User:Music Sorter/Dressed to Kill (Book)

Dressed to Kill is a 1995 book by Sydney Ross Singer and Soma Grismaijer that proposes a link between bras and breast cancer. According to the authors, the restrictive nature of a brassiere inhibits the lymphatic system, leading to an increased risk of breast cancer. Support for the bra-cancer link is mixed. Since the original publication of the book, additional studies around the world have been conducted which support the link, while others state more research is needed. Some major medical and cancer organizations, including the National Institutes of Health and the American Cancer Society dismiss the claim as unsubstantiated.

Synopsis
Singer and Grismaijer argue that bra-wearing may be a major cause of breast cancer because of the purported effect of the bra on lymphatic circulation. Their interpretation is that constriction from tightly worn bras inhibits the proper functioning of the lymphatic system and leads to a buildup of fluid within the breast tissue. In addition, they state carcinogenic substances that we take into our bodies through petrochemically polluted food, air, and water flow throughout the body, including the breast tissue, need to be flushed from the tissues by the lymphatic system. Hence, bra-induced constriction of the breast lymphatic vessels, according to the authors, concentrates these toxins within the breast tissue, which may ultimately lead to cancer.

Singer and Grismaijer site an article from CA: A Cancer Journal for Clinicians that states 70% of breast cancer cases are unexplainable by the then-current [as of 1995] known risk factors for breast cancer. In addition, the authors state that breast cancer is much higher in cultures where women wear bras; in bra-free cultures, breast cancer is a rare event.

Singer and Grismaijer state that they noticed that the indigenous Māori people of New Zealand, who are integrated into white culture and therefore wear bras, have the same rate of breast cancer as the other New Zealand women, while the aboriginals of Australia, who are bra-free, have practically no breast cancer. The same was true for Westernized Japanese, Fijians and other bra-converted cultures.

Singer and Grismaijer examined the bra wearing attitudes and behaviors of 4,730 US women in 5 major cities. They said 43% of the women questioned had had breast cancer and those women were asked about their bra-wearing habits prior to their cancer diagnosis. Among the many results reported from their study, they said that women who wore a bra 24 hours a day were 125 times more likely to develop breast cancer than women who were bra-free. Those women who wore their bra more than 12 hours, but not to bed were associated with a lower instance of cancer, but much higher than the bra-free women. Their study also said that bra-free women have about the same incidence of breast cancer as men.

Covered by the book
The following studies, medical articles, and patents were discussed in the second edition of Dressed to Kill. The majority of them either indicate a positive link between wearing a bra and breast cancer or recommend further investigation.
 * 1929 - Dr. W. Sampson Handley told the British Medical Association that he believed "the origin of cancer is intimately associated with local obstruction of the lymph vessels in the area where the cancer arises."
 * 1931 - Dr. William Mayo published an article that reasoned "cancer of the breast occurs largely among civilized women. In those countries where breasts are allowed to be exposed, that is, are not compressed or irritated by clothing, it is rare.”
 * 1939 - Dr. M.A.R. Young published an article discussing a study of the rarity of breast cancer in Ukrainian women living in Canada. He surmised that both increased lactation and non-constrictive clothing contribute to this state and suggested further study of the Canadian-born Ukranian women.
 * 1942 - Catherine Elberfeld was granted a patent for a new bra design which stated one of the objectives of the design was "to permit easy breathing and to avoid cutting or chafing, which might give rise to cancer or other serious trouble."
 * 1950 - Henry Plehn was granted a patent for an improved bra design which noted "Even in the proper breast size, most brassieres envelop or bind the breast in such a fashion that normal circulation and freedom of movement is constricted. Many cases of breast cancer have been attributed to such breast constriction as caused by improperly fitted brassires [sic]."
 * 1991 - CC Hsieh, D Trichopoulos published results from their study which found, “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.”
 * 1995 - Sydney Singer and Soma Grismaijer published the results of their US study of 4,720 women which proposed a link between bras and breast cancer, recommending further study is warranted.
 * 1996 - Dr. Michael Schachter wrote that poor lymphatic drainage may play a role in breast cancer formation. "The nature of the bra, the tightness, and the length of time worn, will all influence the degree of blockage of lymphatic drainage. Thus, wearing a bra might contribute to the development of breast cancer as a result of cutting off lymphatic drainage, so that toxic chemicals are trapped in the breast."
 * 2000 - Sydney Singer and Soma Grismaijer published a follow-up study of 28 Fijian women with breast cancer noting that all of them wore bras in a country were roughly 50% of all women wore bras.
 * 2009 - A Chinese study of women investigating the risk factors for breast cancer found bras with underwires and sleeping in a bra had a positive relationship to breast cancer development.
 * 2009 - Ted Gansler of the American Cancer Society published a letter to the editor noting that results from a National Cancer Institute study of armpit lymph node removal as part of melanoma treatment: "The surgery, which is known to block lymph drainage from breast tissue, did not detectably increase breast cancer rates, the study found, meaning that it is extremely unlikely that wearing a bra, which affects lymph flow minimally if at all, would do so." In response to the study, Singer noted three concerns. First, bras harm the breasts over decades, not the ten years or less for each patient in this study. Second, the study said that the lack of increase in breast cancer incidences was statistically insignificant to be conclusive. Third, skin cancer rates increased by 700% indicating a link between lymphatic impairment and cancer.
 * 2009 - Dr. Arunachalam Kumar published an article that hypothesizes that heating of the breasts by bras causes breast cancer.
 * 2011 - Marcos Eduardo Quijada Stanovich published his study of 73 women concluded that wearing a bra for more than 12 hours per day increased the chances of breast cancer.
 * 2014 - Lu Chen, et al., at the Fred Hutchinson Cancer Research Center conducted a study funded by the National Cancer Institute to review the bra wearing habits and breast cancer risk of 1,513 postmenopausal women. Their study found "no aspect of bra wearing, including bra cup size, recency, average number of hours a day worn, wearing a bra with an underwire, or age first began regularly wearing a bra, was associated with risks" of breast cancer. The study included a detailed examination of women's lifestyle and bra-wearing habits and found no correlation between bra use and cancer. The study also noted it did not compare women who wear a bra to women who do not wear a bra. Singer noted the exclusion of women under 55 and lacking a control group of bra-free women made this study similar to examining lung cancer among smokers without a non-smoking control group, only looking at lifetime smokers, and concluding smoking has no effect on lung cancer.
 * 2015 - N. A. Othieno-Abinya, et al., at the University of Nairobi, Kenya, studied 694 women to look at known risk factors associated with breast cancer. They found, "Women who wore brassieres all the time, even when in bed were significantly associated with breast cancer occurrence as compared with those who never wore brassieres, or those whom only did so on important occasions (p<0.001).”
 * 2015 - Winnie KW So, et al., at the Chinese University of Hong Kong, studied 12 prior studies on breast cancer and bra use and determined bra wearing during sleep was associated with a 100% increase in breast cancer probability but further research was needed to draw reliable conclusions about bra use during waking hours.
 * 2016 - Salete da Silva, et. al., studied 304 women looking at the number of hours women wore a bra and the percentage of stretch of that bra and found, "a correlation between wearing a tight bra for several hours per day and an increased risk of developing breast cancer.”
 * 2016 - Dr. Parvis Gamagami published a book based on his 50 years of medical expertise observing over 350,000 mammograms. He reported 20%-30% of breast cancer cases developed in a semi-circular line around the breast where the bra underwire presses hard, convincing him that bras can provoke breast cancer.

Published after the book
The following related article was released after the second edition of Dressed to Kill was published.
 * 2018 - Sydney Singer published an article discussing the link between lymph stasis and cancer and how constriction from the bra is likely contributing to the lymph statis and increasing the incidence of breast cancer. He recommended further study.

Additional information
The authors add that they hope that the medical community will follow-up with additional studies to further evaluate their belief in a link between the bra and breast cancer. The authors conclude: "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." To rebut critics of their work, they say the mainstream medical organizations all denied the link between smoking and lung cancer for decades after the initial research was published.

After publishing Dressed to Kill, Singer and Grismaijer wrote Get It Off!, another book about the dangers of wearing bras, and a series of other books in which they sugest that sleeping at an incline can prevent Alzheimer's disease and impotence; that frequent defecation and urination can prevent many conditions such as prostate enlargement and menopausal symptoms; and that high blood pressure is a "major medical scam" because "blood pressure measurements can be whatever the doctor wants them to be."

Scientific reception
In addition to the responses in the studies and articles noted above, the following medical and scientific bodies have responded to the book's claims about bras and breast cancer:


 * The American Cancer Society states, "Internet and e-mail rumors and at least one book have suggested that bras cause breast cancer by obstructing lymph flow. There is no good scientific or clinical basis for this claim, and a 2014 study of more than 1,500 women found no association between wearing a bra and breast cancer risk."
 * The U.S. National Institutes of Health states, "Breast implants, using antiperspirants, and wearing underwire bras do not raise your risk for breast cancer."
 * In November 2000, the UK television show Dispatches asked professor Robert Mansel and Simon Cawthron to conduct a study of 100 women in the UK to examine the link between bra usage and breast pain, and their study showed a positive link. The episode also included an interview with Syndey Ross Singer to discuss his findings in Dressed to Kill. Robert Mansel said he suspects that problems are caused by bras suppressing the lymphatic system. He states that we don't know the cause of breast cancer, but more research is needed into the findings on breast pain to determine if wearing a bra results in any long-term damage. After the television show aired, Mansel stated in a follow-up story that "one of the doctors interviewed for the programme suggested that breast pain may be linked to breast cancer. That theory is not corroborated and is not generally agreed by doctors to be the case. We have no scientific evidence that that is the case." "Cancer Charities" also spoke up to say the evidence did not show an increased risk of breast cancer from wearing a bra.