Despite the many studies that have refuted rumors that antiperspirants are linked to breast cancer, these stories are still being perpetuated today. I was reminded of this recently when a family member shared this rumor with much conviction, having heard it from her hairstylist. The intent of this article is to provide the reader with a synopsis of some of the relevant research on this topic. I hope that this will arm you with an informed response when confronted by an ardent proponent.
First, some basic information: Antiperspirants are classified as over-the-counter drugs by the Food and Drug Administration (FDA) and a monograph has been established that provides guidelines for meeting this classification – FDA’s OTC antiperspirant monograph. The monograph specifies various aluminum salts that can be used as the active ingredients in antiperspirants. Those most commonly used in contemporary antiperspirant formulations include Aluminum Chlorohydrate, Aluminum Tetrachlorohydrex GLY and Aluminum Trichlorohydrex GLY.
Aluminum salts react with moisture on the skin to form a ‘plug’ which temporarily blocks sweat glands and helps reduce perspiration. One hypothesis that supports the link between antiperspirants and breast cancer is that the formation of these ‘plugs’ prevent the body from purging toxins, which then collect in the lymph nodes, eventually causing cellular changes that lead to cancer. This was addressed in an article published by the American Cancer Society1, which explained that lymph nodes do not excrete toxins through sweating since they are not connected to sweat glands.
At the heart of the claim that antiperspirant use elevates the risk of breast cancer is that aluminum salts are capable of penetrating the axillary vault, accumulating in breast cells, where they effect change that eventually leads to cancer. Dermal absorption of aluminum has been investigated. Results indicate that there is minimal absorption into healthy skin, with one study reporting that 0.012% of the applied aluminum was absorbed2.
However, another study found that aluminum uptake increased in compromised skin3. These results then raise the question of whether the combination of frequent underarm shaving and antiperspirant use increases the risk of breast cancer. This does not seem to be the case based on the results of a study which found that the risk of breast cancer did not increase among subjects who shaved4.
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Since carcinomas are commonly found in the upper outer quadrant of the breast, this fact is used to support the hypothesis that aluminum-based underarm cosmetics are linked to breast cancer. Based on the results of a 2005 study5, it would appear that the frequency of occurrence in this region is most likely due to the greater amount of breast tissue in the upper outer quadrant - a conclusion also drawn by the American Cancer Society1. Proponents also speculate that nicks caused by underarm shaving create a pathway for aluminum salts to enter breast cells resulting in mutations that lead to cancer. This, too, has been refuted by the American Cancer Society1.
Despite the body of scientific evidence that contradicts the notion that there is a link between antiperspirant use and breast cancer, skeptics remain unconvinced and questions persist. However, it is important to note that antiperspirants continue to be recognized as safe and effective for use by the FDA as well as major industry organizations.
References
- Cancer.org: Antiperspirants and Breast Cancer Risk
- Flarend R, et al. A preliminary study of the dermal absorption of aluminum from antiperspirants using aluminum 26. Food and Chemical Toxicology. 2001 Feb; 39 (2) 163-8 (Pub Med Abstract)
- Pineau A, et al. In vitro study of percutaneous absorption of aluminum from antiperspirants through human skin in the Franz™ diffusion cell. Journal of Inorganic Biochemistry, May 2012 Vol. 110:21-26 (Pub Med Abstract)
- Mirick DK, Davis S, Thomas DB. Antiperspirant use and the risk of breast cancer. Journal of the National Cancer Institute2002; 94(20):1578–1580. (Pub Med Abstract)
- Lee AHS. Why is carcinoma of the breast more frequent in the upper outer quadrant? A case series based on needle core biopsy diagnoses. 2005;14:151–152
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I too have been frustrated by the persistence of this rumor. My latest dissatation is as follows;
The link between breast cancer and the use of (paraben-containing) underarm cosmetics
Parabens are the alkyl esters of p-hydroxybenzoic acid and are allowed as antimicrobial
preservatives for use in food products, medicinal products and cosmetics. The link between the
use of underarm cosmetics and breast cancer has been promoted through a number of
publications by Darbre and Harvey, in which the following facts were considered:
– underarm cosmetics are applied frequently to an area directly adjacent to the breast;
– they are not rinsed off, but have the opportunity to accumulate in the underarm and upper breast area;
– the upper outer quadrant of the breast is the most frequent site of carcinoma;
– estrogens are known to be involved in breast cancer;
– parabens have shown to exert some weak estrogenic effects;
– parabens have been reported to be included in 99% of all cosmetic products;
– methyl paraben has been measured in human breast tumours at a 12.8 ng/g level, while ethyl, propyl and butyl paraben were found at 2.0 – 2.6 ng/g in the affected tissue.
[Byford et al. 2002, Darbre 2003, Harvey 2003, Harvey and Everett 2004, Darbre et al. 2004a,
Harvey and Darbre 2004].
These publications led to a number of “letters to the editor” and opened a discussion on the
scientific evidence linking the use of underarm cosmetics to a higher incidence in breast cancer.
The major remarks formulated were the following:
(i) there were some important deficiencies in the study design:
– lack of control tissue when measuring concentrations of parabens in breast tumours;
– blank samples clearly contaminated with parabens;
– high variability in individual blank values;
– no study of the general therapeutic history of the tissue donors
– no mention of the paraben-containing anti-cancer drugs the patients were using;
– no study of donors’ exposure to consumer products containing parabens;
– brief descriptions of tissue handling;
(ii) the most frequently occurring paraben was the methyl ester, which had shown to have the lowest estrogenic activity in the in vitro and in vivo estrogenicity studies;
(iii) existing epidemiological data indicate the absence of an association between underarm cosmetics and breast cancer;
(iv) the majority of underarm cosmetics do not contain parabens as preservatives (> 98%)
(v) the lymphatic drainage system that would be considered the major course of transfer would be from Breast to Underarm, not the reverse direction making an effect highly improbable.
[Golden and Gandy 2004, Jeffrey and Williams 2004, Flower 2004].
Darbre et al. and Harvey formulated replies to these comments and therein clearly state that it had never been their aim to link tumour grade, quadrant incidence of the tumour or patterns of underarm cosmetic use in patients. Moreover, Darbre et al. acknowledge that the study on the concentrations of parabens in breast tumours could not identify either the route of entry or the source of the parabens. Carcinogenicity was not considered in the study and the presence of parabens was not claimed to cause the breast tumours. Finally, they mention that epidemiological studies of underarm cosmetic use and breast cancer fell out of the scope of the paper and were, therefore, not discussed [Darbre et al. 2004b, 2004c, 2004d, Harvey 2004].
In September 2004, the Danish Institute of Food and Veterinary Research issued a report titled
“Note on Parabens in Food, Cosmetics and Consumer Products”. Therein, the authors also elaborate on the suggested relationship between the use of parabens in underarm cosmetics and the development of breast cancer. They came to the conclusion that there is no indication to support such a causal relationship [Anonymous 2004].
Conclusion
• Do the data provided within the requests indicate a potential risk for the development of
breast cancer in past users of underarm cosmetics?
As discussed above, there are insufficient data to establish a clear link between the use of underarm cosmetics and breast cancer. The authors of the studies that led to the suggestion of a connection between the use of underarm cosmetics and breast cancer, clearly state that they did not have the intention to prove such a link.
Two recent epidemiological studies on the use of underarm cosmetics in relation to breast cancer exist. The authors of these studies could not establish a relationship between the use of underarm deodorants and antiperspirants and the occurrence of breast cancer [Mirick et al. 2002, McGrath 2003].
Moreover, according to current knowledge in this field, age is the major risk factor with regard to the incidence of breast tumours, followed by family history of breast cancer [De Grève 2004].
The effect of hormones has been acknowledged, but not all cancers are estrogen receptor positive. In fact, it is strongly suggested that for the pathogenesis of a significant proportion of all breast cancers, hormones do not play a significant role. It is true, however, that estrogens might have a role through their mitogenic action to further stimulate the malignant transformation of premalignant cells [De Grève 2004]. For this reason, exposure to potent estrogens should be avoided whenever possible.
Further important clinical data are:
– breast cancer tumours occur most frequently in the upper quadrant of the breast (closest to the armpit). A clear relationship, however, has been found with the amount of gland tissue present at that location;
– it is clinically well-established that the circulation of blood/lymph goes from the breast towards the armpit and further towards different organs and tissues and not vice-versa, making an exchange process from the armpit towards the breast tissue highly speculative.
Hi Priscilla,
Great article. Hard to prove a negative, so scare stories about AP salts and breast cancer will likely continue to appear.
Glad to see you’ve connected with Arun at Bria.
Gene
This can help to convince some customers but he face 2 problems when doing it:
1- If I publish this information in my website I will probably have a lot of discussion with “skeptics” that use to have very “difficult to change” opinion (even with information like this). They will always show you “studies” that prove the opposite (of course most of them just pseudoscientific in best of cases). If you try to answer their comments most of times they get “angry” and this ends in a non positive image to your company.
2-Another typical reaction is: there is a lot of money interest in this, I do not believe this…
If anyone have an strategy to fight against this type od internet users, it would be great to know it 😉
Anyway It is always useful to have arguments, mostly with physical interaction with customers (winnin a discussion in internet is almost imposible).
Thanks for the article