematic review and meta-analysis based on prospective studies

  • Original paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Objective

Although positive association between abortion and breast cancer was frequently reported from case–control studies, results from prospective studies were still unclear. This study aimed to evaluate this association based on prospective studies.

Methods

PubMed, ISI Web of Knowledge and Embase were systematically searched for prospective studies on the association between abortion and breast cancer up to April 2014, supplemented by manual searches on the references. Two reviewers independently conducted the literature search, study selection, data extraction, and quality assessment of included studies. Random effects models were used to estimate the combined relative risks (RRs) and corresponding 95 % confidence intervals (95 % CIs).

Results

Fifteen prospective studies [14 focused on induced abortion (IA), and 12 focused on spontaneous abortion (SA)] were included in the final analysis. The combined RRs (95 % CIs) of breast cancer risk were 1.00 (0.94–1.05) [1.00 (0.92–1.08) for cumulative-incidence data and 1.00 (0.94–1.05) for incidence-rate data] for IA, and 1.02 (0.95–1.09) [1.06 (0.96–1.16) for cumulative-incidence data and 1.01 (0.92–1.09) for incidence-rate data] for SA, respectively. Non-significant associations of breast cancer with IA and SA were also found among nulliparous women, women with abortion before or after the first full-term pregnancy, women with one or ≥2 abortions, and women with first abortion after 30 years old.

Conclusion

The current prospective evidences are not sufficient to support the positive association between abortion (including IA and SA) and breast cancer risk.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Albrektsen G, Heuch I, Kvale G (1995) The short-term and long-term effect of a pregnancy on breast cancer risk: a prospective study of 802,457 parous Norwegian women. Br J Cancer 72:480–484

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  2. Russo J, Russo IH (1980) Susceptibility of the mammary gland to carcinogenesis. II. Pregnancy interruption as a risk factor in tumor incidence. Am J Pathol 100:497–512

    PubMed Central  CAS  PubMed  Google Scholar 

  3. Russo J, Tay LK, Ciocca DR et al (1983) Molecular and cellular basis of the mammary gland susceptibility to carcinogenesis. Environ Health Perspect 49:185–199

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Russo J, Wilgus G, Russo IH (1979) Susceptibility of the mammary gland to carcinogenesis: I Differentiation of the mammary gland as determinant of tumor incidence and type of lesion. Am J Pathol 96:721–736

    PubMed Central  CAS  PubMed  Google Scholar 

  5. Brind J, Chinchilli VM, Severs WB et al (1996) Induced abortion as an independent risk factor for breast cancer: a comprehensive review and meta-analysis. J Epidemiol Community Health 50:481–496

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Huang Y, Zhang X, Li W et al (2014) A meta-analysis of the association between induced abortion and breast cancer risk among Chinese females. Cancer Causes Control 25:227–236

    Article  PubMed  Google Scholar 

  7. Beral V, Bull D, Doll R et al (2004) Breast cancer and abortion: collaborative reanalysis of data from 53 epidemiological studies, including 83 000 women with breast cancer from 16 countries. Lancet 363:1007–1016

    Article  PubMed  Google Scholar 

  8. Stroup DF, Berlin JA, Morton SC et al (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA 283:2008–2012

    Article  CAS  PubMed  Google Scholar 

  9. Higgins JP, Thompson SG, Deeks JJ et al (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560

    Article  PubMed Central  PubMed  Google Scholar 

  10. Egger M, Davey SG, Schneider M et al (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. Goldacre MJ, Kurina LM, Seagroatt V et al (2001) Abortion and breast cancer: a case-control record linkage study. J Epidemiol Community Health 55:336–337

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Howe HL, Senie RT, Bzduch H et al (1989) Early abortion and breast cancer risk among women under age 40. Int J Epidemiol 18:300–304

    Article  CAS  PubMed  Google Scholar 

  13. Harris BM, Eklund G, Meirik O et al (1989) Risk of cancer of the breast after legal abortion during first trimester: a Swedish register study. BMJ 299:1430–1432

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. Clavel-Chapelon F (2002) Cumulative number of menstrual cycles and breast cancer risk: results from the E3 N cohort study of French women. Cancer Causes Control 13:831–838

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Clavel-Chapelon F (2002) Differential effects of reproductive factors on the risk of pre- and postmenopausal breast cancer. Results from a large cohort of French women. Br J Cancer 86:723–727

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  16. Sellers TA, Potter JD, Severson RK et al (1993) Difficulty becoming pregnant and family history as interactive risk factors for postmenopausal breast cancer: the Iowa Women’s Health Study. Cancer Causes Control 4:21–28

    Article  CAS  PubMed  Google Scholar 

  17. Calle EE, Mervis CA, Wingo PA et al (1995) Spontaneous abortion and risk of fatal breast cancer in a prospective cohort of United States women. Cancer Causes Control 6:460–468

    Article  CAS  PubMed  Google Scholar 

  18. Lash TL, Fink AK (2004) Null association between pregnancy termination and breast cancer in a registry-based study of parous women. Int J Cancer 110:443–448

    Article  CAS  PubMed  Google Scholar 

  19. Brewster DH, Stockton DL, Dobbie R et al (2005) Risk of breast cancer after miscarriage or induced abortion: a Scottish record linkage case-control study. J Epidemiol Community Health 59:283–287

    Article  PubMed Central  PubMed  Google Scholar 

  20. Newcomb PA, Mandelson MT (2000) A record-based evaluation of induced abortion and breast cancer risk (United States). Cancer Causes Control 11:777–781

    Article  CAS  PubMed  Google Scholar 

  21. Tang MT, Weiss NS, Malone KE (2000) Induced abortion in relation to breast cancer among parous women: a birth certificate registry study. Epidemiology 11:177–180

    Article  CAS  PubMed  Google Scholar 

  22. Erlandsson G, Montgomery SM, Cnattingius S et al (2003) Abortions and breast cancer: record-based case-control study. Int J Cancer 103:676–679

    Article  CAS  PubMed  Google Scholar 

  23. Brauner CM, Overvad K, Tjonneland A et al (2013) Induced abortion and breast cancer among parous women: a Danish cohort study. Acta Obstet Gynecol Scand 92:700–705

    Article  PubMed  Google Scholar 

  24. Hadjimichael OC, Boyle CA, Meigs JW (1986) Abortion before first livebirth and risk of breast cancer. Br J Cancer 53:281–284

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  25. Henderson KD, Sullivan-Halley J, Reynolds P et al (2008) Incomplete pregnancy is not associated with breast cancer risk: the California teachers study. Contraception 77:391–396

    Article  PubMed Central  PubMed  Google Scholar 

  26. Lazovich D, Thompson JA, Mink PJ et al (2000) Induced abortion and breast cancer risk. Epidemiology 11:76–80

    Article  CAS  PubMed  Google Scholar 

  27. Melbye M, Wohlfahrt J, Olsen JH et al (1997) Induced abortion and the risk of breast cancer. N Engl J Med 336:81–85

    Article  CAS  PubMed  Google Scholar 

  28. Michels KB, Xue F, Colditz GA et al (2007) Induced and spontaneous abortion and incidence of breast cancer among young women: a prospective cohort study. Arch Intern Med 167:814–820

    Article  PubMed  Google Scholar 

  29. Palmer JR, Wise LA, Adams-Campbell LL et al (2004) A prospective study of induced abortion and breast cancer in African-American women. Cancer Causes Control 15:105–111

    Article  PubMed  Google Scholar 

  30. Paoletti X, Clavel-Chapelon F (2003) Induced and spontaneous abortion and breast cancer risk: results from the E3 N cohort study. Int J Cancer 106:270–276

    Article  CAS  PubMed  Google Scholar 

  31. Reeves GK, Kan SW, Key T et al (2006) Breast cancer risk in relation to abortion: Results from the EPIC study. Int J Cancer 119:1741–1745

    Article  CAS  PubMed  Google Scholar 

  32. Ye Z, Gao DL, Qin Q et al (2002) Breast cancer in relation to induced abortions in a cohort of Chinese women. Br J Cancer 87:977–981

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  33. Andrieu N, Goldgar DE, Easton DF et al (2006) Pregnancies, breast-feeding, and breast cancer risk in the International BRCA1/2 Carrier Cohort Study (IBCCS). J Natl Cancer Inst 98:535–544

    Article  PubMed Central  PubMed  Google Scholar 

  34. Brind J, Chinchilli VM (1997) Induced abortion and the risk of breast cancer. N Engl J Med 336:1834 (author reply 1835)

    Article  CAS  PubMed  Google Scholar 

  35. Brind J, Chinchilli VM (2002) Abortion and breast cancer. J Epidemiol Community Health 56:237–238

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  36. Brind J, Chinchilli VM (2004) Breast cancer and induced abortions in China. Br J Cancer 90:2244–2245 (author reply 2245-6)

    PubMed Central  CAS  PubMed  Google Scholar 

  37. Brind J, Chinchilli VM (2004) Abortions and breast cancer: record-based case-control study. Int J Cancer 109:945–946 (author reply 947-8)

    Article  CAS  PubMed  Google Scholar 

  38. Brind J (2008) Breast cancer in relation to abortion: results from the EPIC study. Int J Cancer 122:960–961 (author reply 962)

    Article  CAS  PubMed  Google Scholar 

  39. Brind J (2009) California Teachers Study report on incomplete pregnancy and breast cancer risk is flawed. Contraception 79:240 (author reply 240-1)

    Article  PubMed  Google Scholar 

  40. Russo J, Russo IH (1987) Biological and molecular bases of mammary carcinogenesis. Lab Invest 57:112–137

    CAS  PubMed  Google Scholar 

  41. Kelsey JL (1979) A review of the epidemiology of human breast cancer. Epidemiol Rev 1:74–109

    CAS  PubMed  Google Scholar 

  42. Kelsey JL, Fischer DB, Holford TR et al (1981) Exogenous estrogens and other factors in the epidemiology of breast cancer. J Natl Cancer Inst 67:327–333

    CAS  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Author notes

    Authors and Affiliations

    1. Department of Oncology, Dongfeng Hospital, Hubei University of Medicine, No. 10, Daling Road, Shiyan, 442008, Hubei, China

      Jun Guo, Zhengqiang Xie, Shuhong Song, Juan Yin, Li Kuang & Wengang Qin

    2. Department of Epidemiology and Biostatistics, Tianjin Medical University Cancer Hospital and Institute, Tianjin, 300060, China

      Yubei Huang

    3. Beijing Office for Cancer Prevention and Control, Peking University Cancer Hospital and Institute, Beijing, 100142, China

      Lei Yang

    Authors
    1. Jun Guo
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Yubei Huang
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Lei Yang
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Zhengqiang Xie
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Shuhong Song
      View author publications

      You can also search for this author in PubMed Google Scholar

    6. Juan Yin
      View author publications

      You can also search for this author in PubMed Google Scholar

    7. Li Kuang
      View author publications

      You can also search for this author in PubMed Google Scholar

    8. Wengang Qin
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Wengang Qin.

    Additional information

    Jun Guo and Yubei Huang contributed equally to the first author.

    Electronic supplementary material

    Below is the link to the electronic supplementary material.

    10552_2015_536_MOESM1_ESM.pptx

    Supplement Fig. 1. Sensitivity analysis of association of induced abortion with breast cancer risk after excluding the study with largest weight. Each row in the forest graph represents the original relative risk (RR) with 95 % confidence intervals (CIs) reported in each study. And the last row represents the overall RR (95 % CI). Palmer (2004a) and Palmer (2004b) [Henderson (2008a) and Henderson (2008b)] represented the datasets for nulliparous women and parous women, respectively. (PPTX 52 kb)

    10552_2015_536_MOESM2_ESM.pptx

    Supplement Fig. 2. Sensitivity analysis of association of spontaneous abortion with breast cancer risk after excluding the study with largest weight. Each row in the forest graph represents the original relative risk (RR) with 95 % confidence intervals (CIs) reported in each study. And the last row represents the overall RR (95 % CI). Hadjimichael (1986a) and Hadjimichael (1986b) represented the datasets for women with one parity and women with two and more parity, respectively. And Henderson (2008a) and Henderson (2008b) represented the datasets for nulliparous women and parous women, respectively. (PPTX 52 kb)

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Guo, J., Huang, Y., Yang, L. et al. Association between abortion and breast cancer: an updated systematic review and meta-analysis based on prospective studies. Cancer Causes Control 26, 811–819 (2015). https://doi.org/10.1007/s10552-015-0536-1

    Download citation

    • Received:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s10552-015-0536-1

    Keywords

    Search

    Navigation