Abstract：
BACKGROUND: Epidemiological data indicate that the role of environmental factors on breast cancer (BC) incidence remains undetermined. Our daily life exposure to aluminium (Al) is suspected to influence BC development. This review proposes a state of the art on the association between Al and BC risk combined with a critical point of view on the subject.
METHODS: We searched the PubMed database using terms related to Al and BC up to November 18, 2022. Reports were eligible if they were cohort or case-control studies or meta-analyses.
RESULTS: Six studies focused on the relationship between deodorant and antiperspirant use and BC incidence and didn\'t produce consistent results. Among 13 studies relating Al content in mammary tissues and BC risk, results are not unanimous to validate higher Al content in tumor tissues compared to healthy ones. We detail parameters that could explain this conclusion: the absence of statistical adjustments on BC risk factors in studies, the confusion between deodorant and antiperspirant terms, the non-assessment of global Al exposure, and the focus on Al in mammary tissues whereas a profile of several metals seems more appropriate. The clinical studies are retrospective. They were carried out on small cohorts and without a long follow-up. On the other hand, studies on cell lines have shown the carcinogenic potential of aluminum. Moreover, studies considered BC as a unique group whereas BC is a heterogeneous disease with multiple tumor subtypes determining the tumor aggressiveness.
CONCLUSIONS: In light of the precautionary principle and based on the data obtained, it is better to avoid antiperspirants that contain Al. Deodorants without aluminum are not implicated in breast cancer, either clinically or fundamentally.
METHODS: We searched the PubMed database using terms related to Al and BC up to November 18, 2022. Reports were eligible if they were cohort or case-control studies or meta-analyses.
RESULTS: Six studies focused on the relationship between deodorant and antiperspirant use and BC incidence and didn\'t produce consistent results. Among 13 studies relating Al content in mammary tissues and BC risk, results are not unanimous to validate higher Al content in tumor tissues compared to healthy ones. We detail parameters that could explain this conclusion: the absence of statistical adjustments on BC risk factors in studies, the confusion between deodorant and antiperspirant terms, the non-assessment of global Al exposure, and the focus on Al in mammary tissues whereas a profile of several metals seems more appropriate. The clinical studies are retrospective. They were carried out on small cohorts and without a long follow-up. On the other hand, studies on cell lines have shown the carcinogenic potential of aluminum. Moreover, studies considered BC as a unique group whereas BC is a heterogeneous disease with multiple tumor subtypes determining the tumor aggressiveness.
CONCLUSIONS: In light of the precautionary principle and based on the data obtained, it is better to avoid antiperspirants that contain Al. Deodorants without aluminum are not implicated in breast cancer, either clinically or fundamentally.
摘要：
背景：流行病学数据表明环境因素对乳腺癌（BC）发病率的作用仍未确定。我们的日常生活中接触铝（Al）被怀疑会影响BC的发展。这篇评论提出了关于Al和BC风险之间关联的最新技术，并提出了关于该主题的关键观点。
方法：截至2022年11月18日，我们使用与Al和BC相关的术语搜索了PubMed数据库。如果是队列或病例对照研究或荟萃分析，则报告符合资格。
结果：六项研究集中在除臭剂和止汗剂使用与BC发生率之间的关系上，但没有产生一致的结果。在有关乳腺组织中Al含量和BC风险的13项研究中，结果并不一致，证明与健康组织相比，肿瘤组织中的铝含量更高。我们详细说明了可以解释这一结论的参数：研究中缺乏对BC风险因素的统计调整，除臭剂和止汗剂术语之间的混淆，全球铝暴露的非评估，并且将重点放在乳腺组织中的铝上，而几种金属的轮廓似乎更合适。临床研究是回顾性的。他们是在小组中进行的，没有长时间的随访。另一方面,对细胞系的研究显示了铝的致癌潜力。此外，研究认为BC是一个独特的群体，而BC是一种异质性疾病，具有多种肿瘤亚型，决定了肿瘤的侵袭性。
结论：根据预防原则和所获得的数据，最好避免含有Al的止汗剂。没有铝的除臭剂与乳腺癌无关，临床上或根本上。
方法：截至2022年11月18日，我们使用与Al和BC相关的术语搜索了PubMed数据库。如果是队列或病例对照研究或荟萃分析，则报告符合资格。
结果：六项研究集中在除臭剂和止汗剂使用与BC发生率之间的关系上，但没有产生一致的结果。在有关乳腺组织中Al含量和BC风险的13项研究中，结果并不一致，证明与健康组织相比，肿瘤组织中的铝含量更高。我们详细说明了可以解释这一结论的参数：研究中缺乏对BC风险因素的统计调整，除臭剂和止汗剂术语之间的混淆，全球铝暴露的非评估，并且将重点放在乳腺组织中的铝上，而几种金属的轮廓似乎更合适。临床研究是回顾性的。他们是在小组中进行的，没有长时间的随访。另一方面,对细胞系的研究显示了铝的致癌潜力。此外，研究认为BC是一个独特的群体，而BC是一种异质性疾病，具有多种肿瘤亚型，决定了肿瘤的侵袭性。
结论：根据预防原则和所获得的数据，最好避免含有Al的止汗剂。没有铝的除臭剂与乳腺癌无关，临床上或根本上。
