The unsinkable rubber duck of a myth that bras cause breast cancer

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Besides being a researcher and prolific blogger, I still maintain a practice in breast cancer surgery. It’s one of the more satisfying specialties in oncology because, in the vast majority of cases I treat, I can actually remove the cancer and “cure” the patient. (I use the quotes because we generally don’t like to use that term, given that some forms of breast cancer can recur ten or more years later, but in many cases the term still fits, albeit not as well as we would like.) Granted, I get a little (actually a lot of) help from my friends, so to speak, the multimodality treatment of breast cancer involving surgical oncology, radiation oncology, and medical oncology, but breast cancer that can be cured will be primarily cured with surgery, with chemotherapy, hormonal therapy, and radiation therapy working mostly to decrease the risk of recurrence, either local in the breast or distant elsewhere in the body. Through this multimodality approach, breast cancer mortality has actually been decreasing over the last couple of decades.

However, as a breast cancer surgeon, I not infrequently have to deal with many of the common myths that have sprung up around breast cancer. Some are promoted by quacks; others are just myths that sound plausible but aren’t true. (That’s why they persist as myths.) Last week, I was on staycation and still cleaning up the mess over the "CDC whistleblower" scandal; so I let these sorts of things slide a bit, but fortunately there's time this week. Besides, I feel as though a break is needed from vaccine-related topics, if only for a day or two. It happens. So I thought now was a good time to take a look as any. There’s also so much less mucking about on PubMed and Google that way to make sure I’m not missing something, which is always a bonus. Besides, by waiting until this week, I got to see the response of a proponent of this particular myth, and that's always fun. You'll see what I mean soon enough.

Those who pay attention to breast cancer news (and, of course, I do have a Google Alert set up for just such news) can’t help but notice that late last week there was a flurry of stories (no, not that kind of flurry) about a study looking at the risk of breast cancer due wearing a bra. I’ll cut to the chase. According to this study, there was no increased risk of breast cancer due to wearing a bra, a result that, to breast cancer specialists, was about as surprising as the observation that the sun rises in the east and sets in the west, water is wet, and gasoline flammable. However, the myth that wearing bras increases the risk of breast cancer is one of those unsinkable rubber ducks (as James Randi would put it) of a myth that just won’t die. (Most recently it showed up in a Facebook- and Twitter-spread article entitled "Your Bra May Be Killing You – Scientists Call For Boycott Of Komen", as well as on—of course!—NaturalNews.com.) I keep hoping that a study will do to this myth what a wooden stake in the heart does to the vampires in True Blood, but unfortunately this is one of those unsinkable rubber ducks of a myth (as James Randi would put it) that refuses to die. So I consider it worthwhile to briefly (for me) discuss how it came about.

It’s unclear where and how long ago this myth first appeared, but there’s little doubt on when it was first popularized: 1995. That was the year that a book by Sydney Ross Singer and Soma Grismaijer entitled Dressed to Kill: The Link Between Breast Cancer and Bras was published. The central thesis of the book was that bra-wearing is a major cause of breast cancer because of its claimed effect on lymphatic circulation. Basically, the idea was (and still is) that bras interfered with lymphatic drainage and thereby, though unclear mechanisms, caused cancer. The claim was that there are all sorts of “toxins” (of course) that cause cancer and that the lymph vessels drain those “toxins” away from the breast. Thus, if you believe Singer and Grismaijer, these “toxins” are concentrated in the breast by the constriction that bras produce and result in breast cancer.

This concept, that “toxins” somehow accumulate if lymphatic drainage is somehow blocked is one of the key concepts behind the quackery that is “detoxification,” used by quacks of many stripes. Such “detoxification” often consists of diets that result in purging, coffee enemas, chelation therapy to “remove heavy metals,” and many other treatments without a solid basis in science. However, “manual lymphatic drainage” is yet another form of quackery, at least when it’s claimed to “detoxify.” Sometimes, the quackery becomes rather amusing, such as when people come up with ideas like the “Brassage.”

Perhaps the best example of these beliefs can be found in an article entitled "Can a Bra Cause Breast Cancer? The Answer May Surprise You", in which we find claims like:

Now, if enough pressure is put on your lymphatic system to produce pain and swelling, as in the example of your feet, you'd notice and fix it. Meaning, you'd take off your shoes, put your feet up, and bring the swelling down.

But, what if the pressure were too slight for you to notice? Or, what if it had gone on for so long, you no longer realized your discomfort? This is the case when it comes to bras. Many women simply "get used to" the discomfort of a bra and pay no attention to the indentations bras leave on their skin. Some researchers believe it's precisely this indentation that, over a period of time, causes long-term mild impairment of the lymphatic function.

One of the largest clusters of lymph nodes is located in the armpit and upper chest area. That lymph cluster filters drainage from the breast, arm, and upper chest. But, if your bra is too tight, it constricts drainage from the lymph nodes in your armpit area.

Drainage to the breastbone lymph nodes also gets constricted, especially by bras with underwire. On top of that, shoulder straps from bras potentially cut off drainage of the lymphatics along the top of the breast to the armpit. Also, pressure from the cups of the bra may hinder drainage down to the liver.

If the researchers are right and this is what's happening, what does it mean? Simply this: Toxins are not being drained from the breast area, so breast tissues are more susceptible to degeneration and eventual cancer.

Another variant of this concept includes:

Women evolved under conditions where there was BREAST MOVEMENT with every step that they took when they walked or ran. My reading of the scientific literature about lymphatic flow shows me that this may be as important as the constriction factor. Every subtle bounce of the breast while moving, walking, running, etc. gently massages the breast and increases lymphatic flow and thus cleans the breast of toxins and wastes that arise from cellular metabolism.

There are a lot of jokes I could make here, but, through enormous self-restraint, I will refrain, other than to point out that Ralph Reed, PhD has a rather intense interest in the bouncing of breasts.

In their book, Singer and Grismaijer claimed to have found the following (and you will see this list with minor variations in phrasing scattered throughout alternative medicine sites):

  • Women who wore their bras 24 hours per day had a 3 out of 4 chance of developing breast cancer (in their study, n=2056 for the cancer group and n=2674 for the standard group).
  • Women who wore bras more than 12 hour per day but not to bed had a 1 out of 7 risk.
  • Women who wore their bras less than 12 hours per day had a 1 out of 152 risk.
  • Women who wore bras rarely or never had a 1 out of 168 chance of getting breast cancer. The overall difference between 24 hour wearing and not at all was a 125-fold difference.

Other claims included that breast cancer is only a problem in cultures where women wear bras. In contrast, in cultures where women don’t wear bras, breast cancer is a rare event. I’m guessing you can tell the major flaw in reasoning there, but let’s go on. Specifically, Singer and Grismaijer claimed to have observed that the Māori of New Zealand, who are integrated into white culture and therefore wear bras, have the same rate of breast cancer, while the aboriginals of Australia, who are bra-free, have practically no breast cancer. They made the same claim for “Westernized” Japanese, Fijians and other bra-converted cultures. They even claimed that women who don’t wear bras have the same risk of breast cancer as males. (Males have an incidence of breast cancer about 100-fold less than that of women.)

Of course, this “study” was not published in a scientific journal. It was published for the first time in Singer and Grismaijer’s book, which was updated in 2005. Naturally, cancer scientists immediately pointed out the massive flaws in the “study,” such as:

  • Lack of controlled epidemiological data correlating bra-wearing with the risk for breast cancer
  • Lack of proof that the pressure exerted by a bra reduces the flow of lymph
  • Lack of proof that lymph contains carcinogens
  • Lack of proof that there are carcinogens in the human body that can induce breast cancer
  • Existence of published data correlating obesity with post-menopausal breast cancer

This doesn’t even consider the utter lack of even a perfunctory attempt to control for well-established epidemiological risk factors for breast cancer, such as age at menarche, age at menopause, age of first live birth, obesity, Western pattern diet, and others. There was no proper statistical treatment of the data, and the study participants knew the study hypothesis before they took the survey. By any reasonable scientific standard, Singer and Grismaijer’s “study” was a complete mess, but it had a huge impact on popular views of breast cancer and popularized a myth that’s persisted for nearly two decades. Naturally, Singer and Grismaijer reacted to criticism of their study and book in predictable ways, pulling the “garment industry shill gambit,” saying, “The bra industry is a multi-billion dollar enterprise. And billions of dollars are spent each year researching and treating this disease. Ironically, ending breast cancer can cause financial hardship for many people.”

And, most ridiculously:

We have become a breast cancer culture. As a result, our information was seen as a threat to that culture. Sometimes a disease is less threatening than change.

Unfortunately, in that time, very little actual research existed to refute or confirm this myth. A search of PubMed for “bras” and “breast cancer” results in mainly articles on breast edema after breast cancer treatment, designing bras after breast cancer surgery, and cosmetic implications of breast cancer surgery. There is one study from 1991 cited by Singer and Grismaijer as evidence in support of their hypothesis. There’s just one problem: The article said nothing of the sort. Rather, it concluded that “bra cup size (and conceivably mammary gland size) may be a risk factor for breast cancer.” The reason for this association is almost certainly not because women with larger breasts are more likely to wear a bra regularly and for longer periods of time but rather because they have more breast tissue and are more likely to have larger breasts because they are obese. (Obesity is a known risk factor for breast cancer.)

The utility of this latest study, by Chen et al at the Fred Hutchinson Cancer Center, is that it’s about as rigorous a study as there’s ever been about this issue. Basically, it’s a case-control study that examined women with invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC), comparing them to women without breast cancer matched for relevant risk factors as follows:

Briefly, cases were women between 55 and 74 years of age first diagnosed with invasive breast cancer between January 1, 2000, and March 31, 2004, while residing in the Seattle-Puget Sound area. The Cancer Surveillance System, the region’s population-based cancer registry also participating in the Surveillance, Epidemiology, and End Results program of the National Cancer Institute, was used to identify cases. All ILC cases (identified using ICD-O histology codes of 8520, 8522, and 8524) and a random sample of 25% of the IDC cases (identified using ICD-O histology code of 8500) were targeted for recruitment to enroll equal numbers of ILC and IDC cases. A total of 1,044 out of 1,251 eligible cases were interviewed (83%), consisting of 454 IDC and 590 ILC cases. A common control group, frequency matched 1:1 to the ILC cases within 5-year age groups, was selected from the general population of women living in the three-county area by random-digit dialing.

There were a total of 454 cases with IDC, 590 with ILC, and 469 controls. The authors then looked for differences between cases and controls in various aspects of bra wearing, including bra cup size, recency, average number of hours/day worn, wearing a bra with an underwire, or age first began regularly wearing a bra. They found no correlations. As far as epidemiological studies go, this one is quite good. The only significant weakness, acknowledged by the authors, is that bra wearing was so ubiquitous that it was not possible to examine any differences between women who never wore bras and those who did. So instead the authors concentrated on, in essence, the “dose” of bra wearing; i.e., the number of hours a day on average, cases and controls wore a bra. In this, it is not unlike a previous study of vaccines, in which there was not a true unvaccinated group but there was no correlation between thimerosal dose in vaccines and autism. In epidemiology, it’s not always possible to have a true unexposed group.

In any case, I’m happy to see this study. Before, when confronted with a patient who had heard this myth, I would have to argue on lack of evidence and the extreme implausibility of it all, given that there was no evidence that axillary lymphadenectomy (a.k.a. lymph node dissection) increases the risk of breast cancer. Quite the contrary, in fact. A notable study that looked at breast cancer risk after axillary lymphadenectomy for melanoma found no increased risk of breast cancer.

Sadly, as busted as this myth has been and is now, when I first read this study, I fully expected it would not bury it for good. In fact, it hasn't, as the rotting hand of this myth has pushed its way through the dirt to try to grab the rational and frighten women. Of course. Just the other day, one of the authors of Dressed to Kill, Sydney Ross Singer, published an article on one of the many wretched hives of scum and quackery that I monitor regularly, The Cover-Up Continues: New Study Claims Bra-Cancer Link a “Myth” This response is particularly lame, even for Singer. Get a load of this stupid:

A new study was just announced in mainstream media declaring the bra-cancer link does not exist. The study looked into the bra wearing habits of women ages 55 and older who had all worn bras since puberty. They concluded that women should be "reassured" that bras are not causing breast cancer.

Actually, this study supports the bra-cancer link, since all the women in the cancer group were bra wearers.

Notice that I just addressed this specious criticism above. Clearly, Singer does not understand the concept of dose-response. The only way this is a legitimate criticism, at least in the way Singer meant it, would be if the cancer-causing power of bras was so incredible that even a brief exposure to bra wearing causes cancer. He then goes on to cite the very same 1991 paper that I described above as "evidence" that bras cause breast cancer. As I described, that paper shows nothing of the sort. Then there's this:

Why this study focused only on POST-menopausal women, instead of researching the positive association of pre-menopausal women, suggests a bias and agenda.

Again, the reason for this is simple. Breast cancer is primarily a disease of aging, with the average age of diagnosis being 62. The bra-breast cancer hypothesis is an environmental exposure; so presumably the number of years of "exposure" matters. So it makes perfect sense to look at postmenopausal women, for whom the prevalence of breast cancer is much higher than in pre-menopausal women and for whom the "exposure" to bra wearing would be the longest. There's no bias or agenda; this was clearly a scientific decision that makes perfect sense. Studying premenopausal women in an exposure/risk factor study like this would have resulted in much reduced sensitivity to detect a true difference in breast cancer prevalence, given how much lower breast cancer prevalence is in them, and would have meant smaller differences in cumulative bra wearing. Clearly, Singer doesn't understand the basics of case control studies, where one wants to maximize the chances of finding significant differences in the exposure of interest between cases and controls.

None of this stops singer from ascribing dire motives. Instead of the "pharma shill gambit," think the clothing industry shill gambit:

It seems there is, indeed, a hidden agenda. The main author, who is a PhD student, did not mention that The Fred Hutchinson Cancer Research Center, where this study was done, receives money annually from a "Bra Dash" fundraiser, where bras are worn on the outside of clothing during a 5K race to raise funds.

It would be very ironic to criticize bras for causing cancer when they are used to raise funds for cancer research.

Uh, no. Seriously. No.

Singer doesn't stop there, though:

The fact that this poorly designed study without proper controls is used to conclude that there is no bra-cancer link also reveals a bias. The authors should have called for more research.

All this study really shows is that some women who have worn bras for 40 years or longer will get breast cancer and some will not. We already knew that. You can say the same thing about smokers and lung cancer.

Of course, as the bra-cancer link gains increasing public awareness, there are bound to be studies trying to refute it. Billions of dollars annually are at stake. There are also studies that try to refute the cigarette-cancer link. So I take all this as a good sign of progress, since it brings the topic into mainstream consciousness, and these attempts at denial are expected.

Ugh. The "tobacco industry" gambit, the very same gambit beloved of antivaccine advocates. It's hard to take the criticisms of someone who's already demonstrated himself to be utterly incompetent at epidemiological research seriously. His smoking analogy is also silly. If there's one thing research on smoking shows, it's that dose matters; if you compare a group that has less than a 10 pack-year smoking history, for instance, with a group with more than a 30 pack-year history, for example, you will find a big difference in lung cancer prevalence.

Again, is this study on bra wearing ideal? No. However, it does look at whether there were any differences in the "dose" of bra wearing or the characteristics of bra wearing between cases (women who had had a diagnosis of breast cancer) and controls (those who had not). Ideally, it would be nice to find a group of women who never wore bras who don't have so many other confounding factors (such as being aboriginals) that comparisons between them and bra-wearing women are highly problematic, but that's impractical. In the US and other industrialized countries, the vast majority of women wear bras from puberty on for at least their waking hours, and very few women never wear bras. Given that fact, looking for dose-related effects is the best epidemiologists can do. Given the utter implausibility of the hypothesis, it's even arguable whether the money and resources should have been spent to do this study, but it was done and it was negative—exactly as one would expect.

No, as much as Singer thinks that someday he'll "show them all," it's nothing more than the fallacy of future vindication.

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By c0nc0rdance (not verified) on 10 Sep 2014 #permalink

Frankly, anyone who falls back on the lazy and self-aggrandizing "there's a conspiracy to suppress my findings" argument is exposing themselves as a hand-waving idiot in my books. On the upside, if anyone is not wearing a bra because of this myth, they're probably not causing themselves any harm other than occasional discomfort. Which is more than I can say for some quackery.

By cthulhu eat me first (not verified) on 10 Sep 2014 #permalink

It's rewarding to discover that not only am I a pharma shill but a garment industry shill as well!

Louise Kuo Habakus has declared "Ladies, Ditch the Bra!" ( FearlessParent.com/ 2 parts,recently) and I've heard similarly un-supported research discussed @ PRN which espouses all that is natural and usually, extremely un-attractive as well.

Speaking purely as a person with a drawer full of these devious contraptions I think that the worst women have to fear is getting stabbed by errant underwires which have worked their way - viciously and maliciously, I should add- through layers of lace, netting and assorted frou frou in which they were encased to ungratefully stab their wearer. ( -btw- they're easy to remove and DISCARD).

There may be a budding fashion trend amongst youngsters that eschews these lacey,traditional instruments of torture and replaces them with undershirts, tanks, camisoles and less constricting softer, elasticised** alternatives ( of which I own a few, despite my age ) that provide little support and look as un-appealing as possible.

I doubt that most women will "go without" except for the most woo-entranced because- let's be honest- they make women feel more 'covered-up' and protected from over-interested glances at their bodies from those we'd prefer to remain strangers and they can make you look better in clothes ( and smaller or larger as you will).

Woo seeks to make people frightened about the most mundane stuff of life in order to garner attention for their ideas and products..

** for lack of a better word: there are now so many stretchable fabric choices I can't keep track of the names.

By Denice Walter (not verified) on 10 Sep 2014 #permalink

I remember hearing a form of the cancer-bra hypothesis back in the 1970's, but then it was the opposite. The notion was that bouncing breasts would cause spaces to form between cells (or something like that) and these would lead to cancer. So, bras would prevent cancer. It seemed like a ridiculous idea back then, and I haven't changed my mind since.

By Mark Thorson (not verified) on 10 Sep 2014 #permalink

Wasn't there a large Italian study that did appear to find that overall health outcomes were actually slightly worse for bra-wearing females than non-bra-wearing females.
That could perhaps be that women with heavier breasts are more likely to wear a bra, and also more likely to suffer backache. I never saw the study, it would be nice to know if it's bunk or whatever?

I am continually fascinated by all of the various claims for breast cancer. There is, of course, the idea that antiperspirants cause breast cancer, and the substitution of a natural aluminum salt crystal for the the aluminum in commercial antiperspirants. But the one that always leaves me shaking my head is the claim that mammograms cause breast cancer, because everyone who has been diagnosed with breast cancer had a mammogram. Natch.

By Sasha Loomans (not verified) on 10 Sep 2014 #permalink

the aboriginals of Australia, who are bra-free, have practically no breast cancer.

Oh in the name of fvck. The indigenous Australians have enough problems with white Australian racism without these dingbats to add their own Noble Savage layer of patronising untouched-by-civilisation racist crap.

I have no idea what the rate of breast cancer is among Aborigine women, other than that it's probably under-reported because the Australian health system has traditionally ignored what they die of.

By herr doktor bimler (not verified) on 10 Sep 2014 #permalink

The only significant weakness, acknowledged by the authors, is that bra wearing was so ubiquitous that it was not possible to examine any differences between women who never wore bras and those who did.

Oh no....now the pseudocscience folk are going to start clamoring for a bra vs bra-less study.

By Chris Hickie (not verified) on 10 Sep 2014 #permalink

I have never believed Orac was a shill for Pharma: Big, Medium, Just Right, Small, or, Twiggy (DD, D, C, B, or A in scientific terms). He is obviously, however, a shill for Victoria's Secret.

"[Bras] make women feel more ‘covered-up’ and protected from over-interested glances at their bodies, and they can make you look better in clothes." So you FEEL more protected, while "looking better"? Uh, the 'better" of pushing up and out, has been defined by a fashion industry run by men for men. A bra not only adds emphasis to the boobies by making them, uh, stand out, It eroticses them by making them seem 'firm'. Based on extensive qualitative research in locker rooms, I conclude your average All-American horndog is a pro-bra bro, and considers free-floppage 'gross'. The t-shirt-only look only works for the frat boys if the shirt is at least a size to small, and either Wet or being pulled-up in a Girls Gone Wild video.

Clearly, Sydney Ross Singer is a shill for the well-funded feminazi conspiracy!

@ sadmar:

No. Not all women want them to stand out more or be pushed up. "Covered up' means exactly that- so that there is another layer of cloth between you and observers' eyes.

And "looking better' can mean whatever you like- including having less, having more, pushing up, flattening out**, becoming less of gravity's plaything ( see sportsbra).Not everyone subscribes to the Victoria's Secret school of thought.

** we occasionally wear buttoned, tailored shirts and you want a flatter look.

By Denice Walter (not verified) on 10 Sep 2014 #permalink

I still think bra's are uncomfortable. And if something feels uncomfortable to me, why should I wear it.

“[Bras] make women feel more ‘covered-up’ and protected from over-interested glances at their bodies, and they can make you look better in clothes.” So you FEEL more protected, while “looking better”?

I don't have a dog in this fight, but this much should be obvious: If you are wearing clothes that were designed under the assumption that you would be wearing a bra, then chances are you would look better in those clothes if you were wearing a bra. And while I'm not an expert on women's clothes, my guess is that often (especially for those who need to go for the dressy or professional look), women's clothes have been designed under that assumption. That doesn't mean that all women who wear such clothes will want to wear bras (see Renate, above), but it shouldn't surprise you that many would.

By Eric Lund (not verified) on 10 Sep 2014 #permalink

@Denice similarly un-supported research - Well put. :D

Having properly fitted bras makes all of the difference in the world to comfort. Even my dinky little A-cups aren't comfortable for me when they're bouncing in an unrestrained fashion, and a properly fitting bra makes everything stay in place better. They're small enough that the aforementioned camisoles with elastic support actually do keep them happy, and work on lazy days, but a proper bra is so much better (and conceals the outline of certain decorative piercings that are not appropriate in a work setting).

Of all of the things to worry about when it comes to breast cancer, neither bras nor occasionally secreting a cell phone in them make the list, for me. I have to admit, I had never heard this one before.

By Roadstergal (not verified) on 10 Sep 2014 #permalink

Personally, (not being any kind of professional in any field but goofing off. Black belt in that!) I have traveled extensively in life and except for too tight shoes, or too high heels, have never seen or heard of dangerous clothing.
Wear whatever you damn well please.

By Sojourner (not verified) on 10 Sep 2014 #permalink

My wife is a 'non wearer ', not because of cancer but for comfort reasons.

Nonetheless she does feel that this has kept them in better shape. At 55 I can believe that might be true.

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Perhaps the idea has its origins in the 1960s/70s, growing out of a hippie, free-love subculture where bras were deemed oppressive tools of "the man" (or men).

And I'm sorry, but:

Every subtle bounce of the breast while moving, walking, running, etc. gently massages

Really? Subtle bounce when running? Gentle massage? Clearly written by a man who hasn't bothered talking to women who have to deal with these "subtle" bounces.

Whenever these studies come up, I have to ask- who in their right mind would wear a bra while sleeping!? I could see wearing a bra to *bed,* especially with company, but then the bra should spend the night on the floor (or on the lamp.)

Renate: *Shrug* I've never encountered a perfectly comfortable bra. They aren't designed for comfort.

By Politicalguineapig (not verified) on 10 Sep 2014 #permalink

except for too tight shoes, or too high heels, have never seen or heard of dangerous clothing

I went to junior high and high school in a district where the dress code banned flip-flops on safety grounds: an extra danger of tripping on stairs because the soles are free to move in ways that the soles on other shoes (better attached to the foot) cannot. Judging by the prevalence of flip-flops among students (and people old enough to know better) around here in warm weather, I'm not sure how valid those concerns are. But as someone who occasionally deals with satellite hardware, I am averse to anything that screams "single point failure" as loudly as flip-flops do. A flip flop has a single strap from the toehold to each side of the shoe. If any of those three attachment points comes undone, the wearer is effectively barefoot. You can live with that at the beach or in the shower, but elsewhere, it's a bad thing.

There are some specific situations where you have to avoid certain clothing on safety grounds: no open-toed shoes in lab, and no loose-fitting clothing around certain kinds of heavy machinery. But other than non-sensible footwear, I'm not aware of anything that's generically bad to wear.

By Eric Lund (not verified) on 10 Sep 2014 #permalink

Eric ( @ # 12) is correct ( as usual).

Clothes are often designed with particular undergarments in mind: more traditional ( than today's) women's clothing made exhaustive use of *darts* ( not the kind you throw) - sewn-in folds within clothing in order to fit them to the wearer's body in 3 dimensions -this is especially prevalent in 1950's style dresses and blouses. Things were even more extreme when corsets were involved.

A quick closet review reveals that only that only one amongst my dozens of shirts and blouses has darts; jackets- surprisingly- only one has a vertical dart.
But then, I am not your typical old stylee fashion plate: in fact, at first glance, my wardrobe looks like it could be a man's- but it just doesn't look like that when I wear it.

By Denice Walter (not verified) on 10 Sep 2014 #permalink

I have actually seen a video, from one of those "all electric fields are toxic" cranks, claiming that underwire bras cause cancer by focusing electromagnetic radiation.

By palindrom (not verified) on 10 Sep 2014 #permalink

@ palindrom:

More like, _focus the pointed end of a steel wire through fabric and directly into your flesh_.
This happened to me at a posh restaurant- UNPROVOKED, I might add- seeing this turn of events in the ladies' lounge, I proceeded to rip the miserable thing out and throw it away which is how I learned to dis-arm these implements of destruction.

By Denice Walter (not verified) on 10 Sep 2014 #permalink

I've been thinking about this a bit, and running with their claimed mechanism (pressure on the body cutting off proper lymph drainage). Suppose that they're right, just for the sake of argument. Where else do we have lymph nodes? Well, the stomach, groin and upper legs come to mind. So we shouldn't wear belts, tight-waisted pants or, heck, even underwear, since they run the risk of cutting off lymph drainage and, thus, causing all manner of cancer of the lower abdomen/upper legs. Why, people should be dropping all over the place from cancers of these areas.

The only sensible thing to do is to roam around in our birthday suits. For those who live in cooler climes, you'll just have to huddle together for warmth. But don't huddle too tightly together, or you might give each other cancer.

On the subject of harmful clothing, a story that I seem to hear every few years is that tight pants are bad for men's fertility. Anyone know if there's any truth to this?

Anyway, I think it's high time Big Bra joins Big Oil, Big Pharma, etc on the list of default boogeymen.

By Andreas Johansson (not verified) on 10 Sep 2014 #permalink

Denise Walter: "A quick closet review reveals that only that only one amongst my dozens of shirts and blouses has darts; jackets- surprisingly- only one has a vertical dart."

The vertical dart may be part of a princess seam, which is a form of a dart. There are other ways to put in shaping without darts, especially if the blouses have yokes or gathering.

I am presently making some silk shifts and light jackets that have darts. I went to a fitting class to get a pattern that actually fits me. Without the darts no one can tell that I have a waist if all they see is the yardage hanging off the chest that projects our beyond my ribcage.

"More like, _focus the pointed end of a steel wire through fabric and directly into your flesh_"

Ah, yes. I have experience the attack of the underwire. I finally found a size and style in a fairly costly bra that does not do that. I stock up on them during the Nordstrom big annual sale in July.

@ Chris:

Most of my clothes incorporate quite soft fabrics so I suppose that they drape well and/ or have curved side seams. I am attempting to wear more moderne sort-of-bras made of spandex-ified nylon rather the real deal with wires. I am slightly a bit overmuch for this strategy but who cares! No one has complained so far.

By Denice Walter (not verified) on 10 Sep 2014 #permalink

@palindrom: Yeesh, another idiot who, if he ever took any physics (unlikely), successfully blotted out any inadvertently acquired knowledge with some combination of ethanol-fortified beverages and other mind-altering substances. A rogue sharp end of an underwire will, as you know, enhance static electric fields around the tip (which is why you want such a feature on your lightning rod), but that's not electromagnetic. There are, as Denice notes, some extremely short-term health risks from such a rogue sharp end, but those are easily averted by her methods, and cancer is most definitely not among those risks. Tetanus, maybe, if you like to roll around in the dirt while wearing an old one of those as your outermost clothing on the upper body and aren't scrupulous about washing it afterward, but not cancer.

By Eric Lund (not verified) on 10 Sep 2014 #permalink

Specifically, Singer and Grismaijer claimed to have observed that the Māori of New Zealand, who are integrated into white culture and therefore wear bras, have the same rate of breast cancer

It is hard to believe that Singer and Grismaijer are this ignorant by accident; they have to really work at it. The breast cancer rate among Māori women is in fact substantially higher than among European-origin women (as 30 seconds on the Google would have shown them); not because Māori wear tighter bras, but for the usual socioeconomic poverty-related reasons of poor access to screening, and higher BMI. "Integrated into white culture"? Singer and Grismaijer can DIAF.

By herr doktor bimler (not verified) on 10 Sep 2014 #permalink

Andreas Johansson,

On the subject of harmful clothing, a story that I seem to hear every few years is that tight pants are bad for men’s fertility. Anyone know if there’s any truth to this?

I believe there is some truth to that since spermatogenesis is most efficient at slighter below normal body tenperature. That's why testicles dangle so elegantly outside the body in a convenient air-cooled receptacle. I have seen infertile couples advised to make sure the man's testicles are well ventilated, or even to dabgle them in cold water, though this seems a little extreme.

By Krebiozen (not verified) on 10 Sep 2014 #permalink

That’s why testicles dangle so elegantly outside the body in a convenient air-cooled receptacle.

What a charming description.

Well, now since we're onto tight pants and fertility, here's an oldy but goody (borrowed from http://www.ebaumsworld.com/jokes/read/1057145/), with apologies to any surgeons who might be reading this:

The doctor said, "Joe, the good news is I can cure your headaches. The bad news is that it will require castration. You have a very rare condition, which causes your testicles to press on your spine, and the pressure creates one hell of a headache. The only way to relieve the pressure is to remove the testicles."

Joe was shocked and depressed. He wondered if he had anything to live for. He couldn't concentrate long enough to answer, but decided he had no choice but to go under the knife.

When he left the hospital he was without a headache for the first time in 20 years, but he felt like he was missing an important part of himself. As he walked down the street, he realized that he felt like a different person. He could make a new beginning and live a new life. He saw a men's clothing store & thought, "That's what I need - a new suit."

He entered the shop and told the salesman, "I'd like a new suit." The elderly tailor eyed him briefly and said, "Let's see ... size 44 long." Joe laughed, "That's right, how did you know?" "Been in the business 60 years!" Joe tried on the suit. It fit perfectly.

As Joe admired himself in the mirror, the salesman asked, "How about a new shirt?" Joe thought for a moment and then said, "Sure." The salesman eyed Joe and said, "Let's see, 34 sleeve & 16-1/2 neck." Again, Joe was surprised, "That's right, how did you know?" "Been in the business 60 years!"

Joe tried on the shirt, and it fit perfectly. As Joe adjusted the collar in the mirror, the salesman asked, "How about new shoes?" Joe was on a roll and said, "Sure." The salesman eyed Joe's feet and said, "Let's see ... 9-1/2 E." Joe was astonished, "That's right, how did you know?" "Been in the business 60 years!"

Joe tried on the shoes and they fit perfectly. Joe walked comfortably around the shop and the salesman asked, "How about some new underwear?" Joe thought for a second and said, "Sure." The salesman stepped back, eyed Joe's waist and said, "Let's see... size 36."

Joe laughed. "Ah ha! I got you! I've worn size 34 since I was 18 years old." The salesman shook his head, "You can't wear a size 34. A size 34 underwear would press your testicles up against the base of your spine and give you one hell of a headache.

By Chris Hickie (not verified) on 10 Sep 2014 #permalink

Denice wrote:
"Not all women want them to stand out more or be pushed up."

And I didn't mean to suggest otherwise. My post today (as yesterday) was written as satire. (And this one has nothing to do with bizarre claims of cancer causation.) My points were 1) that most American MEN (not me, fwiw) want the ladies' boobies to stand out and be pushed-up, and 2) a certain degree of patriarchal sexism is incorporated into how many women define "looking better" without calling to conscious any desire to please men. What woman would ever design an "instrument of torture" incorporating stabbing underwires for her own purposes. A cursory glance at the history of conventions for women's attire reveals a constant pandering to (often bizarre) male desires. I could did up a lot of examples, but I'll just go with corsets in the past, and spike heels in the present.

So, yeah, consider Eric Lund's observation that "womens" clothes are "designed under the assumption" the wearer has a bra on underneath, and this applies to the "professional" wardrobe as well. With the exception of the complicated semiotics of neck-ties, the 'professional' dress code for men is un-gendered, wile the comparable code for women remains highly gendered. Women seeking de-gendered attire often have no choice but to shop in the Young Men's department.

For a similar but more extreme example of how masculinist ideology forms the everyday consciousness of women, take cosmetics (Please!). Many women feel they "look better" in make-up, whether they are catering to guys, or just going out with female friends. But what are the semiotics of conventional make-up?

The base eliminates the individuality of skin and certain facial features, Lipstick and rougue mimic the flushing of lips and cheeks during sexual arousal. Eyeshadow brings "bedroom eyes" out into the daylight. Thus make-up creates a generic mas of 'feminity' based on a constant state of sexual arousal. Men, of course, are expected to do nothing of the sort.

If not apprehended as intended, my satirical tone — note the reference in the location field to the master of recasting slimeball attitudes into upper-middle-class respectability (see Chapter 4 of The Hearts of Men by Barbara Ehrenreich) — may have made the last post appear to a critique of Denice Walter. It is not. It is a critique of the cultural norms that lead millions of women to attempt to shield their bodies from 'the Male Gaze' via means likely to produce exactly the opposite result. As satire, the implicit 'Frankfurt School Feminism' is overstated for effect. A more precise discussion of the conventions of women's clothing would integrate the Birmingham School principle that culture is 'a site of struggle' and take due note of how women have forced the apparel industry into providing options to mitigate sexualization as Denice describes: having less, flattening out, and so on.

There's quite a lot of feminist scholarship on the subjects of clothing and fashion, featuring lively debates among varying critical perspectives rather than any unifed 'company line.' (Hetero male skeptics might be interested in the fact 'postmodern' feminists are all about flaunting what you've got, hold Madonna as an icon, see twerking as empowerment, and may go as far as extolling F on F porn — or F on Machine porn even — for it's feminist virtues. Which might make for some joke material, if not enlightenment.) However, I'd guess this material appears in works shelved in aisles of the bookstore skeptics rarely enter, and in journals most skeptics wouldn't be caught dead reading. It's not my territory, but I'd feel remiss if i didn't offer at least one cite, so I'll go with: 'Unbearable Weight: Feminism, Western Culture, and the Body'
by Susan Bordo, (http://tinyurl.com/nekql3v)

"in engaging, jargonless (!) prose, Bordo analyzes a whole range of issues connected to the body in a way that makes sense of our current social landscape." — Katha Pollit.

Eric @28 -- If you're ever visiting, come on by and I'll tell you the story of the underwire bra guy. He's basically a EE who apparently went stark raving mad, and i have to say I'm far more familiar with the case than I would care to be.

By palindrom (not verified) on 10 Sep 2014 #permalink

Thus, if you believe Singer and Grismaijer, these “toxins” are concentrated in the breast by the constriction that bras produce and result in breast cancer.

If that was true, the introduction of the bra should have led to a decrease in breast-cancer rates.

For several centuries before that, women wore corsets.

Denise Walter: "Most of my clothes incorporate quite soft fabrics so I suppose that they drape well and/ or have curved side seams."

Ah, yes, The creative draping methods. I know a few of them (but not enough, rats!).

There is also the miracle of stretch fabrics.

I went to a class to create at custom pattern for a knit top. Despite the fact that there is a several inch difference between the front underarm measurement versus the back, both sides of the garment are the same size.

Thank science for spandex!

Now, if enough pressure is put on your lymphatic system to produce pain and swelling, as in the example of your feet, you’d notice and fix it. Meaning, you’d take off your shoes, put your feet up, and bring the swelling down.

Maybe it's just me, but the last thing I'd worry about in the case of edema of the lower extremities is "pressure on the lymphatic system."

Hmmm....tighty whiteys vs boxers and testicular cancer. The next frontier for pseudoscience?

By Chris Hickie (not verified) on 11 Sep 2014 #permalink

@Chris Hickie

There's already a published study showing no association. Or, looking at it slightly differently, Big Underwear has already started the cover-up!

By The Grouchybeast (not verified) on 11 Sep 2014 #permalink

GrouchyBeast: *Groan.* I hope you're proud of yourself, that hurt to read.

By Politicalguineapig (not verified) on 11 Sep 2014 #permalink

Your rant has some flaws. First, the 1991 Harvard study you quoted actually found higher b.c. rates in pre-menopausal women. "Premenopausal women who do not wear bras had half the risk of breast cancer compared with bra users". Eur J Cancer. 1991;27(2):131-5. That means a 100% higher rate for bra wearers. You can't attribute that to breast size, which some studies show has no effect on incidence.

Second, the melanoma study you cite actually found increased skin cancer rates in women who had had lymph node disruption, actually supporting the lymphstasis model for cancer development. And breasts are accessory skin glands. Their breast cancer numbers were too small to be significant. And their study was only a letter, and was not peer reviewed. Another hatchet job like the Hutchinson study you like so much, despite its lack of a bra-free control.

You also did not mention a 2011 Venezuelan study and a 2008 China study, both of which showed a significant bra-cancer link.

What strikes me as most odious in your position is your unscientific bias against the bra-cancer link. Your mind was made up before any study is done. Scientists need to be open minded. And given that the cancer industry leaders have made up their minds about this issue, I don't think any amount of research will make them change their minds. They need to save face. How can these closed minded people admit that 20 years of naysaying and denial of a bra-cancer link has needlessly killed hundreds of thousands of women? They can't. That's why discoveries like this, and like the tobacco-cancer link, take decades to become accepted. the old guard must retire first.

I realize that you think you know it all. But you cannot explain the cause of over 70% of breast cancer cases. Doctors like yourself have always existed to discredit new ideas and promote the status quo. Simmelweis had to deal with doctors like you, when his antiseptic discovery was vehemently opposed by physicians. People like you are actually a large part of the problem. Of course, since you make a living on breast disease, I suppose the status quo is no problem for you.

By Sydney Ross Singer (not verified) on 11 Sep 2014 #permalink

There is also the miracle of stretch fabrics.

Not to mention sergers. If I had a daughter, she would be named Bernina.

Palindrom@34 -- you tease, you.

*sigh* -- italics fail.

@Singer--so what the heck is your suggested alternative? Most physical activity becomes off limits to all but the tiniest-breasted of us because it's fooking misery without a bra. Even something as low impact as walking isn't exactly pleasant without one. Swimsuits for any actual, you know, fitness swimming, are also compressive.

What's your alternative??

By brewandferment (not verified) on 11 Sep 2014 #permalink

brewandferment@44 -- I have some old National Geographic magazines with photos that answer that question. And all I can say is, no thanks. I'll stick with the bra.

@sidney

[citation needed]

@41
Don't be dishonest; include the full quote from the paper you cite:

"Premenopausal women who do not wear bras had half the risk of breast cancer compared with bra users (P about 0.09), possibly because they are thinner and likely to have smaller breasts." PMID: 1827274

Note that the p-value is not significant, and that they go on to find an association between cup size and breast cancer risk in postmenopausal women.

By Alexis G. (not verified) on 11 Sep 2014 #permalink

Sydney @41: Why do you feel it is necessary to malign the cancer researchers of the Hutch? What on earth makes you think that they go to work every day (working long hard hours for crummy pay) to do bad science about cancer? Don't you think that they would jump at any chance to prevent cancer? Or have you decided that *every* researcher at the entire center is either deluded or in the pay of "big underwear" or "big cancer"?

Why do you assume that because a well-constructed trial gave results that don't agree with you, that the people running the trial, and the entire cancer center, must be lying?

Have you met this researcher? Have you met the patients enrolled in the study? Have you ever been to the Hutch? Maybe, before you condem an entire center and source of important cancer treatments, you should meet some of the people who work there.

I cannot begin to say how insulted I am on their behalf.

By JustaTech (not verified) on 11 Sep 2014 #permalink

sadmar @ #9 wins one Internet for his/her creative description of bra cup sizes ;)

@Shay--yeah, I've seen them too (and in real life too, in my Navy adventures) and I say the same thing. Just wanted to see if Singer was a hit-and-run type.

By brewandferment (not verified) on 11 Sep 2014 #permalink

Krebiozen wrote:

I believe there is some truth to that since spermatogenesis is most efficient at slighter below normal body tenperature.

Yeah, it sounds plausible. I wonder tho if there's any data on it to show if there's any practical effect.

By Andreas Johansson (not verified) on 11 Sep 2014 #permalink

In cultures where men don't wear bras, male breast cancer is rare. A randomized study would be fun, but would it be ethical?

By Daniel Corcos (not verified) on 14 Sep 2014 #permalink

@ Herr Doktor #7

Yes, I agree that the statement that Australian Aboriginal women don't have breast cancer is ignorant, patronising and racist.
However:
The Australian Health System of today does acknowledge and manage Aboriginal Health - aboriginals are not forgotten. There have been big strides in addressing cultural aspects of health as well as a lot of monitoring. We know what the main health risks are: Cardiac, renal, diabetes are all high on the list. We also know that the aboriginal peoples have a shorter lifespan (multifactoral) compared to Australians of European/Asian descent. This is probably one reason the rate of cancer may be perceived as low - the old age is 50-60 rather than 78-90.
So they are not 'forgotten' by health. We don't have it absolutely right, but Aboriginal Health Care is a huge component of the health response, with engagement of the communities and elders a priority.
I also am very sad that Australians are still perceived as racist. Please rest assured that there are a lot of us who aren't.

I also am very sad that Australians are still perceived as racist. Please rest assured that there are a lot of us who aren’t.
Hey now. If New Zealanders can't criticise Australians then what else do we have left to sustain national pride?

By herr doktor bimler (not verified) on 14 Sep 2014 #permalink

Aaaww Herr Doktor, isn't the Bledisloe Cup enough? :)

tobacco-cancer link, take decades to become accepted.

Actually, US official health instances were agreeing on the existence of a link between tobacco and cancer in the 50's. But the Tobacco industry had good PRs.
(and scientists, back that time and still today, are very bad at communicating their findings)

Simmelweis [sic] had to deal with doctors like you,

See note above about scientists and communication.
If I am to believe the French article about him on Wikipedia,
Ignace Philippe Semmelweis had an easier job promulgating his theories once he replicated his results in a second hospital and a fellow physician published Semmelweis' notes in scientific literature.

By Helianthus (not verified) on 14 Sep 2014 #permalink

I have a thought on another refutation to these claims-- not that it's necessary, given that bra-wearing is about as likely to be connected to cancer as malicious invisible unicorns are, as you've shown. However, there is a population of (usually) XX chromosomal people with breasts who never wear bras: transgender men (FTMs), a surprising number of whom do not engage confounding factors like hormonal or surgical transition, especially in the age group most prone to breast cancer. Many wear "binders", usually form fitting undershirt-like garments which have almost none of the qualities (straps, underwire, etc) listed as "toxic" -- except that the chest and underarms are much, much more constricted than with bras. In fact, safe binder use took decades to emerge as many trans men would overconstrict, causing rib or back damage. If restricted movement causes an increase in breast cancer, these men, now common enough to form a statistically valid population, should show a much higher rate, but no such correlation exists as far as I can tell.

Similarly, cisgender men with gynecomastia, who presumably do not wear bras, would have higher than normal rates if any of this were true, but I don't know if that population is prevalent enough to be of statistical interest, and there are probably inseparable confounders due to the causes of the condition in those cases.

"But the one that always leaves me shaking my head is the claim that mammograms cause breast cancer, because everyone who has been diagnosed with breast cancer had a mammogram."

Now you can tell them about your new friend Amanda. 3cm HER2+ tumour, and didn't need a mammogram to get it. Should be evidence enough, in CAM-land.

Also, I heard the bra theory was relevant to underwire bras. Everyone who asked me (and they did ask me) after my diagnosis seemed to be specific about this point. Due to my job, I wore only sports bras for the majority of my 20's. Found the tumour at 29. So there, bra theory.

Amanda, quoted Sasha Looman:

But the one that always leaves me shaking my head is the claim that mammograms cause breast cancer, because everyone who has been diagnosed with breast cancer had a mammogram.

That's a subject that has intrigued me for years. Mammograms do presumably increase the risk of breast cancer by a small but finite amount (unless the radiation hormesis brigade are right), but they can't be to blame for a significant number of breast cancers. This study from 1975* found no increase in the incidence of breast cancer after an average total radiation dose to the breast of 17 rads, and a follow-up period of 20 years. Since the maximum dose per breast during a modern screening mammography is 0.2 rads, I doubt that even 100 mammograms would measurably increase the risk of breast cancer,

John Gofman claimed that mammograms were (x-ray doses used to be a lot higher) a major cause of breast cancer, but he based this on a number of assumptions that are questionable at best. A lot of his work, and other articles and books that take a somewhat alarmist view about the effects of ionizing radiation, can be found here, for those interested.

The latest episode of The Knick shows the staff taking x-rays of themselves for fun (I liked the line, to a doctor standing while holding a photographic plate up to his head, "now keep still, this will take about an hour"). The very large doses used back then probably would have had a measurable effect on cancer rates, had people not died of typhoid, syphilis, childbirth or whatever before it could develop.

* We have to use historical data as such large x-ray doses are no longer used. Even a CT scan of the abdomen and pelvis, repeated with and without contrast material, only uses a dose of about 2 rads

By Krebiozen (not verified) on 25 Sep 2014 #permalink