Anti-Perspirants -- Not a Breast Cancer Risk

Ed Friedlander MD

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Update 1/11/04: Today's popular media gave coverage to a new article in an obscure journal (J. Analyt. Tox.) indicating that para-hydroxybenzoic acid derivatives have been isolated from some samples of breast cancer. The initial reports suggest that there are no controls. We learn that the author failed to report concentrations at organs other than breast, or even in different portions of the same mastectomy specimens. The latter, by her own logic cited in the media, would have clarified whether the compounds in question diffused from the armpits. She could easily have done these assays, and this fact alone makes me suspicious at best. The author describes the upper outer quadrant as "one fifth of the breast" (it's actually by far the largest portion; ask any pathologist), and the industry and press are now going around about which cosmetics contain the stuff and which do not. I do not yet have access to the article, but will review it when I get my copy. Note that this claim is distinct from the claim in the popular e-mail. The author is biochemist-activist with a strong publication record and a focus on estrogenic activities of synthetics. For this, she deserves respect and attention far beyond most other "independent thinkers." She has been campaigning against underarm products since at least 1996. Although she is a member of a large research department with several other members who share her interests, none of her colleagues were willing to place their names as co-authors on her piece in Eur. J. Cancer. Prev. 10: 389-93, 2001 ("Underarm cosmetics are a cause of breast cancer") despite the fact that such an important claim, if correct, would greatly enhance the careers of all its authors. More: Both articles were reviewed in Nat. Med. 10: 216, 2004 and the obvious flaws pointed out; it also describes the original e-mail as a known "hoax". The 2001 article simply found that younger breast cancer patients use deodorant and/or shave more often than do older breast cancer patients; without controls, this merely tells me that young women do more of this than older women. Since this glaring flaw has not been addressed by the author during three years, I must draw the obvious conclusion.

I'm a medical doctor, board-certified in both anatomic and clinical pathology. I operate the world's largest free online personalized health information service. I have received several copies of an inflammatory E-mail that is making rounds right now (spring 1999). According to the anonymous author, "the leading cause of breast cancer is antiperspirants."

As I've noted elsewhere, life has taught me never to attribute to malice what is adequately explained by naïevete. People are all-too-ready to believe lies that make them feel morally and intellectually superior.

This particular one, however, is egregious.

Breast cancer is an ancient disease, and was very common in the descriptions of old Roman physicians. It's also common in animals. And if you control for the fact that more women are living longer and having fewer children (childbearing exerts some protective effect), there's been no clear increase in the rate of breast cancer in the past 100 years despite the introduction of antiperspirants.

Here are the specific claims, and why they are wrong.

(1.) According to the E-mail, "the human body has a few areas that it uses to purge toxins; behind the knees, behind the ears, groin area, and armpits. The toxins are purged in the form of perspiration.". The artificial wording of this sentence is actually legalese. It is technically true, just in case the author is hauled into court. But it is grossly misleading. All these parts of the body produce sweat (just like everyplace else on the skin), and traces of metabolic by-products which are mostly excreted by the kidneys do end up in the sweat. But if sweat were the primary way in which people got rid of toxins, there would be no need for people with kidney failure to go on dialysis. And if there were any known substance that could be lost only in the armpit sweat, whether or not it was concentrated there, the author would name it. If you'll visit the sites of other "independent health thinkers", you'll discover that they often show considerable (though selective) sophistication in biochemistry. The author of this one knows that there is no such substance, so he/she hasn't tried. If the real author ever surfaces, I'll place him/her in touch with the colonic irrigationists, who claim that toxins can only be removed their way.

(2.) The E-mail goes on to claim, "These toxins do not just magically disappear. Instead, the body deposits them in the lymph nodes below the arms since it cannot sweat them out. This causes a high concentration of toxins and leads to cell mutations: a.k.a. CANCER." So what are these chemicals? The author won't say. Now, I have examined thousands of armpit lymph nodes from breast cancer patients, and never seen any special deposits here. The author has a trilemma. Either the chemicals are water-soluble and freely permeable to cell membranes (in which case they would not be able to be concentrated in the lymph nodes), or they are water-soluble and taken up actively by the lymph node cells (in which case I would be able to see them under the microscope), or they are not water-soluble (in which case they could not be lost in perspiration). What's more, the cells that give rise to breast cancers (breast epithelium) are not even found in the lymph nodes of the armpit. And primary cancers very seldom arise in these nodes. Again, the author's non-use of biochemistry reveals his/her fundamental ignorance or worse. There are several known mutagens in normal feces, but no known mutagen that is selectively secreted in armpit sweat.

(3.) The E-mail continues, "Nearly all breast cancer tumors [sic.] occur in the upper outside quadrant of the breast area.". This is a bald-faced lie. About 60% of breast cancers arise here, because about 60% of the total breast tissue is located here (i.e., all the breast tissue that is both above and lateral to the nipple).

(4.) The E-mail goes on, "This is precisely where the lymph nodes are located." Again, this one is written in laywer-language. The lymph nodes are above and lateral to the nipple, but they are remote from the parts of the breast where cancers begin.

(5.) The E-mail continues, "Additionally, men are less likely (but not completely exempt) to develop breast cancer prompted by anti-perspirant usage because most of the anti-perspirant product is caught in their hair and is not directly applied to the skin." First of all, if my anti-perspirant is caught in my own masculine armpit hair, then how come it does such a good job keeping me from perspiring? The sweat glands are deep to the hair. And what about in those parts of Europe where most of the women do not shave their armpits? You'd think they'd have the same low rate of breast cancer as US males. And what about groups of men in the US who usually shave their armpits? If the claim were true, male bodybuilders and others would have more breast cancer than unshaved European women.

(6.) The E-mail continues, "Women who apply anti-perspirant right after shaving increase the risk further because shaving causes almost imperceptible nicks in the skin, which give the chemicals entrance into the body from the armpit area." Whoa. I thought the problem wasn't that the chemicals were mutagens, but that they caused naturally-occurring mutagens to accumulate. The author has completely changed his/her proposed mechanism. And again, if this claim were true, you would find a strikingly higher rate of breast cancer among women in the US, where most shave their armpits, than in those parts of Europe where most do not.

Reasonable people will differ about whether we should smell like nature evidently intended. There's some intriguing new work which suggests that our personal armpit smells help us get chosen by mates who have different tissue types, giving our children a better chance of resisting infections. Love may be blind, but perhaps Love is not anosmic. Right or wrong, today it's hard to keep a real job if you have body odor. Antiperspirants offer some health advantages, especially protecting the skin in hot environments and in invalids. Zirconium and beryllium based products have produced a curious rash ("armpit sarcoid") that's a skin pathologist's curiosity.

Pathologists are mostly not saints, and I'm certainly not one. But we tell the truth, and mostly we deliver value. If you are the author of this E-mail, or have passed it on, please reconsider your position. And if you wrote or passed this E-mail knowing it to be false, I hope your "health" friends take you for every penny you have.

There are no published studies in the refereed medical journals linking antiperspirant use and breast cancer. Scientists thrive on finding out new secrets of nature, and medical editors thrive on publishing credible evidence. Today's journals are full of accounts of whether this particular environmental exposure can cause this particular disease. Of course, if you want to believe conspiracy theories about ultrapowerful antiperspirant makers, that is your business.

Here are all the sites I could find (May 1999) that present antiperspirants as causing breast cancer. Four out of the five are selling deodorants that are not antiperspirants, while the fifth is an anti-bra activist. Draw your own conclusions.

You may use your antiperspirants without worrying about getting breast cancer from them.

Meet Ed

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reset Jan. 30, 2005:

Addendum: May 27, 1999: T-- Z-- wrote me to say that she is NOT the author of the E-mail, and had nothing to do with it. A version has been circulating listing her as the author. This is not the first quack E-mail to list a randomly-selected or nonexistent author.

Addendum: Nov. 29, 1999: A correspondent sent me a version of the E-mail claiming that a group at U. of Reading (UK), which has been studying polychlorinated biphenyls with estrogenic activities in a mouse model of breast cancer, have discovered a link between deodorant chemicals and breast cancer. The actual paper ("A novel oestrogen-regulating gene in human breast cancer cells") in J. Mol. Endocrin. 20(3), June, 1998, has nothing to do with antiperspirants.

Addendum: Dec. 11, 1999. A correspondent reached the "Katrina Scott" who's listed as author of one version. She's not. I've also learned that a private E-mail of mine on the subject, which refers to "lawyer-talk", is making the rounds without my permission. Somebody's violated netiquette, but I'm pleased that the truth is getting out, even it doesn't show me at my most tactful.

Urban folklore describes aluminum in antiperspirants as a cause of Alzheimer's. The lone epidemiologic study (Am. J. Clin. Ep. 43: 35, 1990) showed no link whatever with deodorant use. The lone article suggesting a link is a speculative essay by a non-physician chemist. The talk got started from old studies demonstrating aluminum and silicate in the amyloid of Alzheimer plaques; I suspect these got there from the research instruments, binding to the curious proteins of Alzheimer's, since obviously we're not making quartz or glass in our brains. Aluminum causes dialysis dementia but the neuropathology was very different.

The Anti-Immunization Activists -- A Pattern of Deception