Breast cancer is the primary sub-type of cancer affecting women today. Annually, this disease affects nearly 186,467 women in the United States alone (Centre for Disease Control [CDC], 2009). In the last two decades, health concerns about use antiperspirants and their capability to play a role in breast cancer development have been put forward. Following publication of various internet and press articles relating Breast cancer development and use of deodorants and antiperspirants, various studies have been carried out to validity these claims. According to these articles antiperspirants and deodorants contain certain substances that have detrimental effects if absorbed via the skin or find their way through to the body through cuts resulting from shaving.The various studies that have been carried out in this area have given mixed results.
Theoretically, antiperspirants have the ability to propagate breast cancer based on their chemical constituents. One of the most significant contributing factors to breast cancer is the long term exposure to estrogen and at least two elements in the antiperspirants possess estrogenic activities: parabens and aluminium.
For example a population based, case control study published in the Journal of the National Cancer institute of 2002 indicated that there was marked increase in breast cancer development with use of deodorants, antiperspirant or underarm shaving. This population based case-control study was carried out on women suffering from breast cancer women inhabiting the Western Washington State. It involved breast cancer female patients of ages ranging between 20 and 74 years old, who were initially diagnosed with this condition from 1992 November through 1995 march. The study also employed control subjects, breast cancer free women who were obtained from the same population as the case study subjects. The study not only gathered historical information on the use of deodorants from all its subjects but also asked whether the individual shaved before applying these deodorants and antiperspirants. This was due to their assumption that cosmetics contain harmful chemicals, with cancer causing properties, which could find their way to the body through absorption as well as cut resulting from shaving (Mirick, Davis &Thomas, 2002)
The researchers start by justifying the reasons for their study. For instance they point out that rumours circulating via different media outlets were causing public panic as there were epidemiologic study findings to invalidate or validate those claims.
The researchers constructed numerous measures for cosmetics for the evaluation of a potential connection to breast cancer development including typical application of deodorants within one hour of shaving, exclusive application of antiperspirants versus talc products or deodorants. The study also evaluated the possibility of the variation in the risk of breast cancer development and the method of shaving prior to application of antiperspirants. This study also took into consideration other breast cancer risk factors.
The study employed 813 breast cancer case patients and 793 breast cancer free case control. According to this study almost all case study patients and case study control subjects reported to have regularly shaved prior to the antiperspirant application.
The study also pointed out the number of case study patients who used antiperspirants was less relative to control subjects. Fifty percent of case study patients employed antiperspirants compared to fifty six percent of control subjects.
The study concluded that there is no relationship between antiperspirants and risk of breast cancer development. There was also no evidence connecting razor use or deodorant application with increased risk of breast cancer development.
The study employs a rigorous based on a large population. However, the study failed to evaluate whether the subjects have a clear knowledge between deodorants and antiperspirants.
A study carried out in the United Kingdom by P. D. Darbre on the correlation between breast cancer, antiperspirants and aluminium and appeared in the September 2003 Journal of inorganic biochemistry. This study indicated that aluminium chlorydrate and aluminium chloride has an effect on the normal functioning of the estrogen receptors in the MCF7 human breast cancer cells and hence could play a significant role in the development of breast cancer. Parabens are employed as antimicrobial preservatives in underarm antiperspirants and deodorants in addition to a wide variety of consumer products.
The research particularly singles out aluminium as the principal suspect in the carcinogenic effects of deodorants. It points out that twenty five percent of deodorant content is aluminium and that the body only requires trace amounts of aluminium. The research by Darbre and his colleagues stated that aluminium present in deodorants applied on the skin adjacent to the breast may be absorbed resulting in oestrogen-like effects. Since oestrogen has been shown to posse breast cancer development promoting activities, this study by Darbre PD and colleagues published their postulations, that aluminium based cosmetics can also promote breast cancer development, in the 2005 inorganic Biochemistry journal (Darbre, 2005).
This study involved collection and measurement of aluminium concentration in breast tissues of 17 breast cancer women. The study reported increased quantities of aluminium in the breast regions near the skin and the researchers hypothesized that deodorant aluminium could responsible for increased cases of breast cancer.
However, the design employed by this study was not good enough to provide a conclusive outcome. Another limit for this study is the use a very small sample (17 women) and its failure to compare the levels of aluminium in other regions of the body of the women suffering from breast and include non-cancer women in the study sample.
The research provides a good introduction by referring to previous clinical studies that indicated in most cases breast cancer in women starts in the breast's upper quadrant. The study also points out that despite these increased cases being attributed to the presence of large amounts of epithelial tissues in these regions, most deodorants are applied in these areas. It also provides statistics of upper quadrant breast cancer cases from earlier studies. It also points out that the disproportional upper outer quadrant breast cases cannot be accounted for by the large quantities of epithelial cells in this region but by the increased application of use underarm deodorants and antiperspirants.
The study also provides conclusive background information on the chemical components of the deodorants and their properties, some of which have been shown to promote the development of cancer.
A laboratory based study by Darbre et al (2004) and published in 2004 Journal of toxicology was meant to measure the types and quantities of parabens in breast tissues in their native form. This was due to the fact that esterases on the skin surface have been shown to break parabens down into their simple forms.
The study starts by providing concrete information on the parables including their chemical properties as well as their use in pharmaceutical, food and cosmetic industries. Some of the properties mentioned are their antimicrobial properties and the ability of these compounds to disrupt cellular functions via inhibition of lysosomal enzyme secretion as well causing the dysfunction of the mitochondrion. The study also provides important information obtained from earlier studies in parabens including animal studies that indicated their rapid absorption, metabolism and excretion. It also points out that parabens can be absorbed rapidly via intact skin. Another important point mentioned in the introductory part of this study is the finding from other earlier studies that parabens have no mutagenic activities. But the same study points the presence of reports on the potential chromosomal aberrations due to parabens.
The researchers justify their study by pointing out that since parabens have oestrogen like activities, and oestrogen has been shown to promote breast cancer development, there was need to evaluate whether it is possible for low-dose but long term exposure to enter and accumulate in breast tissue. Hence, the study was meant to evaluate the possibility of detecting and measuring individual parabens in available breast cancer tissues by chromatographic methods in conjunction with tandem mass spectrometry.
The samples in this experiment were breast cancer materials from Edinburg Breast unit that had been stored under liquid nitrogen. The experiment involved chopping of approximately 0.25g of human breast cancer materials followed by analysis of various chromatographic procedures. These samples were obtained from 20 human breast cancer tissues prior to their analysis by HPLC CMS/ MS against standards of parabens.
According to the findings of this study averagely 20 ng parabens breast tumour tissues per a gram of breast tumour tissue were obtained.
However the study failed to reveal the real source of the parabens that is whether they entered the human body via topical or oral route. It was also unable to elucidate the mechanisms through which they found their way to the breast tissue i.e. whether non-systemic or systemic mechanisms. The study points out for the need for a more detailed study involving all body tissues and large samples to provide reliable data.
Fakri, AL-Azzawi and Al-Tawi carried out a case control study on 54 women suffering from breast cancer (cases) and 50 women without breast cancer (controls). This study was meant to evaluate the probable connection between risk of breast cancer development and antiperspirant use, as well as recognize some other risk factors increasing the possibility of breast cancer development. This study was published Eastern Mediterranean Health Journal of 2006. The study found out that more than 82 percent of women without breast cancer used antiperspirants relative to 51 percent of those suffering from breast cancer. Therefore the study concluded that there is no relationship between risk of breast cancer development and use of antiperspirants (Fakri, Al-Azzawi, & Al-Tawil, 2006).
The study provides a good introduction by pointing out the significant of breast in women especially as one of the leading causes of female mortality. They also justify the reason for the study by pointing referring to marked rapid increases in levels of breast cancer cases in Iraq especially during the 1990s. They also point out that breast cancer has become a significant health problem in Iraq. The research also provides some important information on the some properties of antiperspirants that might be important in their role in the development of breast cancer. For instance the researchers point out that since antiperspirants prevent body toxins from being excreted from the body, especially under the armpits, the body is forced to get rid of them by storage in the lymph nodes, situated in the breast areas' upper outside quadrant.
The 54 case patients were breast cancer patients at Al-Kadhmia teaching hospital between September 1, 2002 and February 28, 2003. The other 50 women were obtained from women attending the hospital for other medical purposes other than breast related complications. The study was conducted using questionnaires that included elements like disease duration, age, breast cancer history of the family, marital status, antiperspirant use, smoking status and use of any oral contraceptives.
The study concluded that there was no connection between risk breast cancer development and antiperspirant use. However, the design employed by this study was not good enough to provide a conclusive outcome. Another limit for this study is the use a very small samples.
A retrospective study that was published on the December 2003 European Journal of Cancer prevention indicated that earlier habit and frequency of antiperspirant use after underarm shaving were as a result of earlier age of breast cancer diagnosis. Since the design employed by this study failed to conclusive evidence, there is need for conclusive research to validity these claims.
The study subjects of the study were female breast cancer survivors of between January 1, 1993 and December 31, 2001. The research involved sending approximately 1344 questionnaires to surviving victims of breast cancer to study their underarm shaving and deodorant and antiperspirants use practices. Of the sent questionnaires only 437 were returned The study also considered the mean age at which diagnosis of breast was carried out in relation to individuals undertaking these practices prior to attaining 16 years of age and those undertaking it after the age of 16 years (McGrath, 2003).
The study not only provides important information on the previous studies relating breast cancer development and use deodorants and antiperspirants in conjunction with underarm shaving but also provides statistics of American women using both underarm shaving and cosmetic application.
For instance the study points out that an earlier study by Mirick et al (2002) indicated that there was no connection between high risks of breast cancer development and these hygiene habits. It also points out some of the weakness of the Mirick study including its failure to address the frequency of the habits among breast cancer survivors.
Findings from this research were consistent with the hypothesis that the intensity or frequency of deodorant or antiperspirant use and underarm shaving is related to an earlier age diagnosis of breast cancer. Furthermore, starting these practices at a tender age was related with a marked significant of earlier age diagnosis. The study also indicates that for these habits to increases the risk of earlier age must be carried out together i.e. none of the practices can separately lead to earlier diagnosis. According to this study, various factors such as environmental, cultural and genetic factors need to be considered when undertaking breast cancer risk factors.
Both the design and sample size of the study were too small to provide conclusive connection between breast cancer and underarm hygiene. The study points that there need for case-control studies involving large population to evaluate such relationship.
Unless conclusive epidemiological studies are carried out, the issue of antiperspirants and breast cancer will remain a serious issue in the minds of women throughout the world, who are confronted with the dilemma of their hygiene and the risk of developing the dreaded breast cancer complication. However, finding by studies by National institute of cancer in the United States and FDA (United States Food and Drug Administration) which controls medicines, food, medical devices and cosmetics have not shown any relationship between risk of breast development and use of deodorants and antiperspirants. Studies connecting breast cancer development and cosmetics refer to certain elements forming part of the underarm deodorants or antiperspirants that posse estrogen like properties can promote breast cancer development, provided these chemicals are used regularly and cross proximity to the breast.