"Antiperspirants and Breast Cancer"
A famous case report called The Mortician’s Mystery
in the New England Journal of Medicine back in 80s
described a man whose testicles started shrinking
and breasts started growing.
Turns out, he failed to wear gloves
as he massaged embalming cream onto his corpses.
They concluded there must have been some estrogenic compound
in the cream that got absorbed through his skin into his body,
one of the first such cases described.
This case was cited as inspiration by a group of researchers
that came up with a new theory to explain a breast cancer mystery.
Why do most breast cancers occur in the upper outer corner of the breast?
The standard explanation was simply
because that’s where most of the breast tissue is located,
as the so-called tail of the breast extends up to the armpit.
But that doesn’t explain this.
It didn’t always used to be that way;
there’s been a shift towards that upper corner.
And, it doesn’t explain this: greater genomic instability,
chromosome abnormalities that may signal precancerous changes.
There definitely seems to be something happening
to that side of the breast, and something relatively new,
just in the last 50 years or so.
Is it possible that the increasing use of underarm antiperspirant,
which parallels increasing breast cancer incidence,
could be an explanation for the greater number of tumors
and the disproportionate incidence of breast cancer
in the upper outer quadrant of the breast
near where the stick, spray, or roll-on is applied?
There’s free flow of lymph fluid back and forth
between the breast and the armpit.
And, if you measure aluminum levels in breasts
removed after mastectomies,
the aluminum content of breast tissue in the outer regions
near the armpits was significantly higher,
presumably due to closer proximity to the underarm region.
This is a concern because, in a petri dish at least,
it has been demonstrated that aluminum is a so-called metalloestrogen,
having pro-estrogenic effects on breast cancer cells.
Long term exposure of normal breast tissue cells
in a test tube to aluminum concentrations
in the range of those found in the breast
results in precancerous-type changes.
And then, once the cells have turned, those same concentrations can increase
the migratory and invasive activity
of human breast cancer cells in a petri dish.
This is important, because women don’t die
from the tumor in the breast itself,
but from the ability of the cancer cells to spread and grow
at distant sites, like the bones, lungs, liver, or brain.
But, we don’t care about petri dishes; we care about people.
In 2002, a paper was published in the Journal of the National Cancer Institute,
in which the underarm antiperspirant habits
of 800 breast cancer survivors was compared
to women who never got breast cancer.
The first study of its kind, and they found no indication
of a link between the two.
Based on this study, Harvard Women’s Health Watch
assured women that antiperspirants do not cause breast cancer;
women who were worried that antiperspirants might cause breast cancer
can finally rest easy.
But two months later, this study.
Frequency and early onset of antiperspirant/deodorant usage
with underarm shaving was associated with an earlier age
of breast cancer diagnosis, as much as 20 years earlier,
in women using antiperspirant and shaving their armpits
more than 3 times a week.
And, the earlier they started before vs. after their sweet 16
appeared to move up their breast cancer 10 or 20 years.
They conclude that underarm shaving with antiperspirant use
may play a role in breast cancer after all.
But what does shaving have to do with it?
Shaving removes more than just armpit hair;
it removes armpit skin.
You end up shaving off the top skin layer.
And, while there’s very little aluminum absorption
through intact skin, when you strip off that outer layer
with a razor and then rub on some antiperspirant,
you get a six-fold increase in aluminum absorption through the skin.
So, good news for women who don’t shave,
but on the other hand, the high through-the-skin aluminum uptake
on shaved skin should compel antiperspirant manufacturers
to proceed with the utmost caution.
European safety authorities and the FDA specifically advise
against using aluminum antiperspirants on damaged or broken skin.
Yet, shaving before antiperspirant application
can create abrasions in the skin.
I’m sure everyone knows about the FDA warning,
having read title 21 part 350 subpart C50-5c1 of the code of federal regulations.
But we get so much aluminum in our diet from processed foods—
anti-caking agents in like pancake mix, melting agents in American cheese,
meat binders, gravy thickeners, baking powder, candy—
that the contribution from underarm antiperspirants
would presumably be minimal in comparison.
But, everything was turned topsy-turvy in 2004,
when a case was reported of a woman with bone pain and fatigue
suffering from aluminum toxicity,
but within months of stopping the antiperspirant,
which she was applying daily to her regularly shaved pits,
her aluminum levels came down and her symptoms resolved.
Although not everyone sucks up that much aluminum,
the case suggests that caution should be exercised
when using aluminum-containing antiperspirants frequently.
Recently, it was shown that women with breast cancer
have twice the level of aluminum in their breasts
compared to women without breast cancer,
though this doesn’t prove cause and effect.
Maybe the aluminum contributed to the cancer,
or maybe the cancer contributed to the aluminum.
Maybe tumors just suck up more aluminum?
Subsequent research suggests this alternative explanation is unlikely.
So, where do we stand now?
The latest review on the subject concluded
that as a consequence of the new data,
given that aluminum can be toxic and we have no need for the stuff,
reducing the concentration of this metal in antiperspirants
is a matter of urgency.
Or, at the very least, it should say on the label:
Do not use after shaving.
Or, we could cease usage of aluminum– containing antiperspirants altogether.
But then, won’t we stink?
Ironically, antiperspirants can make us stink worse.
They increase the types of bacteria that cause body odor.
It’s like the story with antidepressant drugs,
how they can actually make you more depressed in the long run.
The more we use antiperspirants, the more we may need them.
Awfully convenient for a billion-dollar industry.