To:
Lu Chen, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, Mail Stop M4-C308, Seattle, WA 98109-1024. Phone: 206-667-5028; Fax: 206-667-5948; E-mail: luchen78@uw.edu
Thomas J. Lynch Jr., MD, President and Director, Fred Hutch, Phone: 206.667.6767, Email: tom@fredhutch.org
American Association for Cancer Research 615 Chestnut Street | 17th Floor | Philadelphia, PA 19106-4404
( 855) 744-4667 E-mail: aacrjournals@aacr.org
Cancer Epidemiology, Biomarkers & Prevention Editorial Office American Association for Cancer Research | Publications Division 615 Chestnut Street | 17th Floor | Philadelphia, PA 19106-4404
Phone: (215) 440-9300 E-mail: cebp@aacr.org
2/18/2024
Dear Ms Chen, Dr. Lynch Jr.:
We are writing to expose the need for the retraction of a study published in 2014, in the journal Cancer Epidemiology, Biomarkers & Prevention, due to its significant flaws, biases, and harmful impact on women’s health.
The study is called,Bra Wearing Not Associated with Breast Cancer Risk: A Population-Based Case–Control Study. It was conducted at Fred Hutchinson Cancer Research Center by then graduate student, Lu Chen.
This study was part of a concerted effort by cancer industry leaders to suppress information about the bra-cancer link. Misinformation about, and created by, this study spread like a cancer around the world, and still serves as the cancer industry’s excuse for ignoring this vital women’s health issue of tight bras.
Fred Hutchinson extensively publicized this flawed study as part of a public relations effort to discredit the bra-cancer link. The Fred Hutch press release shows an extreme bias.
The chosen title for this paper in itself is misleading. It implies the study looked at all women. Actually, it only looked at postmenopausal women, ages 55-75, so the results have unknown application to premenopausal women. Generalizing the results to all women in the title is obviously misleading and false.
Studies which are done on postmenopausal women should indicate that in the title.
This biased title portends other problems. Here is a brief explanation of just some of the other flaws and biases in this “study”.
The Study
This 2014 study compared the incidence of breast cancer in women ages 55-75, all of whom wore bras all their lives. The cancer groups included women with Invasive Ductal Carcinoma (IDC) and invasive lobular carcinoma (ILC), diagnosed between 2000-2004. These women were compared to lifetime bra-users of comparable age who do not (yet) have cancer.
Despite the widespread use of bras among U.S. women and concerns in the lay media that bra wearing may increase breast cancer risk, there is a scarcity of credible scientific studies addressing this issue. The goal of the study was to evaluate the relationship between various bra-wearing habits and breast cancer risk among postmenopausal women. We conducted a population-based case–control study of breast cancer in the Seattle–Puget Sound metropolitan area that compared 454 invasive ductal carcinoma (IDC) cases and 590 invasive lobular carcinoma (ILC) cases diagnosed between 2000 and 2004 with 469 control women between 55 to 74 years of age. (Emphasis added.)
The Errors
1. “Control Women”
The “control women” are age matched with the groups of women with cancer. But what kind of control group is this, really?
This study looks at bra use and cancer incidence in women over 55. That means a control group must exist, not only for age, but also for bra usage and for cancer incidence. Therefore, there must be bra-free women for comparison to women who wear bras. And there must be women who do not have breast cancer to compared with those who have had breast cancer (10-13 years ago).
However, this study does not have a bra-free control group. These women are all bra users, as the authors state under Materials and Methods.
“There was one participant who reported that she never wore a bra and she was excluded from the analysis. There were seven women who did not currently wear a bra and they were included in our lifetime bra wearing analyses but excluded from the analyses of current bra-wearing habits.”
In the Discussion section it explains,
“Because bra wearing was ubiquitous among our participants, we were unable to compare risks among women who never wore a bra to those who regularly wore a bra, and instead, our primary comparison was based on average number of hours per day women wore a bra.”
In addition, the “control women” have not been checked for having breast cancer. They were asked a health history, but were not examined. Hence, an unknown number of these women may have undiagnosed cancer, especially given their age.
This should already invalidate this study. You cannot determine the impact of bra usage on breast cancer incidence without a baseline of bra-free women. That is the purpose of having a control group.
2. Using Postmenopausal Women
The design of this study deliberately tries to confirm a negative finding, not a positive finding, which only a biased study would do.
To our knowledge, the only epidemiologic evidence on bra wearing and breast cancer risk comes from a case–control study published in 1991, which reported a nonstatistically significant two-fold higher risk among premenopausal women who wore a bra versus those who did not, but no elevation in risk was observed for postmenopausal women. Given that questions in the lay media have been raised about breast cancer risk and bra wearing, we evaluated relationships between various aspects of bra wearing and breast cancer risk among postmenopausal women enrolled in a population-based case–control study. (Emphasis added.)
In other words, the authors wanted to confirm the negative results in older women that showed no link, instead of confirming the positive results in younger women for whom there was a link. Hmmm. Obviously, the goal was to show a case where bras do not cause breast cancer, instead of looking for cases where tight bras do cause breast cancer.
So the goal was to attack a theory, not find a cause and cure of breast cancer. Let’s be clear about that, since donors to Fred Hutch may want to know this.
By the way, another thing Lu Chen didn’t mention in the paper is that lifestyle research on old people creates a survivor bias. Time selects out the more susceptible people, leaving survivors. Studying the survivors will underestimate the hazards of a lifestyle. See survivor bias.
3. Ignoring Tightness
To determine whether the amount of time a bra is use daily is related to cancer incidence, the women were divided into groups depending on time worn. However, nothing was done to assess tightness!
The issue of bras, which Lu Chen et al should know, is their tightness. The compression and constriction of the lymphatics is the problem, and the impact gets worse with the amount of time this is done. But you need to know the tightness to understand the significance of time. Wearing bras of different tightness for the same amount of time will have different impacts. Again, this needs to be compared to bra-free women who have never been constricted or compressed by bra usage, as a proper control group.
4. Recall Problems
Another problem is that the study relied on subject recall. Unfortunately, the recall of senior citizens, (of unknown and untested memory abilities), about lifetime bra usage over a period of 50-60 years, is unreliable. Bra styles have changed over that time, too. And sizing is different between bra companies and styles, so wearing the same size in different bra styles and brands does not indicate the same tightness. This is true for all bras, with and without underwire.
So this study doesn’t really test the bra-cancer theory. It ignores bra-free women, and ignores bra tightness. And the results are skewed by older age, which also puts the quality of the data in question.
Why conduct and publish such poor research?
5. Conflict of Interest
The authors claimed no conflicts of interest in their study. However, there are two conflicts that should have been admitted.
First, the researchers were themselves bra users. This should have been disclosed. That’s like having smokers study the harms of smoking. The women doing this study had a personal investment in seeing negative results. They clearly think bras are safe or they would not wear them. This creates a bias and personal conflict of interest.
Second, Fred Hutchinson Cancer Research Center gets donations from a 5K Bra Dash, which is a fundraising event conducted by the organization Wings of Karen.“100% of the proceeds benefit breast cancer research locally through the partnership of UW Medicine, Fred Hutchinson Cancer Research Center and Seattle Cancer Care Alliance.”
How ironic to use bras to raise funds for research into the harms caused by bras.
Fortunately, the cancer cartel does not control all research around the world, just most of it. Since this sham study was published 10 years ago, there have been dozens of studies done internationally which show a significant bra-cancer link, including biomechanics research on bras and the lymphatics.
We believe the fatal flaws of this study, its blatant biases, the conflict of interest of the authors and of Fred Hutchison, and the negative impact this study is having on research into this important issue, demands immediate retraction of this study.
History will judge the medical resistance to this issue as a case of medical corruption.
Do you want to be on the correct side of history, or part of the problem?
Lu Chen, it is not too late to retract your paper. Do a better study where you don’t know the results before you begin. And choose a title that is honest and not misleading.
Dr. Lynch, it’s no shame for Fred Hutch to retract papers. Even Harvard does it.
Editor and publisher, please show integrity. You are spreading misinformation.
We are sharing this letter with the world, which is watching.
Sincerely,
Sydney Ross Singer and Soma Grismaijer
Medical Anthropologists