The British study on bra wearing and breast pain

In year 2000, two breast surgeons started a study including 100 women at two breast clinics (all of whom had breast pain) and found that over half of the premenopausal women with pain found relief when they quit wearing bras for three months. For some the pain relief was very dramatic, changing their lifes. When they resumed bra wearing for the last three months of the study, the pain returned. Besides the pain data, the doctors also showed video thermography footage that dramatically demonstrated the heat build-up from bra wearing, and they discussed the possible connections with cancer causation.

They also made a documentary film that was shown on nationwide television in Britain.  The following is a press release from Channel 4 UK (England), for the documentary on the connection between bras and breast pain.



Thursday, November 2, 10pm

Background Briefing document

Dispatches set out to explore the link between wearing a bra and breast pain - and the implications that has for other breast illnesses. It is estimated that 2 in 5 British women suffer from breast pain. It can be a debilitating illness - and there is no treatment. Some women who suffer from breast pain also have cysts. Other studies have examined the link between breast pain and breast cancer, but this requires further research in Britain.

Dispatches asked 100 women who suffered from breast pain in Wales and Avon to go without a bra for three months. They were then asked to return to wearing a bra for a further three months and measure any differences in breast pain and cysts.

The two medical experts who divided the experiment between their clinics are:

ROBERT MANSEL - Professor of Surgery at the University Hospital of Wales in Cardiff. He has studied breast pain for 25 years. 
SIMON CAWTHORN is a consultant surgeon at the Frenchay Hospital in Bristol. He is a specialist in the area of breast treatment.

On average, for pre-menopausal women, they found that the number of totally pain-free days went up by 7% which is regarded as significant for a problem that is otherwise so hard to treat. They are confident that this research warrants further investigation into the links between bra wearing and breast pain and cysts.

Several other studies have shown a link between breast pain and breast cancer. For example, French researchers at the University of Paris Necker Hospital have found that women with monthly breast pain have double the risk of getting breast cancer. They ascertained that statistically, pain can be as significant a risk factor as a family history of cancer.

It is important to note that this study had a significant effect on pre-menopausal women with breast pain. Post-menopausal women did not benefit as much from not wearing a bra.

Both Mansel and Cawthorne are clear that there is no medical benefit to be obtained from wearing a bra. It does not stop sagging of the breast. Dispatches approached Playtex who confirmed that they are aware that there are no medical benefits.

There are several theories as to why bras may cause breast pain. The fact that bras heat the breast is one theory, while the compression of channels leading from the breast to the lymph nodes through the structure of the bra is another. More research needs to be done into this area.

What follows is a press release and a partial transcript of the British documentary Bras, Bare Facts, which was aired at Channel 4 (UK) on Thursday, November 2, 2000, at 10 pm.


Is it habit, modesty, support or just plain sex appeal that has convinced women that wearing a bra is essential? In the '70s, some women burnt their bras as a sign of liberation, now Dispatches asks if women should go without in the interests of wellbeing. While bra fitters claim that bras stop sagging, medical experts are beginning to examine the down side of wearing a bra.

Bras have become the essential female garment. At the same time, breast problems have been increasing. At least two out of five women suffer from pains in their breasts - some also suffer from cysts.

In the name of fashion, breasts have been pushed into all different shapes and sizes - but for women living with breast pain, it's no joke. "Breast pain affects you on so many different levels - things like picking your children upit hurts so much," says one woman. "It hurts to walk along a street. You just feel miserable all the time," says another. Experts agree breast pain is a serious problem for many women. "It can be very debilitating. I know women who are unable to work because of breast pain. It's very commonit's very hard to treat," says Professor ROBERT MANSEL of the University Hospital of Wales in Cardiff.

The biggest worry of course is breast cancer. Most research looks for an explanation in hormones, genetics and diet, but one man has a simpler solution - he claims that breast cancer could be connected with wearing bras. Medical anthropologist SYDNEY SINGER likens the wearing of bras to the ancient practice of Chinese foot binding. "The purpose [of bras] is to bind the breast. There is nothing good about them - our culture has turned breasts into fashion accessories" he says. While Singer's theories are not supported by scientific evidence, some breast specialists are sceptical about the function a bra performs. Professor Mansel says there is no evidence that bras are good for your health: "There's no positive evidence that wearing a bra is good for the breast."

There has been little research into the causes of breast pain so Dispatches commissioned its own research from a team of medical experts who looked at the possibility of a link between it and wearing a bra. They asked a group of women suffering from breast pain to live without their bras. The women were required to report back on any changes they experienced as a result of going without. For many, the results have changed their lives, and led the doctors involved to call for further research.

Dir: Jill Nicholls
Prod: Martin Weitz
Prod co: MBC/Focus Productions

The next section is a partial transcript of the "Bras Bare Facts" documentary.

Narrator -- In the 60s and 70s, women took off their bras as a gesture of liberation. We got a hundred more women to do the same thing for science. All their lives women have been told that bras are good for their breasts and good for their looks, but is it true? Tonight, some are going to find that the effect of taking off their bra can be surprising.

Lorenza Nicholls-- "When to take your bra off at night it's such a relief."

Narrator -- Breasts weren't designed by nature to be harnessed by a bra. For years women have had their breasts pushed around in the name of fashion and beauty.  From every direction, women are giving the impression that wearing a bra is good for them. Meanwhile, breast problems are on the increase. 2 out of 5 women suffer from pains in their breasts. 7% suffer from lumps in the breasts called cysts. And breast cancer levels in Britain are 2/3rds higher today than they were thirty years ago. Most researchers looked for explanations in hormones, genetics, and diet. But one man has gone out on a limb with a simpler solution. Singer noticed that breast cancer rates were lower in Fiji where many women don't wear bras. His later survey of 5000 US women led him to claim that bras cause cancer.

Sydney Singer -- "Throughout the world, the only cultures where there is breast cancer is where there are bras. Bras are actually a form of breast binding. Just as the Chinese bound feet in the name of fashion, and for hundreds of years distorting feet and causing broken bones and everything. Bras are breast bindings. Their purpose is to change the shape of the breast. There is nothing good about them. In fact, there is nothing good in the medical literature saying that women should wear them, that there are a benefit in any way at all. They're just a fashion accessory, and the problem is that our culture has turned breasts into fashion accessories. The fact that a bra snaps shows how tight it is. This pressure is here too (he demonstates on a woman wearing a bra), all along this part of the breast. And it will go under the armpit. Now if you lift your arm, you will see right here how her body goes in with these straps. If you lift this (side band) up, you will marks left by the bra, right here. And then this underwire here is putting marks right in the skin. Lymph nodes are little factories for white blood cell production; they're essential parts of our immune system. They're fed by lymphatic vessels, which go from the tissue and go to the lymph node, flushing the tissue. Now the lymph nodes, most of the lymph nodes for the breasts are in this part of the body (near and in the armpit). So this is where 85% of the breast drains to. So when you have a bra with the strap cutting it off right here (near the underarm), that's constant chronic constriction."

Several doctors do acknowledge that the bra could be a problem.

Dr. Simon Cawthorne -- "Well, I'm sure women choose their bras for the shape rather than the comfort. And I say that because I invariably see women, when I'm examining their breasts, who have deep marks on their breasts where their bras have been digging into the flesh." He said the following while speaking to the women who volunteered for the study: "We have enormous queues of women when you come to the clinic waiting to be seen, so from our point of view it would make our life a lot easier, but from your point of view, from your perspective, it clearly would be a major advantage."



Dr. Robert Mansel -- "When one looks at where there's positive evidence that bras are good for health, that evidence does not exist, because the groups that don't wear bras, the civilizations of people who don't wear bras, tend to be from the groups having lower breast cancer incidences. There is no positive evidence that bra wearing is good for the breast. Cysts and pain are areas where the facts really are quite sparse. I think the right thing is to do the experiment and see if there's any effect, and that's exactly why I've gone into this enterprise. Breast pain is a major problem. We've been studying it for 25 years now. It's very common - something like 60 or 70 % of women at some time experience it. And it's very hard to treat and so those features alone makes it a very important problem."

Narrator -- What could link the work of these doctors with Singer's is not cancer, but much more common though far less publicized complaints like breast pain and cysts.

Dr. Marlene Schuytvlot, registrar of the Bristol Breast Care Center --
"All the lymphatic flow seems to come from the breast towards the skin and then out into the lymphatic drainage systems. By wearing a bra that is constricting, that could constrict the main flow from the lymph to the draining system, then can therefore accumulate in the breast, which in theory could cause cyst formation."

Rae Marsh, childcare worker, suffers from cysts and severe breast pain. She says, "Having breast pain is really hard to live with, because it affects you on so many different levels. Just things like picking your children up. If your breast pain's bad, picking your children up just makes it hurt so much more that you just can't hug the children the way you'd hug them if you didn't have the breast pain. Walking along a street, it hurts to walk, it's not about having large breasts, it's about having just every step hurt. And it can just be so uncomfortable that you just feel miserable all the time, and it's just an ongoing ache."

Narrator -- So Dispatches (the documentary program from Channel 4-UK) asked Prof. Mansel in Cardiff and Mr. Cawthorne in Bristol to devise a study to test the proposition that there might be a link between breast pain and cysts and the bra. A six-month trial, which is what they proposed, could not explore any immediate link with cancer, since that takes much longer to develop. The doctors are going to ask women who attend their breast clinic to join in, women either with cysts or regular breast pain. And with cysts always comes the fear of cancer.

Lynne Holliday -- "There is always anxiety. You can never quite be sure that it's just a cyst."

Marian Gooden -- "I just seem to grow them, like people grow weeds in their garden. It's almost like a toothache in your breast. They become incredibly painful. You sort of walk around almost holding your breasts, because you are trying to ease the pain in your breasts."

1. For the study, they want a hundred women to wear a bra for three months and go without one for another three months. The women will also have ultrasound scans to see what's happening to their cysts, and keep daily records of their pain. 
2. Bras are marketed on sex appeal and as essential for support. Yet there is no medical evidence to support the widely held belief that bras prevent the breasts from sagging.

Dr. Mansel - "We've got stretching of the breasts ligaments and drooping in later life, that occurs very regularly anyway, and that's a function of weight, often of the heavy breast, and those women are wearing bras, but it doesn't prevent it."

Playtex (a bra manufacturer in England) executive, John Dixey -- "We have no evidence that wearing a bra could prevent sagging, because the breast itself is not muscle, so keeping it toned up is an impossibility. What it can do, particularly for larger-breasted women, is obviously to provide the comfort and the support. So, if a woman wants a particular breast profile, she will buy a particular brand, and that is what they're designed for. There's no permanent effect on the breast from wearing a particular bra. The bra will give you the shape the bra's been designed to give while you're wearing it. Of course, when you take it off, you go 'au natural.' "

Narrator -- After three months living without a bra, some of the women have noticed a difference.
1. Elaine Kirton -- "I've noticed less pain since I've started going braless. It's like a bruised achy pain that I get. Well that's lessened definitely."
2. Rae Marsh -- "I started going brafree 9 or 10 weeks ago. And at first, you felt awful that you were the (first) people to be on the study going brafree. And as the weeks have gone on, it's become much much easier to be without pain. I get the odd days of twinges rather than days of absolute agony. I'm finding more concern about having to go back to the end of the trial to wearing a bra for the final three months. So, from dreading being braless, I'm now dreading being a bra wearer."

Narrator -- As the second half of the trial gets underway, Prof. Mansel draws our attention to another potential problem with wearing a bra, the effect it has on the temperature of the breast.

dr. Mansel -- we know that wearing a bra, the breast is hotter, and there have been studies done of measuring breast skin temperature and it can show hotter areas and cancers are associated with hotter areas of course."

Narrator -- One way of measuring the temperature of the breast is by thermography. Using a heat sensitive camera, a specialist in this technique, Prof. Francis Ring, uses thermography to show that a breast without a bra is cooler.

Prof. Ring (pointing to a live video thermogram of a woman while she is wearing and then ot wearing a bra) -- "You can see a buildup of heat here at the lower edge of the garment, which is caused by pressure on the skin. When the garment is removed, the areas of pressure are shown as hotter areas and a band is visible on the side view showing where the maximum pressure was in this garment. There is some increased heat approximately
overlying the area of the seam, where of course the material has more than one thickness."

Dr. Cawthorne -- It may be that the bra is producing a heating effect on the breast resulting in the breast secreting more fluid. At the moment we don't know, but it is possible that a cooler is a healthier breast from the point of view of producing less fluid, producing less cysts and producing less pain."

Narrator -- Another three months have gone by and the trial period is over. Several women who have taken part now have a radically different attitude to wearing bras.

Lawrenza Nicholls -- "I think that the advertisements, you know, they say "comfort, control and support" on the packaging. And so you just continue wearing the bras, don't you. You don't think for one minute there's the possibility that the bra could be giving you the pain. But after three months of not wearing a bra, the conclusion that I've come to is "contain, restrain, and pain" wearing a bra."

Lynn Holliday (who has gone back to wearing bras even though her condition had improved while braless) -- "I know I shouldn't be wearing a bra. I know I shouldn't, just like I know I shouldn't be eating the things that I eat. But, it's habit; it's being the same as everybody else. I don't want people to look at me and think, "She isn't wearing a bra, strange woman at her age, what is she doing?" So, I conform, I suppose."

Rae Marsh (who is shown taking off her blouse and showing off her burgundy-colored camisole, and then shown taking it off, putting her old bra on, and then taking off the bra in disgust) -- "I actually feel nicer in this (camisole) than I ever did in this (bra). It's sexier; it's nicer; it's a nicer feel. It (the bra) does sorta pull your boobs around for you. And the long-term achs and pains, this is the sort of, you know, the "underwire, hold-it-all-still type" bra. It's just so uncomfortable that you soon lose the novelty value of wanting to wear it (the bra), so for me that's been the answer - get rid of bra."

Narrator - The daily records the women have kept show a marked difference between post-menopausal women and those still having periods. Women with periods who used to suffer pain wearing a bra, found that they had significantly more pain-free days without one. The percentage of days when the pain was moderate to severe was halved. For some individuals like Rae, it feels even better than that.

Rae Marsh - "The results of this breast study has given me back my freedom. I can pick the children up whenever I want to. I can do anything and the breast pain has now for me gone more and more into the background. I'm not anxious about my breast lumps because the pain's not there so you don't have it constantly on your mind and worrying about it. I get on with life; I enjoy life more. I don't have to have a constant pain all the time."


Marian Godden - "For me, this whole trial has been magic, absolute magic. I would have never have thought that leaving one part of my garment, my underwear off, would have such an effect on my life. It's magic. I can't see me ever wearing a bra again."

Narrator - On average in the pre-menopausal group the study reveals that the number of totally pain-free days went up by 7 percent, which the doctors regard as significant for a problem that is otherwise so hard to treat. On the other hand the study yields no useful statistics about cyst formation.

Nicholls -- "The positive result was that the pain is a lot easier. It was a definite difference by not wearing a bra."

Narrator -- The trial does point to a possible link between wearing a bra and breast pain among the women still having periods. That could have wider significance. Several other studies have shown a link between breast pain among pre-menopausal women and breast cancer. Researchers in Paris, for instance, have found that women with monthly breast pain have double the risk of getting breast cancer. Statistically, they say, pain is as significant a risk factor as a family history of cancer.

Prof. Jean-Christophe Thalabard, Univ. of Paris Hospital -"The reason why we were astonished by the results (is) the fact that usually when we look at some risk factor for breast cancer, the order of magnitude is 1.1 or 1.2. It's not so high, I mean. When you go to 2 and above (double the risk, which is what they found for breast pain), it usually deals with familial factors, personal history of breast disease, but not for, I mean, common clinical symptoms. So it was for us something which was astonishingly high."

Narrator -- The trial in Bristol and Cardiff indicates nothing about the onset of cancer, only that breast pain might be relieved by not wearing a bra. But even that could be useful.

Dr. Thalabard -- "I would say that reducing breast pain is an objective by itself, because you need to have a normal life without pain. And if it turns out that it is really connected with a reduction of breast cancer, it might be very important from a public health point of view."

Narrator - The fact that the bra can contribute to making the breast hotter could also have wider significance. Prof. Hugh Simpson, a cancer specialist in Glasgow, invented something called the Chronobra, specifically to measure changes in breast temperature during the menstrual

Professor Hugh Simpson, Glasgow Royal Infirmary -- "The temperature difference, the circulation difference between the pre-cancerous breast, the breast that going to get cancer, (and) the normal breast is a half a degree centigrade. The pre-cancerous breast is a half a degree warmer. And this enables us to pick up the women who we know are at high risk with about a 90% certainty. But the constricting things (like bras) which raise the temperature of the breast too high are theoretically a risk factor for breast cancer. I think anything which increased the temperature of the breasts must raise our eyebrows slightly."

Dr. Mansel -- "The fact that the breast is hotter wearing a bra may have a theoretical effect and it may be a very small effect, so I find it very difficult to give women definite advice based on the current data."

Cawthorne -- "But not forget that the vast majority of women who come to breast clinics don't have breast cancer. And a lot of those are suffering from pain, and perhaps don't need to suffer, simply by avoiding wearing a bra."

Narrator - Though limited, the research responses suggest the need for further studies into what the bra could be doing to the breasts. But the general manager of Playtex does not believe that they are in a position to do that research.

John Dixey, Playtex executive -- "I don't think it's possible to actually do research into the medical side of wearing a bra because it's not really, we're not doctors, but we certainly listen to any advice that comes across or anything associated with wearing a bra, but categorically I could state that we've no previous knowledge of any medical problems with anybody wearing a bra, and I think that it's just hearsay from people who are non-professional."

Narrator - Simon Cawthorne is confident that the research they have done has shown enough of a link between breast pain and bra wearing to justify further studies.

Dr. Simon Cawthorne -- If we were to extend this study, which we intend to do, for women suffering with severe pain, and we demonstrate a similar or even greater reduction of pain from avoiding wearing a bra, then it could have a big difference. It could save a lot of women unnecessary visits to breast clinics, which would save the NHS a lot of time, and also give us more time to care for the women who've got breast cancer, more serious problems. There certainly were women for whom the simple maneuver of removing of their bra seems to have changed their lives."

Rae Marsh -- "I had no idea that for me to get rid of the pain was to get rid of wearing bras. It was a huge breakthrough."