Sawicka and Wiatrowska conducted a narrative literature review of published evidence on aluminum’s potential metalloestrogenic activity and its relevance to breast cancer risk in antiperspirant users. The review is not a primary occurrence study; it synthesizes previously published laboratory, epidemiological, and in vitro work rather than generating new measurements.
Key numbers
Dietary aluminum intake reported in the reviewed literature varies by country: Australia 1.9 to 2.4 mg per day, Finland 6.7 mg per day, Germany 8 to 11 mg per day, Japan 4.5 mg per day, Netherlands 3.1 mg per day, Sweden 13 mg per day, Switzerland 4.4 mg per day, the United States 7.1 to 8.2 mg per day, and Poland 0.6 to 15 mg per day (Table 1, p. 4). Daily intake from all sources is stated as 4,000 to 9,000 micrograms per day on p. 3.
The review cites published cosmetic aluminum concentrations: eye shadow 20,000 to 50,000 micrograms per gram; lipstick 14.2 to 27,032 micrograms per gram; face cream 170 to 650 micrograms per gram; hand cream 5,400 to 8,500 micrograms per gram (p. 3). Antiperspirant use is stated to increase total daily aluminum intake to 50,000 to 75,000 micrograms on p. 3, citing secondary sources.
For breast tissue, the review summarizes published case-control findings. It cites Linhart et al. 2017 as reporting median breast tissue aluminum of 5.8 nmol per gram dry weight in cancer cases versus 3.8 nmol per gram dry weight in healthy controls (p. 7). Aluminum in human breast tissue is reported as 1.5 to 3.5 times higher in tumors than in healthy tissue across reviewed studies (p. 7).
One case report (Guilliard et al. 2004) is cited as describing plasma aluminum of 3.88 mmol per liter in a woman using antiperspirant daily for four years, compared with a normal reference of 0.1 to 0.3 mmol per liter (p. 6).
Cellular studies summarized in Table 2 (pp. 9 to 10) include aluminum chlorohydrate at 10 to the negative 4 molar causing a 2 to 3 fold increase in estrogen receptor alpha protein in MCF-7 cells after a 6-hour exposure (Gorgogietas et al. 2018). NMuMG cells exposed chronically to aluminum chloride formed tumors in mouse models (Mandriota et al. 2016, Table 2). MDA-MB-231 cells exposed to aluminum chloride at 250 micromolar for 72 hours and 21 days did not significantly change migration or invasion in one study (Roszak et al. 2020, Table 2).
Epidemiological studies summarized in Table 2 include Linhart et al. 2017 (n equals 209 cases plus 209 controls), Fakri et al. 2006 (n equals 54 cases plus 50 controls, finding no relationship), and Sanajou et al. 2021 (n equals 803 cases plus 783 controls, finding no association).
Methods (brief)
Narrative review. Literature searched in PubMed, Google Scholar, Science Direct, Scopus, Ovid MEDLINE, and Ovid Embase; English-language papers from 2003 to 2023. No pre-registered protocol, no systematic quality assessment of included studies, no pooled statistics. The review synthesizes reported numbers from other papers; none of the aluminum concentrations originate from measurements conducted by the review authors.
Evidence fitness
This source supports a summary of aluminum exposure routes, the range of reported dietary intake by country, and the state of published evidence on aluminum as a metalloestrogen. It does not support primary occurrence data for antiperspirant aluminum levels because the numbers cited are drawn from secondary sources. It cannot establish a causal relationship between antiperspirant use and breast cancer; the authors explicitly note that the epidemiological evidence is mixed and that the mechanistic findings require extrapolation to humans.
Limitations
Narrative reviews do not conduct a systematic literature search, do not apply pre-specified inclusion criteria, and are susceptible to selection bias. This paper cites positive laboratory findings prominently; Table 2 may not represent the full literature. Daily intake estimates for antiperspirant aluminum (50,000 to 75,000 micrograms) are cited without an original source page reference auditable from this review alone. Country dietary intake figures are reported as ranges and vary substantially, reflecting different study populations and food survey designs. The plasma case report is a single patient and not a population estimate.
Related evidence
- Antiperspirant (Al-salt, dirty sibling of r9 deodorant)
- Aluminum
- Use of Underarm Cosmetic Products in Relation to Risk of Breast Cancer: A Case-Control Study
- Aluminium chloride promotes tumorigenesis and metastasis in normal murine mammary gland epithelial cells
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