MELBOURNE, Australia — In what is believed to be the first case of its kind, a woman in Australia has settled with an abortion practitioner she had sued because he failed to inform her of the research linking abortion with breast cancer. Both pro-life and abortion-rights advocates wonder if similar settlements might not follow suit in the United States.

A confidentiality agreement prevents details of the settlement, which was negotiated in September and just recently became public, from being released. But Australian legal precedent, said Australian attorney Charles Francis, requires doctors to inform their patients of any material risks of a recommended surgical procedure.

Francis said another suit involving the abortion breast-cancer link is also moving forward in Australia. “In a case to be heard in New South Wales shortly, ‘Mary’ is suing a hospital and an abortionist for failure to warn her of the increased breast-cancer risk,” he told the Register.

American pro-lifers hailed the news out of Australia.

“We're delighted with the settlement of an abortion/breast-cancer case,” said Karen Malec, president of the Coalition on Abortion/Breast Cancer. “The abortion industry and its medical experts know that it will be far more challenging for them to lie to women about the abortion/breast-cancer research when they are called upon to testify under oath. Scientists know that abortion causes breast cancer but are afraid to say so publicly in today's hostile political climate.”

Dr. Chris Kahlenborn, physician internist in Altoona, Pa., and author of Breast Cancer: Its Link to Abortion and the Birth Control Pill, admitted that he was surprised by the Australian settlement. And while he said it was good news, he also questioned whether any U.S. courts will follow suit.

“Despite the hard evidence, my opinion is that the medical literature [downplaying the abortion/breast-cancer link] and the secular media are so strong that it would be very difficult to win a case like this,” Kahlenborn said. “I still think it will be more difficult to expect any kind of justice in this country. If Planned Parenthood allows a case to be settled or loses a case, they know it will be the beginning of the end.”

Patrick Gillen, an attorney with the Ann Arbor, Mich.-based Thomas More Law Center, is more optimistic. “I am not at all surprised by the decision to settle given the strength of the scientific evidence showing that induced abortion causes an increased risk of breast cancer,” said Gillen. “For the same reason I think that similar lawsuits are virtually certain to be filed and won in the United States.”

U.S Cases Pending

In fact, two such cases are already pending. In December 1999, a case was filed against an abortion facility in North Dakota for false advertising. And last August, three California women filed suit against Planned Parenthood of San Diego and Riverside Counties and Planned Parenthood Federation of America. The women, Agnes Bernardo of Chula Vista, Pamela Colip of Loma Linda, and Sandra Duffey-Hawkins of Sacramento, are being represented by Gillen, the lead attorney in the case. Kahlenborn has been asked to serve as an expert witness on the case.

The California complaint notes that Planned Parenthood touts the safety of abortion both in its printed materials and on its Web site. “Planned Parenthood dismisses the research that shows a connection between abortion and breast cancer,” said Gillen.

The National Abortion Rights Action League's director of communications William Lutz did not return the Register's phone calls, and a spokesman with the Planned Parenthood Federation of America said, “No statement will be made concerning the Australia decision.” However, Planned Parenthood Web site plainly states that “abortion poses no demonstrated health risks. PPFA believes that women deserve information that is medically substantiated and untainted by a political agenda.”

The Planned Parenthood spokesman referred the Register to the American College of Obstetricians and Gynecologists, known as ACOG.

“The ACOG does not comment on legal settlements,” said college spokeswoman Alice Kirkman. “In 1995, ACOG's Committee on Gynecologic Practice conducted an extensive review of the pertinent scientific literature on the perception of links between abortion and breast cancer. The committee concluded that ‘evidence is insufficient to support claims that induced abortion has an effect on the later development of breast cancer.’”

According to the ACOG statement, with respect to the numerous studies that have found a link between abortion and higher rates of breast cancer, “Some studies reported adverse effect, some no effect, and some a positive effect.” It goes on to state that “many of the case-control studies had methodological problems.”

However, Britain's Royal College of Obstetrics and Gynecologists flatly disagrees with its American counterpart. In a March 2000 statement the Royal College warned British abortion providers that the abortion-breast cancer link “cannot be disregarded.”

The British newspaper The Observer reported Feb. 27, 2001, that “British women are harboring a breast cancer ‘time-bomb’ because of the high abortion rate and low number of children.”

To substantiate its claim that no cancer link exists, Planned Parenthood primarily cites evidence from the National Cancer Institute, the American Cancer Society, and the New England Journal of Medicine to argue that “the entire body of research [is] inconclusive.”

All three organizations, however, have since revised their positions to acknowledge that at least some linkage appears to exist. The National Cancer Institute, for example, now admits of “small elevations in risk.”

Causal Connection

Dr. Joel Brind, an endocrinolo-gist at Baruch College of the City University of New York, who has exhaustively analyzed the international research concerning an abortion/breast cancer link, said that a correlation between breast cancer and induced abortion was observed as long ago as a 1957 Japanese study. In the years since, a body of additional evidence has accumulated from around the world, lending credence to the abortion-breast cancer connection.

“Out of 37 independently published studies, 28 show a causal connection,” Brind said. “And of those, 17 provide positive associations that reach statistical significance suggesting a 95% certainty that this association is not due to chance. That is scientific evidence which simply cannot be ignored.”

Brind noted that research suggests the problem becomes more acute the earlier in life a women has an abortion. Kahlenborn agreed. “Dr. Janet Daling's 1994 National Cancer Institute study demonstrated that if a woman is under 18 and has an abortion, her risk of breast cancer increases by 150%. If she is under 18 and her baby is older than 8 weeks gestation, her risk increases up to 800%,” cited Kahlenborn.

Brind explained the physical process that, the studies indicate, causes the increased risk. “In the early stages of pregnancy, there is a dramatic increase in the level of estrogen, the female sex hormone. This estrogen surge causes an increase in the number of breast cells in preparation for nursing, which is why a pregnant woman's breasts tend to swell. In the last eight weeks of a full-term pregnancy, other hormones cause the increased tissue to stabilize into milk-producing cells. But at the early stage of rapid development, breast cells are in an undifferentiated state and highly vulnerable to mutations that can cause cancer.”

Abortion interrupts the natural process of preparing a woman's body to bear and nurse a child, Brind observed, cutting off the final part of the sequence that provides breast tissue with a significant measure of protection against cancer.

John Kindley, also an attorney with the Thomas More Law Center who is working on the California suit, has published an article on legal liability arising from failure to disclose the abortion-breast cancer link. Kindley listed some of the ways in which Planned Parenthood is alleged to have misled women about the health risks of abortion.

“It's their practice to make claims about the safety of abortion based on very incomplete data,” Kindley said. “At the same time, they attempt to discredit the very real scientific work which has been done showing an abortion-breast cancer link.

“For instance, they cite five studies that say the connection is unclear, while ignoring the overwhelming preponderance of the scientific evidence to the contrary. Then they assure their clients that the case for a connection is unproven. This is not only bad science, it's disingenuous to the point of being unethical.”

Kindley believes that the courts are required to resolve the dispute. Currently, only Mississippi, Texas, Louisiana and Kansas require abortion providers to inform women of the possible abortion-breast cancer link. “Ironically,” said Kindley, “such laws give greater protection to the doctors, not the women, because the Louisiana law, for example, gives the abortionist immunity from prosecution if he complies with the requirements of the law.”

Agnes Bernardo, one of the plaintiffs in the California case, explained that she and her co-plaintiffs have a high degree of personal motivation.

“I have experienced abortion, and I have been treated for a non-malignant tumor,” Bernardo said. “I am very concerned about developing breast cancer as are most women. I strongly believe women should receive complete information about the studies linking induced abortion and breast cancer before making the decision to have an abortion.”

Tim Drake is executive editor of