A RESEARCH PROPOSAL

AS A PARTIAL
REQUIREMENT IN
DELIVERY ROOM

SUBMITTED TO:

ROSEMARIE TADENA, RN, MSN

SUBMITTED BY:

BIRUNG, SHERWIN P.

RAMITERRE, HOWARD JOHN M.

PASCUA, CHRISTEEN ANGELA P.

SIBAL, KENNETH B.

SONGDAY, DIANA MAE A.

TABUR, JESSA MAE J.

 THE EFFECT OF WEARING BRASSIERS TO THE
DEVELOPMENT OF BREAST CANCER
INTRODUCTION

Breast cancer refers to cancers originating from breast tissue, most commonly
from the inner lining of milk ducts or the lobules that supply the ducts with milk.
Cancers originating from ducts are known as ductal carcinomas; those originating from
lobules are known as lobular carcinomas. There are many different types of breast
cancer, with different stages (spread), aggressiveness, and genetic makeup; survival
varies greatly depending on those factors. Computerized models are available to predict
survival. With best treatment and dependent on staging, 10-year disease-free survival
varies from 98% to 10%. Treatment includes surgery, drugs (hormonal therapy and
1
chemotherapy), and radiation.

Worldwide, breast cancer comprises 10.4% of all cancer incidences among

women, making it the second most common type of non-skin cancer (after lung cancer)
and the fifth most common cause of cancer death. In 2004, breast cancer caused
519,000 deaths worldwide (7% of cancer deaths; almost 1% of all deaths). Breast cancer
is about 100 times more common in women than in men, but survival rates are equal in
both sexes.

Some breast cancers require the hormones estrogen and progesterone to grow,
and have receptors for those hormones. After surgery those cancers are treated with
drugs that interfere with those hormones, usually tamoxifen, and with drugs that shut
off the production of estrogen in the ovaries or elsewhere; this may damage the ovaries
and end fertility. After surgery, low-risk, hormone-sensitive breast cancers may be
treated with hormone therapy and radiation alone. Breast cancers without hormone
receptors, or which have spread to the lymph nodes in the armpits, or which express
certain genetic characteristics, are higher-risk, and are treated more aggressively. One
standard regimen, popular in the U.S., is cyclophosphamide plus doxorubicin
(Adriamycin), known as CA; these drugs damage DNA in the cancer, but also in fast-
growing normal cells where they cause serious side effects. Sometimes a taxane drug,
such as docetaxel, is added, and the regime is then known as CAT; taxane attacks the
microtubules in cancer cells. An equivalent treatment, popular in Europe, is
cyclophosphamide, methotrexate, and fluorouracil (CMF). Monoclonal antibodies, such
as trastuzumab (Herceptin), are used for cancer cells that have the HER2 mutation.
Radiation is usually added to the surgical bed to control cancer cells that were missed by
the surgery, which usually extends survival, although radiation exposure to the heart
may cause damage and heart failure in the following years.

1
Reference: www. Wikipedia.com
 Breast cancers can be classified by different schemata 2. They include stage (TNM),
pathology, grade, receptor status, and the presence or absence of genes as determined
by DNA testing:

 Stage. The TNM classification for breast cancer is based on the size of the tumor
(T), whether or not the tumor has spread to the lymph nodes (N) in the armpits, and
whether the tumor has metastasized (M) or spread to a more distant part of the body.
Larger size, nodal spread, and metastasis have a larger stage number and a worse
prognosis.
The main stages are:
3
Stage Tis , a pre-malignant disease or marker.
Stages 1-3 are defined as 'early' cancer and potentially curable.
Stage 4 is defined as 'advanced' cancer and incurable.

 Pathology. Most breast cancers are' derived from the epithelium lining the ducts
or lobules. (Cancers from other tissues are considered "rare" cancers.) Carcinoma in situ
is proliferation of cancer cells within the epithelial tissue without invasion of the
surrounding tissue. Invasive carcinoma invades the surrounding tissue. Cells that are
dividing more quickly have a worse prognosis 4. One way to measure tumor cell growth is
with the presence of protein Ki67, which indicates that the cell is in S phase, and also
indicates susceptibility to certain treatments.

 Grade (Bloom-Richardson grade). When cells become differentiated, they take

different shapes and forms to function as part of an organ. Cancerous cells lose that
differentiation. Cells that normally line up in an orderly way to make up the milk ducts
become disorganized. Cell division becomes uncontrolled. Cell nuclei become less
uniform. Pathologists describe cells as well differentiated (low grade), moderately
differentiated (intermediate grade), and poorly differentiated (high grade). Poorly-
differentiated cancers have a worse prognosis.

 Receptor status. Cells have receptors on their surface and in their cytoplasm and
nucleus. Chemical messengers such as hormones bind to receptors, and this causes
changes in the cell. Breast cancer cells may or may not have three important receptors:
estrogen receptor (ER), progesterone receptor (PR), and HER2/neu. Cells with these
receptors are called ER positive (ER+), ER negative (ER-), PR positive (PR+), PR negative
(PR-), HER2 positive (HER2+), and HER2 negative (HER2-). Cells with none of these
receptors are called basal-like or triple negative. ER+ cancer cells depend on estrogen
for their growth, so they can be treated with drugs to reduce estrogen (eg tamoxifen),
and generally have a better prognosis.
Generally, HER2+ had a worse prognosis, however HER2+ cancer cells respond to drugs
such as the monoclonal antibody, trastuzumab, (in combination with conventional
2
Representation
3
Carcinoma in Situ
4
diagnosis
chemotherapy) and this has improved the prognosis significantly.
All of these receptors are identified by immunohistochemistry.
Receptor status is used to divide breast cancer into four molecular classes: (1) Basal-like,
which are ER-, PR- and HER2- (triple negative, TN). Most BRCA1 breast cancers are basal-
like TN. (2) Luminal A, which are ER+ and low grade (3) Luminal B, which are ER+ but
often high grade (4) HER2+, which have amplified ERBB2.
Finally, receptor status has become a critical assessment for all breast cancers, as it
determines the suitability of using targeted treatments eg tamoxifen and or
trastuzumab. These treatments are now some of the most effective adjuvant treatments
of breast cancer. Conversely, triple negative cancer (ie no positive receptors) is now
thought to indicate a poor prognosis.

 DNA microarrays have compared normal cells to breast cancer cells and found
differences in hundreds of genes, but the significance of most of those differences is
unknown. Several screening tests are commercially marketed, but the evidence for their
value is limited. The only test supported by Level II evidence is Oncotype DX, which is
not approved by the U.S. Food and Drug Administration (FDA) but is endorsed by the
American Society of Clinical Oncology. MammaPrint is approved by the FDA but is only
supported by Level III evidence. Two other tests have Level III evidence: Theros and
MapQuant Dx. No tests have been verified by Level I evidence (in a prospective,
randomized controlled trial, patients who used the test had a better outcome than
those who did not). In a review, Sotirou concluded, "The genetic tests add modest
prognostic information for patients with HER2-positive and triple-negative tumors, but
when measures of clinical risk are equivocal (e.g., intermediate expression of ER and
intermediate histologic grade), these assays could guide clinical decisions."

Breast cancer is usually, but not always, primarily classified by its histological
appearance. Rare variants are defined based on physical exam findings. For example,
IBC5, a form of ductal carcinoma or malignant cancer in the ducts, is distinguished from
other carcinomas by the inflamed appearance of the affected breast. In the future, some
pathologic classifications may be changed.

5
inflammatory breast cancer
Signs and symptoms

Early signs of breast cancer.

The first noticeable symptom of breast cancer is typically a lump that feels
different from the rest of the breast tissue. More than 80% of breast cancer cases are
discovered when the woman feels a lump. By the time a breast lump is noticeable, it has
probably been growing for years. The earliest breast cancers are detected by a
mammogram. Lumps found in lymph nodes located in the armpits can also indicate
breast cancer.

Indications of breast cancer other than a lump may include changes in breast size
or shape, skin dimpling, nipple inversion, or spontaneous single-nipple discharge. Pain 6
is an unreliable tool in determining the presence or absence of breast cancer, but may
be indicative of other breast health issues.

When breast cancer cells invade the dermal lymphatics—small lymph vessels in
the skin of the breast—its presentation can resemble skin inflammation and thus is
known as inflammatory breast cancer (IBC). Symptoms of inflammatory breast cancer
include pain, swelling, warmth and redness throughout the breast, as well as peau
d'orange7.

Another reported symptom complex of breast cancer is Paget's disease of the

breast. This syndrome presents as eczematoid skin changes such as redness and mild
flaking of the nipple skin. As Paget's advances, symptoms may include tingling, itching,
6
Clinically termed as mastodynia
7
an orange-peel texture to the skin
increased sensitivity, burning, and pain. There may also be discharge from the nipple.
Approximately half of women diagnosed with Paget's also have a lump in the breast.

Occasionally, breast cancer presents as metastatic disease, that is, cancer that
has spread beyond the original organ. Metastatic breast cancer will cause symptoms
that depend on the location of metastasis 8. Unexplained weight loss can occasionally
herald an occult breast cancer, as can symptoms of fevers or chills. Bone or joint pains
can sometimes be manifestations of metastatic breast cancer, as can jaundice or
neurological symptoms. These symptoms are "non-specific", meaning they can also be
manifestations of many other illnesses.

Most symptoms of breast disorder do not turn out to represent underlying

breast cancer. Benign breast diseases such as mastitis and fibroadenoma of the breast
are more common causes of breast disorder symptoms. The appearance of a new
symptom should be taken seriously by both patients and their doctors, because of the
possibility of an underlying breast cancer at almost any age.

Risk factors

The primary risk factors that have been identified are sex, age, lack of
childbearing or breastfeeding, and higher hormone levels.

In a study published in 1995, well-established risk factors accounted for 47% of

cases while only 5% were attributable to hereditary syndromes. Genetic factors usually
increase the risk slightly or moderately; the exception is women and men who are
carriers of the breast cancer susceptibility gene mutations, BRCA1 and BRCA2, are at a
very high lifetime risk for breast and ovarian cancer, depending on the portion of the
protein where the mutation occurs. Instead of a 12 percent lifetime risk of breast
cancer, women with one of these genes have a risk of approximately 60 percent. In
more recent years, research has indicated the impact of diet and other behaviors on
breast cancer. These additional risk factors include a high-fat diet, alcohol intake,
obesity, and environmental factors such as tobacco use, radiation, endocrine disruptors
and shiftwork. Although the radiation from mammography is a low dose, the cumulative
effect can cause cancer.

In addition to the risk factors specified above, demographic and medical risk factors
include:

Personal history of breast cancer: A woman who had breast cancer in one breast
has an increased risk of getting cancer in her other breast.
 Family history: A woman's risk of breast cancer is higher if her mother, sister, or
daughter had breast cancer. The risk is higher if her family member got breast cancer

8
Common sites of metastasis include bone, liver, lung and brain
 before age 40. Having other relatives with breast cancer (in either her mother's or
father's family) may also increase a woman's risk.
 Certain breast changes: Some women have cells in the breast that look abnormal
under a microscope. Having certain types of abnormal cells (atypical hyperplasia and
LCIS9) increases the risk of breast cancer.
 Race: Breast cancer is diagnosed more often in Caucasian women than Latina,
Asian, or African American women.

Abortion has not been found to be a risk factor for breast cancer. The breast cancer
abortion hypothesis, however, continues to be promoted by some pro-life groups.

Complications list for Breast Cancer:

The list of complications that have been mentioned in various sources for Breast
Cancer includes:

Complications and sequel10 of Breast Cancer from the Diseases Database include:

 Cachexia
 Cerebral metastases
 Lymphangitis carcinomatosa
 Breast lump
 Opsoclonus
 Lung metastases
 Brachial plexus neuropathy
 Back pain
 Liver metastases
 Bone metastases
 Prostate specific antigen levels raised (plasma or serum)
 Bone pain
 CEA raised
 Renal metastases
 Mastalgia
 Pleural effusion
 Lymphadenopathy
 Leukoerythroblastic anemia
 Cutaneous metastasis
 Osteosclerosis
 Nipple discharge

Diagnostic Tests

9
lobular carcinoma in situ
10
Progression of disease
 The list of diagnostic tests mentioned in various sources as used in the diagnosis of
Breast Cancer includes:

 Self breast examination11

 Clinical breast examination
 Screening mammogram
 Diagnostic mammograms - more detailed mammograms than the basic
screening.
 Ultrasonography
 Breast biopsy
o Fine-needle aspiration biopsy
o Needle biopsy
o Surgical biopsy
 Pathology test - the cells from a biopsy are sent to a pathologist or lab for
analysis.
 HER-2 gene test - tests for the human epidermal growth factor receptor-2 (HER-
2) gene that indicates how fast a tumor may grow.
 Tests for spreading (metastasis) of breast cancer to other areas of the body:
o Lymph node tests
o Bone tests
o Liver tests
o Lungs tests

Surgery is usually the first line of attack against breast cancer. This section
explains the different types of breast cancer surgery.

Decisions about surgery depend on many factors. You and your doctor will
determine the kind of surgery that’s most appropriate for you based on the stage of the
cancer, the "personality" of the cancer, and what is acceptable to you in terms of your
long-term peace of mind.

 If you need to choose between surgeries, Mastectomy vs. Lumpectomy explains

the pros and cons of each.
 Lumpectomy12, is the removal of only the tumor and a small amount of
surrounding tissue.
 Mastectomy is the removal of all of the breast tissue. Mastectomy is more
refined and less intrusive than it used to be because in most cases, the muscles under
the breast are no longer removed.
 Lymph node removal13, can take place during lumpectomy and mastectomy if
the biopsy shows that breast cancer has spread outside the milk duct. Some people
qualify for the less-invasive sentinel lymph node dissection.
11
Clockwise palpation of the breast 1 week after menstruation
12
also known as breast-conserving surgery
13
Aka axillary lymph node dissection
 
Breast reconstruction is the rebuilding of the breast after mastectomy and
sometimes lumpectomy. Reconstruction can take place at the same time as cancer-
removing surgery, or months to years later. Some women decide not to have
reconstruction and opt for prosthesis instead.
 Prophylactic mastectomy is preventive removal of the breast to lower the risk of
breast cancer in high-risk people.
 Prophylactic ovary removal is a preventive surgery that lowers the amount of
estrogen in the body, making it harder for estrogen to stimulate the development of
breast cancer.

Chemotherapy treatment uses medicine to weaken and destroy cancer cells in the
body, including cells at the original cancer site and any cancer cells that may have
spread to another part of the body. Chemotherapy14, is a systemic therapy, which means
it affects the whole body by going through the bloodstream.

There are quite a few chemotherapy medicines. In many cases, a combination

of two or more medicines will be used as chemotherapy treatment for breast cancer.

Chemotherapy is used to treat:


early-stage invasive breast cancer to get rid of any cancer cells that may be left
behind after surgery and to reduce the risk of the cancer coming back
 advanced-stage breast cancer to destroy or damage the cancer cells as much as
possible

In some cases, chemotherapy is given before surgery to shrink the cancer.

Radiation therapy15— is a highly targeted, highly effective way to destroy cancer

cells in the breast that may stick around after surgery. Radiation can reduce the risk of
breast cancer recurrence by about 70%. Despite what many people fear, radiation
therapy is relatively easy to tolerate and its side effects are limited to the treated area.

Your radiation treatments will be overseen by a radiation oncologist, a cancer doctor

who specializes in radiation therapy.

Radiation therapy uses a special kind of high-energy beam to damage cancer cells.
(Other types of energy beams include light and x-rays.) These high-energy beams, which
are invisible to the human eye, damage a cell’s DNA, the material that cells use to
divide.

Over time, the radiation damages cells that are in the path of its beam — normal
cells as well as cancer cells. But radiation affects cancer cells more than normal cells.
14
often shortened to just "chemo"
15
also called radiotherapy
 Cancer cells are very busy growing and multiplying — 2 activities that can be slowed or
stopped by radiation damage. And because cancer cells are less organized than healthy
cells, it's harder for them to repair the damage done by radiation. So cancer cells are
more easily destroyed by radiation, while healthy, normal cells are better able to repair
themselves and survive the treatment.

There are two different ways to deliver radiation to the tissues to be treated:

 a machine called a linear accelerator that delivers radiation from outside the
body
 pellet, or seeds, of material that give off radiation beams from inside the body

Tissues to be treated might include the breast area, lymph nodes, or another part of
the body.

In some cases, your doctor may recommend hyperthermia be used in combination

with radiation therapy. Hyperthermia16 uses an energy source such as ultrasound or
microwave to heat cancer cells to high temperatures, up to 113 degrees Fahrenheit.
Early research has shown that hyperthermia may make some cancer cells more sensitive
to radiation. Hyperthermia is still being studied in clinical trials and isn't available
everywhere. Hyperthermia and radiation are usually given within an hour of each other.

Some people may fear radiation therapy. They may worry that therapeutic radiation
may be dangerous like an atomic bomb or nuclear power plant. Stories about radiation
side effects, some of them exaggerated can circulate around hospital waiting rooms. It's
important for you to know that there is NO connection between therapeutic radiation
and the types of radiation in bombs and nuclear reactors. The radiation used in cancer
treatment is highly focused, controllable, and generally safe.

Why radiation is necessary

Radiation is an important and often necessary form of anti-cancer therapy

because it is able to reduce the risk of recurrence after surgery. Although it's quite
possible that your surgeon removed all the cancer, breast cancer surgery cannot
guarantee that every last cancer cell has been removed from your body.

Individual cancer cells are too small to be felt or seen during surgery or detected
by testing. Any cells that remain after surgery can grow and eventually form a new lump
or show up as an abnormality on a test such as a mammogram.

Research has shown that people who are treated with radiation after
lumpectomy are more likely to live longer, and remain cancer-free longer, than those
who don't get radiation. In one large study, women who didn't get radiation after
16
also called thermal therapy or thermotherapy
 lumpectomy were shown to have a 60% greater risk of the cancer coming back in the
same breast. Other research has shown that even women with very small cancers (1
centimeter or smaller) benefit from radiation after lumpectomy.

Hormonal therapy17 works against hormone-receptor-positive breast cancer. It is

completely different from HRT18, which some women take during or following
menopause. HRT is not a breast cancer treatment, and for women with a breast cancer
diagnosis, HRT is considered relatively unsafe.

Hormonal therapy medicines treat hormone-receptor-positive breast cancers in two

ways:

 by lowering the amount of the hormone estrogen in the body

 by blocking the action of estrogen on breast cancer cells 

Most of the estrogen in women's bodies is made by the ovaries. Estrogen makes
hormone-receptor-positive breast cancers grow. So reducing the amount of estrogen or
blocking its action can reduce the risk of early-stage hormone-receptor-positive breast
cancers coming back (recurring) after surgery. Hormonal therapy medicines can also be
used to help shrink or slow the growth of advanced-stage or metastatic hormone-
receptor-positive breast cancers.

Hormonal therapy medicines are NOT effective against hormone-receptor-negative

breast cancers.

There are several types of hormonal therapy medicines, including aromatase

inhibitors, selective estrogen receptor modulators, and estrogen receptor down
regulators.

In some cases, the ovaries and fallopian tubes may be surgically removed 19 to treat
hormone-receptor-positive breast cancer or as a preventive measure for women at very
high risk of breast cancer. The ovaries also may be shut down temporarily using
medication.

It's important to know that hormonal therapy IS NOT hormone replacement therapy
(HRT). HRT isn't used to treat breast cancer. HRT is taken by some women to treat
troublesome menopausal side effects such as hot flashes and mood swings. HRT is used
to raise estrogen levels that drop after menopause. HRT contains estrogen and can
contain progesterone and other hormones. Hormonal therapy is exactly the opposite --
it blocks or lowers estrogen levels in the body.

17
anti-estrogen therapy
18
hormone replacement therapy
19
Termed as oophorectomy and salphingectomy
 To prevent new cancers from starting, scientists look at risk factors and protective
factors. Anything that increases your chance of developing cancer is called a cancer risk
factor; anything that decreases your chance of developing cancer is called a cancer
protective factor.

Some risk factors for cancer can be avoided, but many cannot. For example, both
smoking and inheriting certain genes are risk factors for some types of cancer, but only
smoking can be avoided. Regular exercise and a healthy diet may be protective factors
for some types of cancer. Avoiding risk factors and increasing protective factors may
lower your risk but it does not mean that you will not get cancer.

Different ways to prevent cancer are being studied, including:

Changing lifestyle or eating habits.

Avoiding things known to cause cancer.
Taking medicines to treat a precancerous condition or to keep cancer from
starting.

RELATED LITERATURE

Do bras cause breast cancer?

Singer and Grismaijer are medical anthropologists and directors of the Institute for the Study of
Culturogenic Disease with backgrounds in biochemistry and medicine, behavioral science,
ecology and environmental health. The duo journeyed to Fiji for a follow-up to their Bra and
Breast Cancer Study20. The experiment21, looked into a possible link between brassieres and
breast cancer. Almost half of the subjects were afflicted with the disease.
The results showed that wearing a bra for more than 12 hours every day may lead to breast
cancer. In particular, women who wore their bras for more than 12 hours but less than 24 hours
are 21 times more likely to contract breast cancer than those who wore their bras for less than 12
hours. For those who slept with their brassieres on, the risk is frightening at 125 times.
Meanwhile, those who went bra-less exhibited about the same incidence level of breast cancer in
men, which is low.

How can bras cause breast cancer?

Singer and Grismaijer say the link between wearing a bra and breast cancer is 4 to 12 times as
strong as the connection between smoking and lung cancer. They explain that the reason lies in
the body’s lymphatic system.
It acts as the drainage mechanism, with its soft, tiny, thin- walled vessels and lymph fluid
flushing out the various substances accumulating in body tissues. These include toxins, bacteria,
viruses, cancer cells, cell debris and other products from the breast.
To function the effectively, the lymph fluid needs to properly circulate. Body movement—from
walking to breathing, among others, help accomplish this. The lymph vessels should not be
constricted either. However, because lymph vessels are located close to the skin’s surface, they
are subjected to pressure from tight clothes and underwear. They also prevent the wearer from
breathing fully. These factors hinder the lymph fluid from circulating and washing cancer-
causing toxins away. As such, these toxins remain in the tissues until they start causing cancers.
The brassiere is one garment that applies constant pressure to the delicate breast tissues. Red
marks and indentation left on the skin after the bra is taken off prove this. Because of this, the
woman’s breathing and lymphatic systems become constricted and thus, unable to function
efficiently.
In the 1995 book Dress to Kill: The link between breast cancer and bras, Singer and Grismaijer
discussed the results of their two-year study. According to them, some woman who learned of
the experiment began exporting the bra-less look. With weeks, they noted the disappearance of
breast pain, tenderness and cysts which previously needed regular aspiration.

Bras and fibrocystic breast disease

In 2000, two British breast surgeons conducted their own clinical trails in England and Wales,
involving 100 women with fibrocystic breast disease. Their conclusions: majority of pre-
menopausal women experienced less pain during three-month bra-free period. A documentary on
these clinical trails was produced and shown a nationwide television in England. The
documentary, titled ”Bras-the bare facts,” featured interviews with some of the subjects who
revealed how going bra-less changed their lives. They shared how they can now pick up their
kids or hug their husband without accompanying pain.

Previous Studies
Although ground breaking and controversial, the bra and breast cancer studies was actually not
the first of its kind. Take note of the following:

20
conducted in the United States between 1991 and 1993
21
involving 4,700 American women in five major cities in the US,
1930 -A paper was established revealing a connection between corsets and increase breast
cancer rates.

1978 -In a medical journal published an article linking breast temperature with bras and
possibly, breast cancer.

1991 -In a medical journal article on breast cancer, Harvard University researchers offered the
observation that woman in their study who did not wear bras had a 60% lower rates of breast
cancer than those who wore bras.

Breast cancer: The numbers speak

 Worldwide, breast cancer is the leading cause of death for women ages 35 to 54.
 More than a million women develop breast cancer without knowing it. Almost 500,000
die from it every year.
 One out of four individuals diagnosed with the disease die within the first five years.
More than 40% die within 10 years
 Mammography fails to detect as much as 20% of all breast cancer cases and as much as
40% in women under 50.
 One out of eight American women will have breast cancer. The San Francisco bay area in
the United States has the highest incidence worldwide.
 The Philippines has the highest incidence in Asia and the 9th highest in the world.

Going Braless?
Luzmindo B. Fajardo, executive director of the Philippine cancer society, confirms that breast
cancer is the number one cause of death among Filipino women. The Philippine cancer registry
meanwhile, reveals that breast cancer cases among Filipinas number to 10,000 with an annual
mortality rate of 40%.
He estimated that up to 75% of breast cancer cases could be prevented if woman wear their bras
less often.

No just the bra…

Risk factors of breast cancer (adapted from Mayo Clinic.com)

 Age. Older women have a greater risk of developing breast cancer.

 Personal history of breast cancer. Women who have had breast cancer in one breast
have a greater chance of getting cancer in the other breast.
 Family history. If you have a close relative with breast or ovarian cancer, you have a
higher risk of developing a breast cancer.
 Exposure to radiation. People who received radiation treatments to the chest as a child,
teen, or young adult are more likely to get breast cancer later in life.
 Excess weight. Being overweight or obese increases the risk of breast cancer.
 Early onset of menstruation. Women who got their first period before age 12 are more
likely to develop breast cancer later.
 Late menopause. Women who undergo menopause after age 55 are more likely to
develop breast cancer.
 First pregnancy at older age. Women who have never become pregnant or had their
first pregnancy after age 30 have a greater likelihood of developing breast cancer.
 Race. White women are more likely to develop breast cancer than black, Hispanic or
Asian women are.
 Hormone therapy. Treating menopausal symptoms with estrogen and progesterone for
four years or more increases the risk of breast cancer.
 Birth control pills. Use of birth control pills is associated with an increased risk of breast
cancer in premenopausal women. However, the overall risk of breast cancer users of birth
control pills is small and appears to be short term. Risk levels return to normal with five
to 10 years after discontinuing use.
 Smoking. Some studies show no link between cigarette smoking exposure to secondhand
smoke and breast cancer, but other suggest that smoking increases breast
 Excessive use of alcoholic. Women who take more than one alcoholic drink a day have a
greater risk of breast cancer than women who don’t drink.
 Precancerous breast changes (atypical hyperplasia, lobular carcinoma in situ). If
these changes are present, your risk of breast cancer is higher than it is for women who
don’t have any of these so-called “markers”. If you have carcinoma in situ, ask your
doctor about treatment and monitoring.
 Mammographic breast density. Women with dense breast tissues (with a high ratio of
connective and glandular tissue to fat) Have an increased risk of breast cancer.

Conflicting claims, questionable methods

Certain quarters have debunked these findings, however. The American Cancer
Society states, “ Internet e-mail rumors and at least one book have suggested that bras
cause breast cancer by obstructing lymph flow. There is no scientific or clinical basis for
that claim. (Singer and Grismaijer’s) study was not conducted according to standard
principles epidemiological research and did not take into consideration other variables,
including known risk factors for breast cancer.
Sydney Ross Singer had this reply: “No study exist because this is a
breakthrough. However, as Dressed To Kill shows, bras have a history of causing health
problems. Corsets have a history of damaging women by constriction, too, and bras are
breast corsets. As for our ignoring other variables, all research ignores some variables.
You cannot do research and include all variables, particularly since you never know all
the variables. The ones we ignored were unnecessary for considering the effect of bras on
the breast.”
Cindy Pearson, executive director of the National Women’s Health Network and
Adriane Fugh-Berman, chairperson of the Network Board of Directors, added that the
two medical anthropologist did not set up entry criteria, matched subjects, merely for
their geographic location, and recruited subjects mainly through other subjects, among
others. Questions about the subjects’ family history and medical history were not tackled.
Plus this subjects already knew about the researchers’ objectives, which may have
affected their answers.
Furthermore, Pearson and Fugh-Berman revealed and Grismaijer discovered a
lump in her breast while working in the Fiji Islands. Seeing the red marks on her skin
from the bra, her husband linked breast cancer to women’s bra-wearing habits. Grismaijer
did not have the lump examined. Instead, she took the living route: she lived in the
mountains, exercised, had a diet consisting of organic vegetarian food and purified water,
took vitamins and hung up her brassiere. When the lump disappeared, she attributed this
to her new bra-less habit, which Pearson and Fugh-Berman believed to be biased. They
also cited that hormonal changes as a result of Grismaijer’s pregnancy may have caused
the lump in her breast. The authors never mentioned this in their reports.
Virginia Soffa, M.Ed., breast cancer activist and author of :The Journey Beyond
Breast Cancer: Form the Personal to the Political,’ also had this to say,” Another reason
that Singer and Grismaijer’s research might be considered controversial is because the
authors chose to publish their work in the popular press rather than in medical journals
Confronted with this statement in an interview, Singer reasoned that this was the
easiest and fastest to get their massage across a wider segment of the public.