Role of antiperspirant or deodorants in breast cancer developments

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By special request I have been asked to comment on any potential role that antiperspirant or deodorants may have in breast cancer development. Risk factors for any disease become accepted through epidemiological studies of the population through case-control studies, cohort studies and studies involving subsets of the population at risk such as high risk groups. These are then verified in parallel studies by different organizations and must stand the test of time. Accepted risk factors for breast cancer in this context include those listed in Table 1. Most of these reflect some degree of interplay between genetics, familial risks, endocrine factors and environmental factors. Many factors identified in population studies are difficult to attribute to individuals. Other confounding variables are likely to cause difficulties in identifying specific risk factors in the aetiology of cancer. These include the time between exposure to a particular potential environmental risk factor, overlapping influences of life style correlates and differences in threshold of risk between individuals.

There is no direct evidence for any influence that antiperspirants might play in breast cancer pathogenesis. Antiperspirants are widely used and breast cancer is common. Consequently the degree of overlap between users of antiperspirants who develop breast cancer must by definition be large. The constituents of antiperspirants are not known to be carcinogenic but can cause skin conditions such as axillary eczema and granular parakeratosis in predisposed individuals. None of these are risk factors for cancer. The distribution of breast cancer in the upper outer quadrant and central areas of the breast is probably related to the distribution of glandular tissue that forms the at risk component of the breast. Sweat does not contain chemicals nor toxins that are known to predispose to breast cancer. Speculation that blockage of sweat glands by antiperspirants causes malignancy through lymph nodes is unfounded.

Primary breast cancer spreads to lymph nodes rather than vice versa. There is no evidence to support the view that blockage of orifices that open into the skin of the axilla are associated with breast cancer. Glands that open onto axillary skin tend to be sweat glands or modified sweat glands. These are independent of the breast glandular ductal system that is based on the terminal duct lobular unit that centres on the nipple areolar complex. Women who have abnormal ducts or indeed have previously had surgery to the terminal ducts in the area of the nipple have no increased predisposition to cancer. Breast cancer does not start in the lymph nodes. It starts from cellular abnormalities in the terminal duct lobular unit. There is no evidence that toxic changes in the lymph nodes subsequently affect the pathogenesis of breast cancer. 

Acceptance of new hypotheses requires studies to test each theory under rigorous clinical conditions and need to be subject to peer review. There is no such study or publication relating to the role of antiperspirants in the aetiology of breast cancer. There is a very high probability that any observation of any association between antiperspirant use and breast cancer occurs purely by chance. Women should therefore not be alarmed by any suggestion that antiperspirants are a risk factor for breast cancer with current clinical evidence. Instead, the principles of breast awareness breast self examination and screening are important for the early detection of cancer in general and is strongly recommended.

Table 1          Risk factors for developing breast cancer

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