After President Trump tapped Charmaine Yoest as assistant secretary of health and human services, critics resurfaced this 2012 New York Times feature story. The Times article described Yoest’s position supporting the discredited theory that abortion increases a woman’s risk for breast cancer.

Yoest is a breast cancer survivor and a prominent national activist who opposes abortion rights. Until her new appointment, which did not require Senate confirmation, Yoest was the president and chief executive of Americans United for Life, a group that opposes abortion rights.

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Since Yoest now holds one of the top posts at Health and Human Services, readers asked us to find out: Does Yoest still hold this position? We reached out to her, but she would not answer whether she still believes in this alleged link. Instead, she offered this written explanation:

“As far as my comments on this, I hope that you will note that the wild accusations that I have said ‘abortion *causes* breast cancer’ are false. I have not said that and would not say that.”

Update: After this fact-check published, we were alerted to Yoest’s April 2015 presentation at the Conservative Political Action Conference, during which she stated she is confident that there is a connection between abortion and breast cancer. Yoest also signed letters and reports from Americans United for Life in 2013-2016 describing this connection. From her 2015 presentation:

“I get a lot of questions about the connection between abortion and breast cancer. This is important to me because I’m a breast cancer survivor myself, and in my entire treatment for breast cancer, no one ever talked about abortion. No one ever does in the medical community. But the data is really, really clear that having a full-term first pregnancy helps to protect women from a future incidence of breast cancer. So if you interrupt that pregnancy, you also interrupt that protective effect that the woman gets from having a full term pregnancy. So there is a connection — I feel confident in stating that — between abortion and breast cancer.”

We’ve dug into this issue before. We took another look at the research, given that the issue is back in the national dialogue.

The Facts

The theory that abortion is associated with a greater risk of breast cancer dates to the 1950s, and was widely promoted in the wake of the 1973 Roe v. Wade decision. In the 1990s, a series of studies were published in support of this link.

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In 2003, the National Cancer Institute held a workshop of more than 100 experts from around the world to study whether abortion and miscarriage are linked to breast cancer. They reviewed existing research, identified gaps in research and recommended areas of future research.

Experts found that the studies published in the 1990s supporting this link were poorly designed. Subsequent, methodologically sound studies consistently showed no association between induced abortion (which excludes stillbirth and miscarriages) and increased breast cancer risk, according to the report from the 2003 workshop. One researcher submitted a minority dissent report claiming partial disagreement with this conclusion.

The report concluded that neither induced abortions nor miscarriages (also called “spontaneous abortions”) are associated with breast cancer risk. Subsequent reviews by the American Congress of Gynecologists and Obstetricians, American Cancer Society and other medical organizations affirmed this conclusion.

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There are many known risk factors for breast cancer, including: family history, the woman’s age (the risk of breast cancer increases as a woman gets older), how old she was at her first menstrual period (people who get their first periods earlier* face a higher risk), how old she was when she delivered her first full-term pregnancy (women who have children later or who never have children face a higher risk), certain breast conditions, certain oral contraceptives, excessive alcohol consumption and obesity after menopause. (*correction: an earlier version of this column incorrectly said later.)

A woman’s risk is doubled if one first-degree relative has breast cancer. Her risk increases fivefold if she has two first-degree relatives who are diagnosed with breast cancer, according to the National Cancer Institute.

There also are known factors that decrease the risk, including breast-feeding and regular exercise. Having a full-term pregnancy before the age of 20 is the best lifetime decrease in breast cancer risk for women — even if she has an abortion later in life. Women who deliver a baby before 20 face a 50 percent decreased risk of breast cancer than women who don’t give birth or give birth after 35 years old, according to the National Cancer Institute.

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Still, some studies — including some using the disputed method — argue there is an association, and some opponents of abortion rights continue to research this alleged link. In her Times interview, Yoest pointed to data and research by the American Association of Pro-Life Obstetricians and Gynecologists. We contacted the group, which provided us studies on the development of breast tissue in various stages of a woman’s pregnancy. We uploaded the studies here.

According to the group and research from the Breast Cancer Prevention Institute, which advocates for the abortion-breast cancer link theory, hormones produced at certain stages of the pregnancy can affect cancer susceptibility of breast tissues. The further along a woman is in her pregnancy — specifically, after 32 weeks — her body produces breast tissues that decrease cancer susceptibility, the groups claim.

These groups say that based on the hormone production and breast tissue development, pregnancies that end between 20 to 32 weeks double your risk of breast cancer. Whether you have an abortion, a premature delivery or a miscarriage, you become vulnerable to breast cancer if it happens between 20 to 32 weeks, according to the study by the Breast Cancer Prevention Institute.

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In other words, it’s that specific period in the pregnancy — around the second trimester — that is the problem, not the method (premature delivery, abortion or miscarriage).

Despite these claims of increased risk, this research does not find support in the scientific academy.

“There are a variety of competing hypotheses from various laboratory scientists. The best tool of all to identify significant risks is high-quality population studies,” said Robert Hoover, director of epidemiology and biostatistics at the National Cancer Institute’s Division of Cancer Epidemiology and Genetics.

Regarding the study from the Breast Cancer Prevention Institute, Hoover said: “As noted in the review, there is conflicting evidence in the literature about the risk of breast cancer associated with induced abortion. To date, the high-quality studies (large prospective cohorts) find no excess risk. This is the basis for our current assessment as stated on the Cancer.gov web site. I see nothing in this recent material that would alter this.”

The Bottom Line

We provided Yoest the opportunity to set the record straight and clarify her stance on this matter. She told us she does not believe abortion causes breast cancer, but she did not answer our follow-up questions for her stance on whether abortion increases a woman’s risk of breast cancer.

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Research provided from the group that she pointed to in her 2012 New York Times article theorizes about the relationship between breast tissue development during a pregnancy, and how it affects a woman’s risk for breast cancer when the pregnancy ends before it reaches full-term — through induced abortion, a miscarriage or premature delivery. But it is inconsistent with extensive review and medical research by experts convened by the National Cancer Institute in 2003, or the subsequent conclusions by other cancer research organizations since then.

If Yoest repeated this claim now, it certainly would be Pinocchio-worthy. The 2012 interview is an old quote. She repeated a version of it in 2015, but would not say one way or another when we inquired. We urge readers to be skeptical of claims of an alleged association between abortion and breast cancer.

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