Fatal Fashion?

About a year ago, medical researchers Sydney Ross Singer and Soma Grismaijer called a press conference to present something more than just a helpful fashion tip. Grismaijer--whose experience with and recovery from breast cancer induced her and Singer (her husband) to pursue a hitherto unexplored line of research on the deadly epidemic--had reason to believe that the constriction bras place upon the breast may inhibit the normal function of the lymphatic system in and around the breast. That is, simply by constricting the breast over long periods of time, women could be unwittingly restricting their body's ability to flush out whatever carcinogens they may be exposed to. As a result, the authors suggest, bras could be one reason why breast cancer is an epidemic in many "developed" nations (that also tend to have Western styles of dress). Although they notified cancer research and women's groups ranging from the American Cancer Society to the National Organization for Women, Singer and Grismaijer's audience that April afternoon turned out to be an empty room. The following day, the Wonderbra hit the sales racks, proving to be one of the most eagerly-awaited wire and lace scaffolds since the bra was first introduced in 1912. "That was painful for us--just watching and knowing we had some important information and that nobody wanted to listen to us. Nobody," recounted Singer, who last month released his study with Grismaijer in the book Dressed To Kill: The Link Between Breast Cancer and Bras (Avery Publishing Group). The 192-page book presents Singer and Grismaijer's study of nearly 5,000 women, half of whom had been diagnosed with breast cancer. It finds, in Singer's words, "Women are wearing their bras too tightly for too long and women with breast cancer tend to do that more than other women." "The theory behind it," he continued, "is that it's cutting off their lymphatics, which drain all of our body. And the lymphatics of the breast, because the breast is a skin organ, are easily cut off by a slight constriction. If that happens, there's a chronic long-term edema [swollen tissue] building up in the breast." As Singer and Grismaijer continue in their book, "Meanwhile, as the breasts are being constricted, the woman is exposed to toxins as part of everyday life in America. These toxins are delivered to all parts of her body, including the constricted area, by the bloodstream... Other tissues of the body remove the toxins through normal lymphatic drainage, but the breasts, due to reduced drainage, experience longer-term toxin exposure." When Grismaijer was able to stave off her own cancer by allowing her own lymph system to do its job unconstricted, the couple was quite surprised. (She was two months pregnant at the time of her diagnosis and refused to endanger her child with radiation, chemotherapy or surgery.) Grismaijer had overcome one of the most common cancers for first-world women, and yet the couple could find no previous research pursuing what seemed an obvious line of inquiry. The two then set out to put their theory to a test. That is, if women consistently wore their bras tight, did it have any consequence on their breast cancer incidence rates? And what about women who wore their bras 18 or 24 hours a day? Their Bra and Breast Cancer Study, the essence of the argument in Dressed to Kill, provided several correlations that suggested the researchers were on to something (see sidebar). "When we compared these women with breast cancer to the general population," Singer said, "we found that their bra-wearing behavior was substantially different and unique, characterizing what we termed a fashion focus--which is over 12 hours a day and 18 percent wearing it 24 hours a day--much different than the standard group. And there's nothing that we can see that would explain this, no other variable that we can imagine that would make any more sense than the bra. So if someone else can offer us another explanation of our data, we'd be happy to accept it. The data is something we've got to deal with. You get data, you have to come up with an explanation or an understanding of it. And this all fits, so that's my answer. But we're certainly open to new ideas." Their analysis shows women who wear a bra or breast-supporting garment all the time greatly increase their risk for breast cancer. On the other hand, they find, those women who wear their bra less than 12 hours a day decrease their risk of breast cancer 19-fold (1900%) compared to the one-in-eight risk factor the average American woman presently faces. Overall, Singer and Grismaijer's numerical results should certainly not be taken as incontrovertible figures. Rather, they are approximate values presented to notify women of what they hope further research will be refining over the next five to 10 years. "What we wanted to do is find a direction for future research, so that while people are getting grants and conducting other studies, women can be aware of some of the dangers right now. It warrants women to loosen up until we can say more for certain." Of course, some women may be satisfied enough with the Bra and Breast Cancer study results to make a few changes. As Grismaijer offers, "Every woman will deal with it in her own way. Some women may not want to wear their bras for more than 12 hours per day. Some women who have a lump, like I had, may say 'To hell with the bra, my life is more important.' It's actually a strange garment once you've not worn it for a while. We have this view that the breasts must point up and outwards or somehow people look at you askance. I think it's ridiculous in a way." Perhaps the most important consequence of Singer and Grismaijer's research is the revelation that preventive measures against breast cancer can be made with a lifestyle change that costs nothing. "Until now there has been no prevention for women, they've just been offered mammograms--which is detection," Singer said. "And that's not prevention, although they've been told it's prevention." Singer and Grismaijer hope to provoke the very groups who did not appear at their 1994 press conference to fund or encourage more studies on the relationships between bras and the lymphatics of the breast--and, by extension, breast cancer. (I reached several of the organizations the authors had originally attempted to notify about their research. A spokesperson for the National Cancer Institute sounded a common theme when she replied, "We look forward to the publication of the Bra and Breast Cancer Study in a peer-reviewed scientific journal, where the study results can be properly evaluated.") Not surprisingly, Singer and Grismaijer would also like to be among the teams following up on the Bra and Breast Cancer study. "We want to go into other cultures too, and do these types of studies. And that's a good way of reinforcing these results and repeating them. Because all good research has to be repeated in different ways. You should get the same answer if you approach it from different angles." Singer, whose training is both in medical research and anthropology, sees a promising future for further breakthroughs in the field of applied medical anthropology. "We're focusing on the cultural creation of health problems. It's a different spin, totally," he said. "If 60 to 70 percent of our deaths are due to lifestyle-caused disease, you'd expect that maybe some emphasis would be on studying lifestyle from an objective point of view, which anthropologists try to achieve. And with that objective point of view on lifestyle, informed by an understanding of medicine, you can come up with correlations, like bras, lymphatics and cancer." Dressed to Kill may indeed prove a pioneering study, akin to the first research pointing out that nearly all lung cancer patients had been heavy cigarette smokers. And like that 1950 Journal of the American Medical Association article, the Bra and Breast Cancer study may be faulted for its lack of test-tube-and-petri-dish data. However, Singer responds to such accusations with a firm resolve: "You can't just look at a breast in a research model and ignore what is around it and how women treat it. So the biggest issue here is that people have to be considered in research on humans. If you're looking to cure human diseases, you have to understand people as cultural entities. "As we say in the book, people are three things, they're culture, environment and biology. Right now everybody's looking at the biology. They've got you under a microscope. It reminds me of that Gary Larson cartoon where they have these scientists looking through a microscope at the foot of a mammoth, saying 'I think it's a mammoth.' And that's what they've been doing, they've been looking so far into the cell they don't even see what they're dealing with, that they're dealing with humans who have certain behaviors that will totally skew their biology... All these other health-care experts that have been studying the issue, other breast-cancer researchers, feminist groups, they've all overlooked their basic cultural biases. One of which is that bras are benign." However, studying cultural issues and disease does have its drawbacks, Singer noted. "No culture likes to look at itself. That's why anthropologists go to Africa. They don't want to look at America. Americans don't want to hear about this in themselves. I hope I don't become in this the bearer of bad tidings. Although I think this is really good news, because we can stop it. But it's bad news because people are really invested in these behaviors. They're really invested in wearing bras, women identify with their breasts so much. Can they stop? Can they stop wearing bras as long as they do even if it meant saving their lives? "I mean, isn't that an interesting statement: can you survive without a bra? The fact that we even have to ask that shows how out of hand this whole thing is as a cultural phenomenon. Can you go without your bra? A lot of women would say no. That's what's going to be the major test here for this culture. Can it really look at itself and address a major fundamental identity for women?" SIDEBAR: Survey Said... Soma Grismaijer and research assistants (all women) interviewed 4,730 Caucasian American women between ages 30 and 79 about their bra-wearing habits. The group was selected so that half of the women (the "standard group") did not have breast cancer or any history of it, while the other half had the disease. For the group with breast cancer, the survey questions pertained to the women's habits before being diagnosed. What they found was curious indeed. For instance, nearly twice the women with cancer as without reported that their bras had always made red marks on their skin or caused irritations (40 percent in the breast cancer group compared with 23 percent in the standard group). They discovered six times as many women in the breast cancer group had regularly worn bras or breast-supporting garments to sleep compared with the standard group (18 percent in the breast cancer group compared with 3 percent). And when they asked the women in the breast cancer group if they wore their bras less than 12 hours per day, only 1 percent responded yes (as compared with 20 percent of the women in the standard group). While such preliminary findings certainly require independent verification and further investigation, Singer's basic claim that "women are wearing their bras too tightly for too long and that women with breast cancer tend to do that more than other women" appears to be consistent with the survey results. --M.K.A.

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