This review was first published in The Human Ecologist.
Breasts: A Natural and Unnatural History
by Florence Williams. Hardcover; 336 pages. 2012. New York, NY: WW Norton & Co.
Florence Williams, the author of Breasts: A Natural and Unnatural History, is a prolific and respected journalist with numerous awards to her name. Her investigative work often focuses on environment, health and science. But this book actually began as personal musings for the author who was a breast feeding mom at the time. She also has a strong family history of breast cancer and a daughter approaching puberty to worry about. So in addition to years of research and compiling the most extensive scope of expert opinions on everything breasts, Williams adds a personal narrative to balance the investigative nature of the work.
Breasts has a lot packed into it’s 336 pages. It contains very thoroughly researched facts, personalized perspective and intent, a wide scope ranging from evolution to toxicology reports, and a uniquely conversational tone. Williams describes her own book by writing, “At its heart, Breasts is an environmental history of a body part. It is the story of how our breasts went from being honed by the environment to being harmed by it. It is part biology, part anthropology, and part medical journalism. The book’s publication marks the fiftieth anniversary of two significant milestones in the natural history of breasts whose themes will recur here; the publication of Rachel Carson’s Silent Spring and the first silicone implant surgery.” Specifically, this book covers why breasts evolved, how they evolved, how they work, implants, endocrine disruptors, early puberty onset, detox trials, formula vs breastfeeding, breast milk contents (natural and unnatural), contraception, hormone replacement therapy, mammograms, possible breast cancer factors, and male breast cancer in marines exposed to contaminated drinking water. Except that Williams manages to organize the sobering content with better chapter names, like “Are You Dense? The Aging Breast.” If the main content doesn’t have enough depth for the reader, the end notes will. They consist of a traditional bibliography with scientific publications, but also fuller explanations of items she only had time to reference in the main text.
The author devotes most of the book, and apparently years of her time, reporting from different experts; a whole spectrum of perspectives, advice, and scary statistics are shared. Some are familiar to the chemically injured like, “In 2004, the United Nations implemented the Stockholm Convention on Persistent Organic Pollutants (POPs) whereby 162 countries agreed to ban or severely restrict 21 of the worst persistent organic pollutants, the worlds most egregious chemical offenders… The United States has not ratified the treaty.” And of course, the often quoted fact that in the United States 700 new chemicals are marketed every year combining with the 82,000 already in use, but only a few hundred are tested for health effects.
Some statistics were new and alarming to this reader, “breast density is the biggest risk factor for cancer after age. It’s also the biggest risk factor you’ve never heard of: 90 percent of women do not know if they fall into this category” and only about 7% of National Cancer Institute budget is spent on prevention. However, the reader is always comforted knowing that the author’s intent is not to alarm, but rather to inform and include. She keeps her tone wry and almost chatty. For example when describing The Human Microbiome Project, she explains that it is “decoding the microbial genes of every major human gland, liquid and orifice, from the mouth to the skin to the ears to the genitals. It neglected to include breast milk, the life-giving, life-saving, older-than-mammals-themselves elixir. Oops.” Williams also excels at putting a complicated concept into a simple apt phrase, “Menopause is simply the end zone in a long game of chicken between breasts and carcinogens.”
HEAL readers will find that Breasts is a great fit for our interest in the interaction between the human body and chemicals in our environment. Williams belives that breasts “are a particularly fine mirror of our industrial lives” as they accumulate more toxins than other organs. As the author reflects on the completion of her investigative work she summarizes, “It became increasingly clear that we are not simply agents of environmental change; we are also objects of that change. And breasts are particularly vulnerable and visible pair of objects. To their credit and their detriment, breasts were built to be great communicators. From their earliest circular beginnings breasts have been highly sensitive to the world around them, conversing both within and outside the body.”
The author’s concerns about these ecological connections prompted her to test her breast milk and her DNA; the results were sobering. Knowing that she couldn’t control her high genetic risk factor, she was curious to see if she could effect the environmental one by minimizing her body’s chemical burden. Williams was also concerned for her daughter, having discovered that in addition to social factors and lifestyle, there is a strong connection between endocrine disruptors and early onset of puberty. Early puberty, in turn, is associated with increased risk of breast cancer; a girl whose first period occurs before twelve years of age, has a 50% greater risk of breast cancer than one who begins at sixteen.
So Williams and her daughter conducted before and after urine analysis testing for the presence of chemicals known to mimic or interfere with sex hormones. They indulged in three days of normal lives, “absorbing hidden molecules of plastics” from their food, drinks, shampoo and moisturizers. Then they tested for the presence of triclosan (disinfectant), BPA (plastic), phthalate metabolites (fragrance stabilizer and plastic softener), and parabens (preservative). A week later they did three days of detoxification, avoiding those chemicals as much as possible and going so far as to avoid cars, due to the upholstery, and any food that had ever touched plastic. They repeated the analysis after the detox time and then compared the results to participants in a Silent Spring Institute/ Breast Cancer Fund family study and a larger CDC database. The results were startling, baffling, and encouraging. But overall, the difference in the before and after showed just how easy it is to get high levels of biologically active chemicals into one’s body and that it is possible to dramatically reduce some of them by avoidance. As HEAL readers know, avoidance will only work if the labels on food, drugs, and cosmetics are fully disclosed. Regardless, in this section of the book particularly, Williams demonstates how much more effective our actions can be when armed with clear information.
After years of investigation and writing, Williams has a good deal of respect, even reverence for the human breast. She followed them through evolution, puberty, lactation, implants, menopause and cancer. Her attitude towards them combines protectiveness and humor. It is a healthy perspective and one that makes her book an accessable and compelling read. Before reading this book, I firmly felt that I could not add any more health concerns onto my mental radar. As a long time MCS survivor, I have plenty of health issues to keep me busy and as an added challenge, my daughter has inherited a host of food allergies, gastro-intestinal problems, and skin issues from me. Instead, Breasts has been a catalyst for me; not by shifting my health focus, but by putting issues into a clearer perspective. Gastro-intestinal imbalances, leading to food allergies and skin issues, may have their groundwork in breast milk imbalances. The autoimmune issues that run so strongly in the women in our family may be an inherited genetic defect, initially caused and then further damaged by interactions between pubescent hormones and endocrine disruptors from a variety of environmental sources. The bigger picture of a family pattern provides a valuable perspective for someone like me, struggling with my own isolating health issues. More importantly, this book has empowered me with information on what changes I can make now that might extend some protection to the next generation in our family problem – my 8 year old daughter. All of this perspective shift and parenting empowerment happened while I laughed along with William’s humor. That is what elevates Breasts: A Natural and Unnatural History from a good read to a truly neccesary read.