Breasts : a natural and unnatural history

NOTES

INTRODUCTION • PLANET BREAST

they are bigger than ever: Susan Nethero, aka “the Bra Whisperer,” founder and owner, Intimacy Management Co. LLC, author interview, July 2011.

Its incidence has almost doubled: Barry A. Miller et al., “Recent Incidence Trends for Breast Cancer in Women and the Relevance of Early Detection,” CA: A Cancer Journal for Clinicians, vol. 43 (1993), pp. 27-41. See also Stephanie E. King et al., “The ‘Epidemic’ of Breast Cancer in the U.S.—Determining the Factors,” Oncology, vol. 10, no. 4 (1996), pp. 453-462.

“I would sit in the bathtub”: Nora Ephron, “A Few Words about Breasts,” Esquire (1972), republished in Crazy Salad: Some Things about Women (New York: Knopf, 1975), p. 4.

a piece published in the New York Times Magazine: Florence Williams, “Toxic Breast Milk?” New York Times Magazine, January 9, 2005.

Linnaeus could have classified us: Carolus Linnaeus, Systema Naturae, 10th ed. (Stockholm: Laurentius Salvius, 1758).

Londa Schiebinger argues: Londa Schiebinger, Nature’s Body: Gender in the Making of Modern Science (Boston: Beacon Press, 1993), p. 67.

“The primary biological function of breasts”: Dave Barry, “Men, Get Braced; Wonderbra Coming,” Aitken Standard (syndicated column), February 27, 1994. The rest of Barry’s joke is worth repeating: “This was proved in a famous 1978 laboratory experiment wherein a team of leading male psychological researchers at Yale deliberately looked at photographs of breasts every day for two years, at the end of which they concluded that they had failed to take any notes.”

Before advanced organisms produced their own estrogen: Kenneth Korach at the National Institutes of Health and Michael Baker at the University of California, San Diego, among others, posited this theory. Baker thinks our estrogen receptors retain ancient wiring once used for picking up plant, fungal, or other environmental estrogens (author interview, March 2011). Korach believes these early estrogens were critical for influencing and controlling reproduction (author interview, March 2011).

In times of trouble and stress, it may be these women: Elizabeth Cashdan, professor of anthropology, University of Utah, author interview, October 2009. Cashdan told me, “I was just sitting in a conference and there’s talk after talk about what men prefer in women’s body types. I got tired of it.” See also Cashdan (n.d.), “Waist-to-Hip Ratio across Cultures: Trade-Offs between Androgen- and Estrogen-Dependent Traits,” Current Anthropology, vol. 49, no. 6 (2008), pp. 1099-1107.

CHAPTER 1 • FOR WHOM THE BELLS TOLL

“A 41-inch bust and a lot of perseverance”: Jayne Mansfield, quoted in Raymond Strait, Here They Are (New York: SPI Books, 1992), p. 11.

“[Breasts] are a body part”: Francine Prose, quoted in Sarah Boxer, “As a Gauge of Social Change, Behold: The Breast,” New York Times, May 22, 1999.

“This treatment made them smooth”: Mae West, Goodness Had Nothing to Do with It (Englewood Cliffs, N.J.: Prentice-Hall, 1959), p. 56.

no other mammal has “breasts” the way we do: Owen Lovejoy, professor of anthropology, Kent State University, author interview, July 2010; see also R. V. Short, “The Origins of Human Sexuality” (1980), in C. R. Austin and R. V. Short (eds.), Reproduction in Mammals and Human Sexuality, 2nd ed. (Cambridge: Cambridge University Press, 1982), pp. 1-33.

Barnaby was preparing to publish his study: Barnaby Dixson et al., “Watching the Hourglass: Eye Tracking Reveals Men’s Appreciation of the Female Form,” Human Nature, vol. 21, no. 4 (2010), pp. 355-370.

“Whenever Barny gives seminars on waist-to-hip ratios”: Scientists like studying both breasts and waist-to-hip ratios (WHRs) because they’re easy to measure. To get a WHR, you divide the size of the waist by the size of the hips. The WHR for Jennifer Lopez is supposedly .67, and for both Marilyn Monroe and Venus de Milo, around .70, so their waists are 70 percent of the size of their hips. Although some anthropologists have claimed the .70 ratio is universally preferred, others point out that body mass index (BMI) is a stronger indicator of both attractiveness and fitness. One study found that women with a .70 WHR and with large breasts have higher circulating levels of estradiol, and therefore might be more fertile (see Grazyna Jasienska et al., “Large Breasts and Narrow Waists Indicate High Reproductive Potential in Women,” Proceedings of the Royal Society, London, vol. 271 (2004), pp. 1213-1217). But the study lacks ecological relevance, meaning no one has measured whether these slightly higher hormone levels actually result in more babies being born.

an eighty-pound English bulldog named Huxley: Thomas Huxley, a biologist and contemporary of Darwin, referred to himself as “Darwin’s bulldog” for his fierce defense of On the Origin of Species.

Alan’s latest book: Alan Dixson, Sexual Selection and the Origins of Human Mating Systems (New York: Oxford University Press, 2009).

men have relatively small testicles: Dixson, Sexual Selection and the Origins of Human Mating Systems, p. 38.

“there could be a profound preference among men”: Barnaby is referring to work by Frank Marlowe, “The Nubility Hypothesis,” Human Nature, vol. 9, no. 3 (1998), pp. 263-271.

A few years ago in Brittany, France: Nicolas Gueguen, “Women’s Bust Size and Men’s Courtship Solicitation,” Body Image, vol. 4 (2007), pp. 386-390.

In a similar experiment, Miss Elasto-chest tried hitchhiking: Nicolas Gueguen, “Bust Size and Hitchhiking: A Field Study,” Perceptual and Motor Skills, vol. 105, no. 4 (2007), pp. 1294-1298.

Another study showed that waitresses with larger breasts: Michael Lynn, “Determinants and Consequences of Female Attractiveness and Sexiness: Realistic Tests with Restaurant Waitresses,” Archives of Sexual Behavior, vol. 38, no. 5 (2009), pp. 737-745.

In his earlier data from the eye-tracker: Barnaby Dixson, Gina Grimshaw, Wayne Linklater, and Alan Dixson, “Eye-Tracking of Men’s Preferences for Waist-to-Hip Ratio and Breast Size of Women,” Archives of Sexual Behavior, vol. 40, no. 1 (2009), pp. 43-50.

Other studies have shown: Clellan Ford and Frank Beach, Patterns of Sexual Behavior (New York: Harper & Row, 1951), p. 88.

One study found that Western men prefer curvier women: Terry F. Pettijohn et al., “Playboy Playmate Curves: Changes in Facial and Body Feature Preferences across Social and Economic Conditions,” Personality and Social Psychology Bulletin, vol. 30, no. 9 (2004), pp. 1186-1197.

Barnaby expected men to prefer: For Barnaby’s papers on male preferences, breast size, and areolar pigment and size, see Barnaby Dixson et al., “Men’s Preferences for Women’s Breast Morphology in New Zealand and Papua New Guinea,” Archives of Sexual Behavior, (2010), e-publication ahead of print edition, available at http://www.ncbi.nlm.nih.gov/pubmed/20862533; Dixson et al., “Eye Tracking of Men’s Preferences for Female Breast Size and Areola Pigmentation,” Archives of Sexual Behavior, vol. 40, no. 1 (2011), pp. 51-58; Dixson et al., “Eye-Tracking of Men’s Preferences for Waist-to-Hip Ratio and Breast Size of Women,” Archives of Sexual Behavior, vol. 40, no. 1 (2011), pp. 43-50; Dixson et al., “Watching the Hourglass,” Human Nature, vol. 21, no. 4 (2010), pp. 355-370.

Desmond Morris published his famous and influential book: See Desmond Morris, The Naked Ape: A Zoologist’s Study of the Human Animal (New York: McGraw-Hill, 1967); quote from p. 67.

Elaine Morgan, a Welsh writer: For a lively read, see Elaine Morgan, The Descent of Woman (New York: Bantam Books, 1972); quote from p. 5.

breasts helped increase a woman’s fat reserves: Typically 43.6 percent of the female physique is composed of fat in comparison to 28.4 percent in men, according to J. P. Clarys et al., “Gross Tissue Weights in the Human Body by Cadaver Dissection,” Human Biology, vol. 56 (1984), pp. 459-473. Boguslow Pawloski also defends the idea of fat, including breast fat, as being adaptive to the woman. See Pawloski, “Center of Body Mass and the Evolution of Female Body Shape,” American Journal of Human Biology, vol. 15, no. 2 (2003), pp. 144-150.

SWAG: I am indebted to Joseph H. Williams, professor of evolutionary biology, University of Tennessee, and a most outstanding brother-in-law, for this term.

One desert zoologist sees in breasts the camel’s hump: See Ron Arieli, “Breasts, Buttocks, and the Camel Hump,” Israel Journal of Zoology, vol. 50 (2004), pp. 87-91.

“The reasons why the breasts of women”: Henri de Mondeville, quoted in Marilyn Yalom, A History of the Breast (New York: Random House, 1997), p. 211.

In 1840, one physician speculated: Sir Astley Paston Cooper, On the Anatomy of the Breast (London: Longman, Orme, Green, Brown, and Longman’s, 1840), p. 59.

an Israeli researcher posited that fatty breasts: Arieli, “Breasts, Buttocks, and the Camel Hump.”

“ensures that the nipple is no longer anchored”: Elaine Morgan, The Descent of the Child (New York: Oxford University Press, 1995), p. 47.

We may be the only mammal: Daniel Lieberman, professor of human evolutionary biology, Harvard University, author interview, August 2011. I will note that Lieberman warned me away from making too much of the basicranial flexion argument. Just as it is difficult to know when pendulous breasts evolved, it is also difficult to know when speech evolved or how closely speech, neck, and breasts may be related. Point taken.

“They’re pretty, they’re flamboyant”: Natalie Angier, Woman: An Intimate Geography (New York: Random House, 1999), p. 124.

CHAPTER 2 • CIRCULAR BEGINNINGS

“… from so simple a beginning”: Charles Darwin, On the Origin of Species (New York: Thomas Y. Crowell, 1860), p. 460.

The manatee has nipples under her flippers: The information on mammal features came from various sources, including Olav Oftedal, author interview, March 2010; Alan Dixson, author interview, June 2010; Sandra Steingraber, Having Faith: An Ecologist’s Journey to Motherhood (Cambridge, Mass.: Perseus, 2001), p. 215; and, on the opossum, “With the Wild Things,” at http://digitalcollections.fiu.edu/wild/transcripts/possums1.htm (accessed October 2011).

the ability to lactate is among our most valuable genetic assets: Bruce German, professor of food science and technology, University of California, Davis, author interview, October 2010.

one-sixth the protein found: On milk fat compositions of various species, see Caroline Pond, “Physiological and Ecological Importance of Energy Storage,” Symposia of the Zoological Society of London, Physiological Strategies in Lactation, vol. 51 (1984), pp. 1-29.

The earliest lactating species: Sarah Blaffer Hrdy, Mothers and Others: The Evolutionary Origins of Mutual Understanding (Cambridge, Mass.: Belknap Press, 2009), p. 39; and M. Peaker, “The Mammary Gland in Mammalian Evolution: A Brief Commentary on Some of the Concepts,” Journal of Mammary Gland Biology and Neoplasia, vol. 7, no. 3 (2002), p. 347.

Mammals owned the Cenozoic: For readable discussions of the ascendance of mammals, see T. S. Kemp, The Origin and Evolution of Mammals (New York: Oxford University Press, 2005); and Donald R. Prothero, After the Dinosaurs: The Age of Mammals (Bloomington: Indiana University Press, 2006).

Darwin himself went out on a limb: Discussed in Charles Darwin, On the Origin of Species (New York: Penguin, 2009; first published 1859), pp. 322-323.

we would never have breasts if we didn’t have teeth: Neil Shubin, Your Inner Fish: A Journey into the 3.5-Billion-Year History of the Human Body (New York: Random House, 2008), p. 78.

even what sex the fetus is in order to fine-tune the composition of the milk: Katherine Hinde, assistant professor, Department of Human Evolutionary Biology, Harvard University, author interview, December 2010.

The first fluid was a sort of natural Lysol: There are a number of fascinating journal articles about the origins of the mammary gland and its beginnings as part of the innate immune system. I recommend D. G. Blackburn et al., “The Origins of Lactation and the Evolution of Milk: A Review with New Hypotheses,” Mammal Review, vol. 19 (1989), pp. 1-26; D. G. Blackburn, “Evolutionary Origins of the Mammary Gland,” Mammal Review, vol. 21 (1991), pp. 81-96; and two Oftedal papers: “The Mammary Gland and Its Origin during Synapsid Evolution,” Journal of Mammary Gland Biology and Neoplasia, vol. 7, no. 3 (July 2002), pp. 225-252; and “The Origin of Lactation as a Water Source for Parchment-Shelled Eggs,” Journal of Mammary Gland Biology and Neoplasia, vol. 7, no. 3 (July 2002), pp. 253-266.

Lactation, with its tremendous metabolic efficiencies: Kemp, Origin and Evolution of Mammals, p. 113.

CHAPTER 3 • PLUMBING

“I have heard a good anatomist say”: Astley Paston Cooper, On the Anatomy of the Breast (London: Lea & Blanchard, 1845), p. 6.

Napoleon’s penis: See Tony Perrottet, Napoleon’s Privates: 2,500 years of History Unzipped (New York: HarperCollins, 2008), pp. 20-27; and Charles Hamilton, Auction Madness: An Uncensored Look behind the Velvet Drapes of the Great Auction Houses (New York: Everest House, 1981), pp. 54-55.

woman said to have the largest implants in the world: Fox News reported that the Houston woman, Sheyla Hershey, suffered a serious staph infection after her latest implant surgery. It was her thirtieth operation, according to “Woman with World’s Largest Breasts Fighting for Her Life,” July 14, 2010, available at http://www.foxnews.com/health/2010/07/14/woman-worlds-largest-breasts-fighting-life/#ixzz1DmS8FrTD.

“What goes up must go down”: Patrick McCain, “World’s Largest Breasts, 38KKK Sheyla Hershey Breast Implants Removed,” Rightpundits.com, September 14, 2010 (originally published in 2009), at http://www.rightpundits.com/?p=2822.

Over the course of a menstrual cycle: Z. Hussain et al., “Estimation of Breast Volume and Its Variation during the Menstrual Cycle Using MRI and Stereology,” British Journal of Radiology, vol. 72, no. 855 (1999), pp. 236-245.

“Brassiere design is one engineering activity”: Quote and equation from Edward Nanas, “Brassieres: An Engineering Miracle,” Science and Mechanics, February 1964, available at http://www.firstpr.com.au/show-and-tell/corsetry-1/nanas/engineer.html (accessed October 2011). Nanas backed up his statement with a description from Mrs. Ida Rosenthal, the seventy-seven-year-old head of Maidenform. “She recently returned from a tour of the Soviet garment industry and found that bra designers on the other side of the Iron Curtain have not yet discovered stretch fabrics, foam padding, hooks and eyes, or the strapless bra.”

She showed me the action footage: To see Werb’s film clips, check out http://anatomy.ucsf.edu/Werbwebsite/egebald%20movies%202008/Movie_1.mov.

a digression: On the cadaver trade, see Julie Bess Frank, “Body Snatching: A Grave Medical Problem,” Yale Journal of Biology and Medicine, vol. 49 (1976), pp. 399-410; and W. B. Walker, “Medical Education in 19th Century Great Britain,” Journal of Medical Education, vol. 31, no. 11 (1956), pp. 765-777.

“a breadth of experience unparalleled before or since”: James Going, clinical senior lecturer in pathology, University of Glasgow, author interview, May 2010.

“galactograms”: Cooper, On the Anatomy of the Breast; for a digital version, see http://jdc.jefferson.edu/cooper/61/.

on rare occasion have been able to produce milk-like fluid: For more on male lactation, see Jared Diamond, who lays out a plausible male breast-feeding scenario in “Father’s Milk,” Discover, vol. 16, no. 2 (February 1995), pp. 82-87. This essay perhaps inspired a Swedish college student named Ragnar “Milkman” Bengtsson, who, in 2009, tried to stimulate milk production by pumping his nipples every three hours for two months. It didn’t work. See “Swedish ‘Milkman’ Loses Breastfeeding Battle,” The Local, December 1, 2009, at http://www.thelocal.se/23592/20091201/. The anthropologist Barry Hewlett documented suckling among men of the Aka Pygmy tribe in central Africa, but they appeared to be providing “comfort suckling” and not nutrition. See Joanna Moorhead, “Are the Men of the African Aka Tribe the Best Fathers in the World?” The Guardian, July 15, 2005.

“the breasts are generally two in number:” Cooper, On the Anatomy of the Breast, p. 13.

CHAPTER 4 • FILL HER UP

“… but on the fourth night”: Maria Edgeworth, Tales and Novels: Harrington; Thoughts on Bores; Ormond (London: George Routledge and Sons, 1893), p. 394.

cosmetic surgery: Statistics are from the American Society for Aesthetic and Plastic Surgery, “Statistics,” Press Center, at http://www.surgery.org/media/statistics (accessed October 2011).

performs more augmentations by far than any doctor in Texas: Becca Quisenberry, Patient Coordinator, Ciaravino Plastic Surgery, author interview, September 2011.

Falsies, made out of wire, sheet metal, papier-mâché: See Teresa Riordan, “We Must Increase Our Bust: A History of Breast Enhancement, Told in Patent Drawings,” Slate, April 11, 2005, at http://www.slate.com/id/2116481; and Elizabeth Haiken, Venus Envy: A History of Cosmetic Surgery (Baltimore: Johns Hopkins University Press, 1997), pp. 243-246.

Consider the case of poor Elisabeth Trevers: Gordon Letterman and Maxine Schurter, “Will Durston’s Mammaplasty,” Plastic and Reconstructive Surgery, vol. 53, no. 1 (1974), quoted in Nora Jacobsen, Cleavage: Technology, Controversy, and the Ironies of the Man-Made Breast (New Brunswick, N.J.: Rutgers University Press, 2000), p. 50.

Vincenz Czerny: The first boob job was technically a reconstruction. See Theodore W. Uroskie Jr. and Lawrence B. Colen, “History of Breast Reconstruction,” Seminars in Plastic Surgery, vol. 18, no. 2 (May 2004), pp. 65-69.

glass balls, ivory, wood chips: For information on the early-twentiethcentury implant materials used, see Haiken, Venus Envy; also Bernard M. Patten, former chief of neuromuscular disease, Baylor College of Medicine, author interview, February 2011.

disadvantages of paraffin: Jacobsen, Cleavage, pp. 52-54.

Women have painted their faces: Julie M. Spanbauer, “Breast Implants as Beauty Ritual: Woman’s Sceptre and Prison,” Yale Journal of Law and Feminism, vol. 9, no. 157 (1997).

Ivalon: S. Murthy Tadavarthy, James H. Moller, and Kurt Amplatz, “Polyvinylalcohol (Ivalon)—A New Embolic Material,” American Journal of Roentgenology, vol. 125, no. 3 (November 1975), pp. 609-616.

“The material’s one drawback”: Plastic surgeon Milton Edgerton, paraphrased in Jet Magazine, December 12, 1957, available at http://www.flickr.com/photos/vieilles_annonces/3778246964/ (accessed October 2011).

Dow Corning: For the history of Dow Corning, see Haiken, Venus Envy, pp. 246-247. Also see this colorful document from the Dow website: www.dowcorning.com/content/publishedlit/01-4027-01.pdf (accessed October 2011).

the breasts of Japanese prostitutes, who were being injected with it: M. Sharon Webb, “Cleopatra’s Needle: The History and Legacy of Silicone Injections,” Harvard Law School paper, January 1997, available at http://leda.law.harvard.edu/leda/data/197/mwebb.pdf; and Haiken, Venus Envy, p. 246.

Back in Houston, plastic surgeon Thomas Cronin: As recounted by Thomas Biggs, retired plastic surgeon, Houston, Texas, author interview, January 2011. Biggs also recounted the story of Cronin’s ambition and the first surgery, including parts about Esmerelda. He was a resident of Cronin’s at the time.

On the back of the bag, they added several patches of Dacron: Jacobsen, Cleavage, pp. 78-79.

Some authors say they tested it in six dogs: John Byrne, Informed Consent (New York: McGraw-Hill, 1997), pp. 47-50.

Surgery to remove implants, known as explantation: For a discussion of what’s found at the explant site, see R. Vaamonde et al., “Silicone Granulomatous Lymphadenopathy and Siliconomas of the Breast,” Histology and Histopathology, vol. 4 (October 1997), pp. 1003-1011.

“Many women with limited development of the breast”: Gerow, quoted in Jacobsen, Cleavage, pp. 78-79.

One surgeon’s autobiography: Robert Alan Franklyn, Beauty Surgeon (Long Beach, Calif.: Whitehorn, 1960).

“there is a substantial and enlarging body”: The American Society of Plastic and Reconstructive Surgery’s statement to the Food and Drug Administration, in 1982, is a well-known quote. I love the not-quite-subliminal use of the word enlarging. See the quote referenced with biting commentary from Barbara Ehrenreich, “Stamping Out a Dread Scourge,” Time, February 17, 1992, available at http://www.time.com/time/magazine/article/0,9171,974902,00.html.

The largest was called “the Burlesque”: Jacobsen, Cleavage, p. 79.

Gerow reputedly liked big breasts: Bernard Patten, author interview, January 2011.

One Houston doctor boasted: For an excellent article on Houston in its boob-job glory days, see Mimi Swartz, “Silicone City,” Texas Monthly, vol. 23, no. 8 (1995), pp. 64-78.

By 1985, one hundred thousand women: Newsweek noted in 1985 that nearly one hundred thousand breast augmentations had been performed over the past year “for a total addition to the nation’s mammary capacity of some 13,000 gallons (of silicone gel),” as quoted in Haiken, Venus Envy, p. 273.

Carol Doda: For more on Doda, there’s a great section on her breasts (and the infamous piano) in Mike Sinclair’s San Francisco: A Cultural and Literary History (Oxford: Signal Books, 2004), pp. 84-85.

“Carol Doda’s breasts are up there”: Thomas Wolfe, The Pump House Gang (New York: Bantam, 1969), p. 67.

strippers instantly saw their tips increase: Bernard Patten, author interview, January 2011.

Houston became the strip-club capital of the world: Michael Ciaravino, author interview, January 2011.

Rick’s Cabaret: For more on the history of Rick’s Cabaret, see Swartz, “Silicone City.”

restricted the use of the “medical-grade” stuff: On the FDA restrictions on the “medical-grade” stuff and reports of infection, gangrene, and so on, see Haiken, Venus Envy, pp. 274-275.

Many patients—41 percent, according to a 1979 study: G. P. Hetter, “Satisfactions and Dissatisfactions in Patients with Augmentation Mammaplasty,” Plastic and Reconstructive Surgery, vol. 64, no. 2 (August 1979), p. 151.

An enormous percentage of patients—around 25 to 70 percent: Neal Handel et al., “A Long-Term Study of Outcomes, Complications, and Patient Satisfaction with Breast Implants,” Plastic and Reconstructive Surgery, vol. 117, no. 3 (March 2006), pp. 757-767.

“They were like doorbells”: Bernard Patten, author interview, January 2011.

Early dissections of the affected tissue: Thomas Biggs, author interview, January 2011.

The operation itself: Michael Ciaravino, author interview, January 2011.

Company salesmen were told to wash the leaking implants: This comes from an internal Dow Corning memo dated January 15, 1975, that was made public when the group Public Citizen sued the FDA; cited in Jack Doyle, Trespass against Us: Dow Chemical and the Toxic Century (Monroe, Maine: Common Courage Press, 2004), p. 257.

causing a prolonged inflammatory response and “microencapsulations”: See Michelle Copeland et al., “Absent Silicone Shell in a MEME Polyurethane Silicone Breast Implant: Report of a Case and Review of the Literature,” Breast Journal, vol. 2, no. 5 (September 1996), pp. 340-344.

manufacturer of the foam was apparently surprised: See Nicholas Regush, “Toxic Breasts,” Ms. Magazine, vol. 17, no. 1 (January/February 1992), pp. 24-31.

Many surgeons remember these implants fondly: Thomas Biggs, author interview, January 2011.

76 foam-covered implants continue to be used: Handel et al., “Long-Term Study of Outcomes.”

“we know more about the life span of automobile tires”: David Kessler, quoted in Spanbauer, “Breast Implants as Beauty Ritual.”

Dow Corning declared bankruptcy: On Dow Corning’s bankruptcy history, see Dow Corning’s publication “Highlights from the History of Dow Corning Corporation, the Silicone Pioneer,” available at www.dowcorning.com/content/publishedlit/01-4027-01.pdf (accessed October 10, 2011); and John Schwartz, “Dow Corning Accepts Implant Settlement Plan; $3.2 Billion Earmarked for Health Claims,” Washington Post, July 9, 1998.

anaplastic large-cell lymphoma: Denise Grady, “Breast Implants Are Linked to Rare but Treatable Cancer, F.D.A. Finds,” New York Times, January 26, 2011.

“The message that never reaches the public”: Spanbauer, “Breast Implants as Beauty Ritual.”

from a high of 150,000: Marcia Angell, “Breast Implants— Protection or Paternalism?” New England Journal of Medicine, vol. 326 (June 18, 1992), pp. 1695-1696.

the FDA approved: On FDA approvals, see “Breast Implants,” U.S. Food and Drug Administration, at http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/Implantsand Prosthetics/BreastImplants/default.htm (accessed October 14, 2011).

roughly $820 million a year: Denise Grady, “Dispute over Cancer Tied to Implants,” New York Times, February 17, 2011.

Between five and ten million women: Grady, “Dispute over Cancer Tied to Implants.”

product insert data sheet: For Mentor’s product insert data sheet, see http://www.mentorwwllc.com/global-us/SafetyInformation.aspx (accessed October 2011).

a major review of the literature from the Institute of Medicine: Safety of Silicone Breast Implants (Washington, D.C.: Institute of Medicine National Academy Press, 2000). Also available through the Institute of Medicine website, at www.iom.edu.

“It is not known if a small amount of silicone”: For information on the effects on nursing infants, see “FDA Breast Implant Consumer Handbook—2004,” at www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm064242.htm.

“Fortunately, patients undergoing plastic surgery of the breast”: Eugene H. Courtiss and Robert M. Goldwyn, “Breast Sensation before and after Plastic Surgery,” Plastic and Reconstructive Surgery, vol. 58, no. 1 (July 1976), pp. 1-13, quoted in Haiken, Venus Envy, p. 270.

Mentor’s study to date: Summary of the study is available at http://www.mentorwwllc.com/global-us/SafetyInformation.aspx (accessed October 2011).

critics like Naomi Wolf: Naomi Wolf, The Beauty Myth (New York: William Morrow, 1991), p. 242.

Barbie’s proportions are naturally found: Kevin I. Norton et al., “Ken and Barbie at Life Size,” Sex Roles, vol. 34, no. 3-4 (1996), pp. 287-294.

a twenty-nine-year-old named Gloria: I’ve changed the names of Dr. C’s patients to protect their privacy.

CHAPTER 5 • TOXIC ASSETS

“I tell people I come from a different planet”: Sylvia Earle, author interview, February 10, 2012.

nature writer and biologist had received a disturbing letter: For a description of Huckins’s experience with DDT, see Eleni Himaras, “Rachel Carson’s Groundbreaking ‘Silent Spring’ Was Inspired by Duxbury Woman,” Patriot Ledger (Quincy, Mass.), May 26, 2007.

“elixirs of death”: Rachel Carson, Silent Spring (New York: Ballantine Books, 1962), pp. 24-43.

“The sedge is wither’d from the lake, / And no birds sing”: Carson, Silent Spring, p. 12.

“For the first time in the history of the world”: Carson, Silent Spring, p. 25.

“I was born with a plastic spoon in my mouth”: The Who, “Substitute,” 1966.

The term endocrine disruptor: Theo Colborn, founder and president of The Endocrine Disruption Exchange and professor emeritus of zoology, University of Florida, Gainesville, author interview, March 2010.

women reportedly get better at verbal and fine-motor skills: For example, see Elizabeth Hampson, “Estrogen-Related Variations in Human Spatial and Articulatory-Motor Skills,” Psychoneuroendocrinology, vol. 15, no. 2 (1990), pp. 97-111.

do humans cultivate marijuana: For more on the wonders of evolutionary adaptations of marijuana, see Michael Pollan, The Botany of Desire: A Plant’s-Eye View of the World (New York: Random House, 2001).

Giant fennel, found by the Greeks in the seventh century BC: Timothy Taylor, The Prehistory of Sex: Four Million Years of Human Sexual Culture (New York: Bantam Books, 1996), p. 90.

BPA’s molecular structure is simple and elegant: Jeffrey Stansbury, polymer chemist, University of Colorado, Denver, author interview, March 2011.

Now produced in mind-boggling quantities: Fact sheet, “Bisphenol A (BPA) and Breast Cancer,” published by the Breast Cancer Fund, December 8, 2008, available at www.breastcancerfund.org/assets/pdfs/bpaandbc_factsheet_120808.pdf.

DES: For the effects of DES on daughters and sons, see Nancy Langston, Toxic Bodies: Hormone Disruptors and the Legacy of DES (New Haven, Conn.: Yale University Press, 2010), p. 135.

BPA has been shown to cause: A. G. Recchia et al., “Xenoestrogens and the Induction of Proliferative Effects in Breast Cancer Cells via Direct Activation of Oestrogen Receptor Alpha,” Food Additives and Contaminants, vol. 21 (2004), pp. 134-144; S. V. Fernandez and J. Russo, “Estrogen and Xenoestrogens in Breast Cancer,” Toxicologic Pathology, vol. 38, no. 1 (January 2010), pp. 110-122.

There is something about BPA: Sarah Jenkins et al., “Oral Exposure to Bisphenol A Increases Dimethylbenzanthracene-Induced Mammary Cancer in Rats,” Environmental Health Perspectives, vol. 117, no. 6 (June 2009), pp. 910-915.

In other rat experiments: Milena Durando et al., “Prenatal Bisphenol A Exposure Induces Preneoplastic Lesions in the Mammary Gland in Wistar Rats,” Environmental Health Perspectives, vol. 115, no. 1 (January 2007), pp. 80-86.

Higher EZH2 levels are associated with an increased risk: Leo F. Doherty et al., “In Utero Exposure to Diethylstilbestrol (DES) or Bisphenol-A (BPA) Increases EZH2 Expression in the Mammary Gland: An Epigenetic Mechanism Linking Endocrine Disruptors to Breast Cancer,” Hormones and Cancer, vol. 1, no. 3 (2010), pp. 146-155.

Scientists call this “phenotypic plasticity”: For an interesting overview, see Richard G. Bribiescas and Michael P. Muehlenbein, “Evolutionary Endocrinology,” in Michael P. Muehlenbein (ed.), Human Evolutionary Biology (New York: Cambridge University Press, 2010), pp. 127, 137.

DES was still manufactured: Furthermore, its illegal use as a growth hormone in cattle continued well into the 1980s. For more on DES and its dates of use, see http://www.websters-online-dictionary.org/definitions/Diethylstilbestrol; Nancy Langston offers a compelling history in Toxic Bodies, p. 117; see also Orville Schell, Modern Meat: Antibiotics, Hormones, and the Pharmaceutical Farm (New York: Vintage, 1985), p. 331.

In the United States, every chemical is assumed safe: Lynn Goldman, “Preventing Pollution? U.S. Toxic Chemicals and Pesticides Policies and Sustainable Development,” Environmental Law Reporter, vol. 32 (2002), pp. 11018-11041.

Of the 650 top-volume chemicals in use: Rick Smith and Bruce Lourie, Slow Death by Rubber Duck (Berkeley, Calif.: Counterpoint, 2009), p. xiv.

“They leave the mammary gland in the trash can”: Ruthann Rudel, director of research, Silent Spring Institute, author interview, February 2011. See also Ruthann Rudel et al., “Mammary Gland Development as a Sensitive Indicator of Early Life Exposures: Recommendations from an Interdisciplinary Workshop,” presented at The Mammary Gland Evaluation and Risk Assessment Workshop in Oakland, Calif., November 2009. Also see S. L. Makris, “Current Assessment of the Effects of Environmental Chemicals on the Mammary Gland in Guideline EPA, OECD, and NTP Rodent Studies,” Environmental Health Perspectives, vol. 119, no. 8 (2011), pp. 1047-1052; and Florence Williams, “Scientists to Chemical Regulators: Stop Ignoring Boobs,” Slate, June 27, 2011, available at http://www.slate.com/articles/double_x/doublex/2011/06/scientists_to_chemical_regulators_stop_ignoring_boobs.html.

In the body it appears to increase: J. L. Raynor et al., “Adverse Effects of Prenatal Exposure to Atrazine during a Critical Period of Mammary Gland Growth,” Journal of Toxicological Sciences, vol. 87 (2005), pp. 255-266.

The journal Cancer reported in 2007: Ruthann A. Rudel et al. “Chemicals Causing Mammary Gland Tumors in Animals Signal New Directions for Epidemiology, Chemicals Testing, and Risk Assessment for Breast Cancer Prevention,” Cancer, vol. 109, no. 12 (2007, Supplement), pp. 2635-2666.

Roughly one thousand chemicals: Theo Colborn, author interview, March 2010.

“The possibilities of DDT are sufficient”: For this quotation from Simmons and other information on DDT, see Will Allen, The War on Bugs (White River Junction, Vt.: Chelsea Green, 2008), p. 171.

by the early 1970s, 1.3 trillion pounds had been sprinkled: EPA report, “DDT Regulatory History: A Brief Survey (to 1975),” excerpted from DDT, A Review of Scientific and Economic Aspects of the Decision to Ban Its Use as a Pesticide, prepared for the Committee on Appropriations of the U.S. House of Representatives by EPA, July 1975, available at http://www.epa.gov/history/topics/ddt/02.htm.

shortened duration of lactation: For a good introduction to the potential links between chemicals and mammary gland dysfunction, see Ruthann Rudel et al., “Environmental Exposures and Mammary Gland Development: State of the Science, Public Health Implications, and Research Recommendations,” Environmental Health Perspectives, vol. 119, no. 8 (August 2011), pp. 1053-1061; also available at http://ehp03.niehs.nih.gov/article/fetchArticle.action?articleURI=info%3Adoi%2F10.1289%2Fehp.1002864.

The younger women, the ones exposed to the most DDT: See Barbara A. Cohn et al., “DDT and Breast Cancer in Young Women: New Data on the Significance of Age at Exposure,” Environmental Health Perspectives, vol. 115, no. 10 (October 2007), pp. 1406-1414.

women born after 1940 have much higher levels: See Tom Reynolds, “Study Clarifies Risk of Breast, Ovarian Cancer among Mutation Carriers,” Journal of National Cancer Institute, vol. 95, no. 24 (2003), pp. 1816-1818.

Cheap by-products of fossil-fuel production: Theo Colborn, “Foreword,” in Smith and Lourie, Slow Death by Rubber Duck, pp. viii-x.

Today we use thirty times more synthetic pesticides: Theo Colborn, Diane Dumanoski, and John Peterson Myers, Our Stolen Future: Are We Threatening Our Fertility, Intelligence, and Survival?—A Scientific Detective Story (New York: Penguin Books, 1996), p. 138.

Now, the rate is 1 out of 2.5: “Lifetime Risk of Developing or Dying from Cancer,” from the American Cancer Society, available at http://www.cancer.org/Cancer/CancerBasics/lifetime-probability-of-developing-or-dying-from-cancer.

Chemical World News reacted: James Stuart Olson, Bathsheba’s Breast: Woman, Cancer and History (Baltimore: Johns Hopkins University Press, 2002), p. 226.

“If we are going to live so intimately with these chemicals”: Carson, Silent Spring, p. 17.

CHAPTER 6 • SHAMPOO, MACARONI, AND THE AMERICAN GIRL

“Still she went on growing”: Lewis Carroll, Alice’s Adventures in Wonderland and Through the Looking Glass (New York: Macmillan Co., 1897), p. 45.

ship them to Canada for testing: We used Axys Analytical Services, Sidney, British Columbia.

girls were developing breasts and sprouting pubic hair: Marcia E. Herman-Giddens et al., “Secondary Sexual Characteristics and Menses in Young Girls Seen in Office Practice: A Study from the Pediatrics in Office Settings (PROS) Network, American Academy of Pediatrics,” Pediatrics, vol. 99, no. 4 (1997), pp. 505-512.

2007 report for the Breast Cancer Fund: Sandra Steingraber, “The Falling Age of Puberty in U.S. Girls: What We Know, What We Need to Know,” published by the Breast Cancer Fund (2007), p. 24, available at http://www.breastcancerfund.org/assets/pdfs/publications/falling-age-of-puberty.pdf.

“We think that puberty”: Suzanne Fenton, research biologist, Reproductive Endocrinology Group, National Institute of Environmental Health Sciences, author interview, December 2007.

If you get your first period before age twelve: Steingraber, “Falling Age of Puberty in U.S. Girls,” p. 24.

by 2011, one-third of black girls: F. M. Biro et al., “Pubertal Assessment Method and Baseline Characteristics in a Mixed Longitudinal Study of Girls,” Pediatrics, vol. 126, no. 3 (September 2010), pp. 583-590.

The tragic result, according to pediatrician Sharon Cooper: Patricia Leigh Brown, “In Oakland, Redefining Sex Trade Workers as Abuse Victims,” New York Times, May 23, 2011.

the age of sexual maturity in girls has dropped slowly but steadily: Anne-Simone Parent et al., “The Timing of Normal Puberty and the Age Limits of Sexual Precocity: Variations around the World, Secular Trends, and Changes after Migration,” Endocrine Reviews, vol. 24, no. 5 (2003), pp. 668-693.

a whopping 13 million calories: Sarah Blaffer Hrdy, Mothers and Others: The Evolutionary Origins of Mutual Understanding (Cambridge, Mass.: Belknap Press, 2009), p. 31.

When poor, once-hungry immigrants: Peter D. Gluckman and Mark A. Hanson, “Evolution, Development and Timing of Puberty,” Trends in Endocrinology and Metabolism, vol. 17, no. 1 (2006), pp. 7-12.

Adopted Indian girls who move to Sweden as infants: Parent et al., “Timing of Normal Puberty.”

“For the first time in our evolutionary history”: Peter Gluckman, professor of paediatric and perinatal biology, University of Auckland, author interview, January 2010.

“chemical, physical and social factors interact with genes”: As stated in a public talk by Robert Hiatt, Department of Epidemiology and Biostatistics, University of California, San Francisco, and principal investigator at Breast Cancer and the Environment Research Centers (BCERC), Cavallo Point, California, November 2011.

the percentage of American girls aged six to eleven: “Health, United States, 2008, with Special Feature on the Health of Young Adults,” Centers for Disease Control and Prevention, National Center for Health Statistics, February 18, 2009. For highlights of the report, see http://www.cdc.gov/nchs/pressroom/09newsreleases/hus08.htm.

Fat has been called “the third ovary”: Debbie Clegg, assistant professor of internal medicine, University of Texas Southwestern Medical Center, author interview, November 2008.

girls who reached puberty earlier ate more meat: Imogen S. Rogers et al., “Diet throughout Childhood and Age at Menarche in a Contemporary Cohort of British Girls,” Public Health Nutrition, vol. 13, no. 12 (2010), pp. 2052-2063.

“The nutritional factor consistently associated with timing of puberty”: Frank Biro, director of adolescent medicine, Cincinnati Children’s Hospital, author interview, July 2009.

Pubic hair is influenced more by adrenal hormones: Parent et al., “Timing of Normal Puberty,” p. 668.

In a recent Swedish study: Jingmei Li et al., “Effects of Childhood Body Size on Breast Cancer Tumour Characteristics,” Breast Cancer Research, vol. 12, no. 2 (2010), pp. 1-9.

breast-feeding rates in Denmark: For breast-feeding rates, see the Centers for Disease Control and Prevention, Breastfeeding Report Card (2010), at http://www.cdc.gov/breastfeeding/data/reportcard.htm.

women who work under lights on the night shift: Joe Russo and Irma Russo, The Molecular Basis of Breast Cancer: Prevention and Treatment (Berlin: Springer-Verlag, 2003), p. 5.

Studies have found that girls with precocious puberty: Steingraber, “Falling Age of Puberty in U.S. Girls,” p. 37.

it’s been documented that girls not living with a biological father: For example, see Julianna Deardorff et al., “Father Absence, Body Mass Index, and Pubertal Timing in Girls: Differential Effects by Family Income and Ethnicity,” Journal of Adolescent Health, vol. 48, no. 5 (2011), pp. 441-447.

Female elephants do something similar: In zoos, elephants reach maturity at age eleven, compared to sixteen to eighteen in the wild. Unfortunately for them, it doesn’t always translate into higher fertility; see http://buzzle.com/editorials/10-22-2002-28715.asp. Wildlife biologists Mark and Delia Owens documented an eight-year-old female with a newborn in a region of Zambia that had been heavily hunted by ivory poachers. The mother, an orphan with no guiding adults, was “not a good mother.” Recounted in Mark Owens and Delia Owens, Secrets of the Savannah (New York: Houghton Mifflin, 2006), p. 133.

families are actually slightly more stable: Lise Aksglaede, author interview, July 2009.

the once-rare birth defect of undescended testicles: Leonard J. Paulozzi, “International Trends in Rates of Hypospadias and Cryptorchidism,” Environmental Health Perspectives, vol. 107, no. 4 (April 1999), pp. 297-302.

In a study of 1,600 babies born between 1997 and 2001: Katharina M. Main et al., “Larger Testes and Higher Inhibin B Levels in Finnish Than in Danish Newborn Boys,” Journal of Clinical Endocrinology and Metabolism, vol. 91, no. 7 (2006), pp. 2732-2737. For more on male genital defects and possible environmental links, see Florence Williams, “The Little Princes of Denmark,” Slate, February 24, 2010, available at http://www.slate.com/articles/double_x/doublex_health/2010/02/the_little_princes_of_denmark.html.

“In the first photo, a four-and-a-half-year-old girl”: Orville Schell, Modern Meat: Antibiotics, Hormones, and the Pharmaceutical Farm (New York: Vintage, 1985), p. 283.

One study did find unusually high levels of phthalates: Ivelisse Colon et al., “Identification of Phthalate Esters in the Serum of Young Puerto Rican Girls with Premature Breast Development,” Environmental Health Perspectives, vol. 108, no. 9 (September 2000), pp. 895-900.

recently linked to genital abnormalities: Shanna H. Swan et al., “Decrease in Anogenital Distance among Male Infants with Prenatal Phthalate Exposure,” Environmental Health Perspectives, vol. 113, no. 8 (August 2005), pp. 1056-1061; S. H. Swan et al., “Prenatal Phthalate Exposure and Reduced Masculine Play in Boys,” International Journal of Andrology, vol. 33, no. 2 (April 2010), pp. 259-269; Shanna H. Swan, “Environmental Phthalate Exposure in Relation to Reproductive Outcomes and Other Health Endpoints in Humans,” Environmental Research, vol. 108, no. 2 (August 11, 2008), pp. 177-184.

Girls in New York City: Mary S. Wolff et al., “Investigation of Relationships between Urinary Biomarkers of Phytoestrogens, Phthalates, and Phenols and Pubertal Stages in Girls,” Environmental Health Perspectives, vol. 118, no. 7 (July 2010), pp. 1039-1046.

When the BCERC researchers in Cincinnati: Susan Pinney, Department of Environmental Health, University of Cincinnati College of Medicine, author interview, September 2011.

A newspaper in Taiwan: Shelley Huang, “Smell May Indicate Plasticizers: Experts,” Taipei Times, June 6, 2011.

sniffed it out in everything: Environmental Working Group, “Pesticide in Soap, Toothpaste and Breast Milk—Is It Kid-Safe?” Washington, D.C., July 17, 2008; see also Antonia M. Calafat et al., “Urinary Concentrations of Triclosan in the U.S. Population: 2003-2004,” Environmental Health Perspectives, vol. 116, no. 3 (March 2008), pp. 303-307.

“have become ubiquitous in the environment”: Dominique J. Williams, Division of Health Sciences, U.S. Consumer Product Safety Commission, “Toxicity Review of Di-n-butyl Phthalate,” staff assessment memo, April 7, 2010, available at www.cpsc.gov/about/cpsia/toxicityDBP.pdf. See also Susan M. Duty et al., “The Relationship between Environmental Exposures to Phthalates and DNA Damage in Human Sperm Using the Neutral Comet Assay,” Environmental Health Perspectives, vol. 111, no. 9 (July 2003), pp. 1164-1169; and Mary S. Wolff et al., “Pilot Study of Urinary Biomarkers of Phytoestrogens, Phthalates, and Phenols in Girls,” Environmental Health Perspectives, vol. 115, no. 1 (January 2007), pp. 116-121. For more information about levels of these chemicals in the general U.S. population, see the Centers for Disease Control and Prevention, Fourth National Report on Human Exposure to Environmental Chemicals, July 2010, available at http://www.cdc.gov/exposurereport/.

It has been associated with liver toxicity: See Centers for Disease Control and Prevention, “Chemical Information: Di-2-ethylhexyl Phthalate,” National Report on Human Exposure to Environment Chemicals, November 15, 2010, available at www.cdc.gov/exposurereport/pdf/FourthReport.pdf.

“The results were rather striking to us”: G. D. Bittner et al., “Most Plastic Products Release Estrogenic Chemicals: A Potential Health Problem That Can Be Solved,” Environmental Health Perspectives, vol. 119, no. 7 (2011), pp. 989-996.

Some scientists argue that in addition to our genome: For example, see Christopher Paul Wild, “Complementing the Genome with an ‘Exposome’: The Outstanding Challenge of Environmental Exposure Measurement in Molecular Epidemiology,” Cancer Epidemiology, Biomarkers and Prevention, vol. 14, no. 8 (2005), pp. 1847-1850.

atomic bombs dropped on Hiroshima and Nagasaki: On breast cancer rates among Hiroshima and Nagasaki bomb survivors, see Masayoshi Tokunaga et al., “Incidence of Female Breast Cancer among Atomic Bomb Survivors, 1950-1985,” Radiation Research, vol. 182, no. 2 (1994), pp. 209-223.

Women with the BRCA genes: Nancy Langston, Toxic Bodies: Hormone Disruptors and the Legacy of DES (New Haven, Conn.: Yale University Press, 2010), p. 12.

“ecological disorder”: Steingraber, “Falling Age of Puberty in U.S. Girls,” p. 59.

recent experiments with adolescent rats: For research on fat and inflammation in adolescent mice, see Sandra Z. Haslam, “Is There a Link between a High-Fat Diet during Puberty and Breast Cancer Risk?” Women’s Health, vol. 7, no. 1 (2011), pp. 1-3.

Forty-four percent of TV ads: Charles Atkins, professor, Department of Communications, Michigan State University, author interview, November 2008.

CHAPTER 7 • THE PREGNANCY PARADOX

“The beginning is glorious”: Nora Ephron, Heartburn (New York: Knopf, 1983), p. 45.

a woman who has her first child before age twenty: National Cancer Institute Fact Sheet, “Reproductive History and Breast Cancer Risk,” May 10, 2011, available at http://www.cancer.gov/cancertopics/factsheet/Risk/pregnancy.

in the 1930s the average age: Associated Press, “Age Increases for Motherhood,” St. Petersburg Times, December 2, 1948.

Before 1960, nearly one-third of American females: “Teen Pregnancy,” Encyclopedia of Children and Childhood in History and Society, 2008, at http://www.faqs.org/childhood/So-Th/Teen-Pregnancy.html.

Since 1970, the percentage of women: T. J. Mathews and Brady E. Hamilton, “Delayed Childbearing: More Women Are Having Their First Child Later in Life,” National Center for Health and Statistics Data Brief, no. 21 (August 2009), available at http://www.cdc.gov/nchs/data/databriefs/db21.pdf.

Lakshmanaswamy envisions a hormone patch: Raj Lakshmanaswamy, assistant professor of pathology, Texas Tech University Health Sciences Center, author interview, September 30, 2010.

developing a fake-pregnancy drug: As you might imagine, the idea of giving healthy women large doses of hormonal drugs to prevent a disease they might never get is still extremely controversial. Of course, millions of healthy women are already taking hormones—witness the pill. In another scheme, Malcolm Pike has been thinking for years about how to incorporate his cancer-protection ideas into a contraceptive device. Pike wants to essentially “fix” the pill so that it prevents breast cancer at the same time that it prevents pregnancy. “The amazing thing is that tens of millions of women took the pill this morning,” he says. “If only one could get it right, one could get at the disease.” Rather than a pill mimicking pregnancy in order to work, though, Pike envisions a better pill as more closely mimicking menopause. Currently, the pill stops ovulation, which is good for preventing cancer. But then the pill essentially replaces all those natural hormones, which is not good. Pike wants to stop ovulation by a different route, by blocking an upstream hormonal signal from the hypothalamus called gonadotropin-releasing hormone, or GnRH. Then he’d put back only a small amount of the lost estrogen and progesterone, just enough to keep women from feeling like crones, but not enough to stimulate breast or uterine cells. Problematically, GnRH is a peptide and would break down in the stomach if taken as a pill, so Pike has imagined this anticancer elixir as a nasal spray. He had the whole spritzing device packaged and ready to bring to market about ten years ago, but he couldn’t get any investors or pharmaceutical companies to bite. “The best thing I ever did was to propose adding a third component to the pill,” he now reminisces. “I still have to find a pharmaceutical company that would be willing to market it and that’s a big if. I still think something like this is the way to go. Stop ovulation. Some way. It won’t happen in my lifetime. We’ll sort it out; it’s just slow.”

Janet Daling published results: Janet R. Daling et al., “Risk of Breast Cancer among Young Women: Relationship to Induced Abortion,” Journal of the National Cancer Institute, vol. 86, no. 21 (1994), pp. 1584-1592.

Pro-life groups even sought legal action: Chinué Turner Richardson et al., “Misinformed Consent: The Medical Accuracy of State-Developed Abortion Counseling Materials,” Guttmacher Policy Review, vol. 9, no. 4 (2006), pp. 6-11.

“was wonderfully rapid and its course excessively malignant”: Samuel Weissel Gross, A Practical Treatise on Tumors of the Mammary Gland (New York: D. Appleton, 1880), p. 146.

A study in 2011 found that the more times a woman gives birth: Amanda I. Phipps et al., “Reproductive History and Oral Contraceptive Use in Relation to Risk of Triple-Negative Breast Cancer,” Journal of the National Cancer Institute, vol. 103, no. 6 (2011), pp. 470-477.

In the United States, about 3,500 cases: Karen Hassey Dow, “Pregnancy and Breast Cancer,” Journal of Obstetric, Gynecologic, and Neonatal Nursing, vol. 29, no. 6 (2000), pp. 634-640.

CHAPTER 8 • WHAT’S FOR DINNER?

“First we nursed our babies”: Mary McCarthy, The Group (New York: Harcourt, Brace, 1991), p. 291.

“crawl” to the nipple: Marshall Klaus has written a nice description of the breast crawl in the journal Pediatrics: “While moving up, he often turns his head from side to side. As he comes close to the nipple, he opens his mouth widely and, after several attempts, makes a perfect placement on the areola of the nipple.” In addition to visual cues, scent also plays a major role in the crawl. If the right breast is washed with soap and water, the infant will crawl to the left breast and vice versa. Marshall Klaus, “Mother and Infant: Early Emotional Ties,” Pediatrics, vol. 102, no. 5 (1998), pp. 1244-1246.

Breast-feeding may have helped the species evolve: Before the recent dawn of antibiotics, many women died shortly after childbirth, not only from puerperal fever (a post-hemorrhage infection of the genital tract), but also from “milk fever,” or breast infections. To help prevent dangerously engorged breasts, sometimes small puppies were brought in to suck off the milk (I kid you not). Women also applied “suction cups” to each other. For more in this vein, read Valerie Fildes’s excellent Breasts, Bottles and Babies: A History of Infant Feeding (Edinburgh: Edinburgh University Press, 1986).

“slight sleepiness, euphoria”: Klaus, “Mother and Infant.”

It was the late 1960s: Penny Van Esterik, “The Politics of Breastfeeding,” in Stuart-Macadam and Dettwyler (eds.), Breastfeeding, p. 149.

Archaeologists have found four-thousand-year-old graves: Tina Cassidy, Birth: The Surprising History of How We Are Born (Boston: Beacon Press, 1999), p. 235.

the tight corsets of the Restoration: Fildes, Breasts, Bottles and Babies, p. 102.

“while taking every precaution”: Plato, quoted in Naomi Baumslag and Dia Michels, Milk, Money, and Madness: The Culture and Politics of Breastfeeding (Westport, Conn.: Bergin & Garvey, 1995), p. 40.

“If a man has given his son to a wet-nurse”: Quoted from C. H. W. Johns, Babylonian and Assyrian Laws and Letters (Edinburgh: T&T Clark, 1904), p. 61.

Even today, a child born in a developing country: Baumslag and Michels, Milk, Money, and Madness, p. 8.

mortality rates reached 50 percent: Claire Tomalin, Jane Austen: A Life (New York: Knopf, 1997), pp. 7-9.

Jane Austin’s story: Tomalin, Jane Austen, pp. 7-9.

Some sources claim this is where the term farmed out: Baumslag and Michels, Milk, Money, and Madness, p. 46.

“the bread and butter”: For this quote by John Keating and a good overview of the early days of pediatrics, see Rima D. Apple, Mothers and Medicine: A Social History of Infant Feeding, 1890-1950 (Madison: University of Wisconsin Press, 1987), p. 55ff.

“good Swiss milk and bread”: As quoted in Apple, Mothers and Medicine, p. 9.

rise of germ theory: For a good discussion of this and its influence in separating humans from nature, see Linda Nash’s Inescapable Ecologies: A History of Environment, Disease and Knowledge (Berkeley: University of California Press, 2006).

mother was sent home with a pat on the back: “Infant Food, Nestle’s Lactogen,” National Museum of American History, at http://ameri canhistory.si.edu/collections/object.cfm?key=35&objkey=110 (accessed October 12, 2011).

“It just didn’t seem fair”: Marian Thompson, quoted in Margot Edwards and Mary Waldorf, Reclaiming Birth: History and Heroines of American Childbirth Reform (Trumansburg, N.Y.: Crossing Press, 1984), p. 88.

“You didn’t mention ‘breast’ in print”: Edwina Froehlich, quoted in Emily Bazelon, “Founding Mothers: Edwina Froehlich, b. 1915,” New York Times, December 23, 2008.

In Ghana, only 4 percent of women: Laurie Nommsen-Rivers, research assistant professor, Cincinnati Children’s Hospital Medical Center, author interview, October 2010. For Sacramento rates, see Nommsen-Rivers, “Delayed Onset of Lactogenesis among First-Time Mothers Is Related to Maternal Obesity and Factors Associated with Ineffective Breastfeeding,” Journal of Clinical Nutrition, vol. 92, no. 3 (2010), pp. 574-584.

the activists asserting we’re in the midst of “a biocultural crisis”: Dettwyler, “Beauty and the Breast,” p. ix.

“And in any case, if a breast-feeding mother”: Hanna Rosin, “The Case against Breast-Feeding,” Atlantic, April 2009, accessed online at http://www.theatlantic.com/magazine/archive/2009/04/the-case-against-breast-feeding/7311/.

formula confers the same average loss in points: Herbert L. Needleman et al., “Deficits in Psychological and Classroom Performance of Children with Elevated Dentine Lead Levels,” New England Journal of Medicine, vol. 300, no. 3 (1970), pp. 679-695.

Two major reviews of the literature: Christopher G. Owen et al., “Effect of Infant Feeding on the Risk of Obesity across the Life Course: A Quantitative Review of Published Evidence,” Pediatrics, vol. 115, no. 5 (2005), pp. 1367-1377; and S. Arenz, “Breast-Feeding and Childhood Obesity—A Systematic Review,” International Journal of Obesity, vol. 28 (2004), pp. 1247-1256.

CHAPTER 9 • HOLY CRAP

“O, thou with the beautiful face”: Susruta Samhita, quoted in Valerie Fildes, Breast, Bottles and Babies: A History of Infant Feeding (Edinburgh: Edinburgh University Press, 1986), p. 14.

equivalent of one thousand light trucks: Daniel W. Sellen, “Evolution of Infant and Young Child Feeding: Implications for Contemporary Public Health,” Annual Review of Nutrition, vol. 27 (2007), pp. 123-148. Also, see A. M. Prentice and Ann Prentice, “Energy Costs of Lactation,” Annual Review of Nutrition, vol. 8 (1988), pp. 63-79.

“Breastfeeding is a form of matrotropy”: Sandra Steingraber, Having Faith: An Ecologist’s Journey to Motherhood (Cambridge, Mass.: Perseus, 2001), p. 214. (Note, the more conventional spelling for this is matrotrophy.)

In the old days, people used to measure milk output: In fact, some doctors told women the only way to be absolutely certain their babies were getting enough to eat was to weigh them before and after every feed, including the two-in-the-morning one. It was another highly effective incentive to switch to formula.

In a paper describing the work: Jacqueline C. Kent et al., “Breast Volume and Milk Production during Extended Lactation in Women,” Experimental Physiology, vol. 84 (1999), pp. 435-447.

In addition to recruiting the good bugs, these sugars prevent the bad bugs: A quick word about the use here of “good” and “bad” bacteria. As scientists learn more about the role of microflora in our bodies, these terms appear somewhat reductive because what the scientists really mean is the overall healthful balance of bugs. I continue to use these terms, though, because that is the way people described them to me and it still seems apt enough when talking about the role of milk sugars and microbes.

a dreadful disease called NEC: Information on NEC and premature babies from Lars Bode, assistant professor of pediatrics, University of California, San Diego, author interview, October 2010.

“We’ll take little tiny droplets of milk”: Video by CBS/ Smartplanet. com, August 26, 2010, can be accessed at http://www.smartplanet.com/video/is-the-cure-for-cancer-inside-milk/460136.

There are ten times more microbacteria in our guts: Roderick I. Mackie et al., “Developmental Microbial Ecology of the Neonatal Gastrointestinal Tract,” American Journal of Clinical Nutrition, vol. 69, no. 5 (1999), pp. 1035S-1045S.

Nearly a billion people don’t live near clean drinking water: World Health Organization, “Global Health Observatory: Use of Improved Drinking Water Sources,” available at http://www.who.int/gho/mdg/environmental_sustainability/water_text/en/index.html (accessed October 2011).

One Japanese company: For information on this and other products being developed with lactoferrin and marketed, and the economic analysis, see Vadim V. Sumbayev et al. (eds.), Proceedings of the World Medical Conference: Malta, September 15-17, 2010 (Stevens Point, Wisc.: WSEAS Press, 2010), available at http://www.wseas.us/e-library/conferences/2010/Malta/MEDICAL/MEDICAL-00.pdf.

HAMLET kills forty different types of cancer cells in a dish: Catharina Svanborg et al., “Hamlet Kills Tumor Cells by an Apoptosis-like Mechanism—Cellular, Molecular and Therapeutic Aspects,” Advances in Cancer Research, vol. 88 (2003), pp. 1-29.

several studies found: For example, see X. O. Shu et al., “Breastfeeding and Risk of Childhood Acute Leukemia,” Journal of the National Cancer Institute, vol. 91, no. 20 (1999), pp. 1765-1772; for a more recent (and somewhat less enthusiastic) review of this literature, see Jeanne-Marie Guise et al., “Review of Case-Control Studies Related to Breastfeeding and Risk of Childhood Leukemia,” Pediatrics, vol. 116, no. 5 (2005), pp. e724 -e731.

donor milk is used mostly in neonatal intensive care units: For

an interesting discussion of markets for breast milk, see Linda C. Fentiman, “Marketing Mothers’ Milk: The Commodification of Breastfeeding and the New Markets in Human Milk and Infant Formula,” Nevada Law Journal (2009), available at Pace Law Faculty Publications, Paper 566: http://digitalcommons.pace.edu/lawfaculty/566.

mothers of sons produced fatter, more-energy-dense milk: Katherine Hinde, “Richer Milk for Sons but More Milk for Daughters: Sex-Biased Investment during Lactation Varies with Maternal Life History in Rhesus Macaques,” American Journal of Human Biology, vol. 21, no. 4 (2009), pp. 512-519. Also, Katherine Hinde, author interview, December 2010.

Babies have evolved their own tricks: David Haig, “Genetic Conflicts in Human Pregnancy,” Quarterly Review of Biology, vol. 68, no. 4 (December 1993), pp. 495-532; Sarah Blaffer Hrdy, Mother Nature: Maternal Instincts and How They Shape the Human Species (New York: Ballantine Books, 1999), pp. 430-441.

When the baby is older than one year: Dror Mandel et al., “Fat and Energy Contents of Expressed Human Breast Milk in Prolonged Lactation,” Pediatrics, vol. 116, no. 3 (2005), pp. e432-e435.

After the terrorist attacks of 9/11: Sandra Steingraber, Raising Elijah (Philadelphia: Da Capo Press, 2011), p. 19.

A mother loses up to 6 percent of her calcium: J. M. Lopez, “Bone Turnover and Density in Healthy Women during Breastfeeding and after Weaning,” Osteoporosis International, vol. 6, no. 2 (1996), pp. 153-159.

“I was storing some of my milk”: Eleanor “Bimla” Schwarz, assistant professor of medicine, epidemiology, obstetrics, gynecology, and reproductive sciences, University of Pittsburgh, author interview, October 2010.

humans are the only primates: Daniel W. Sellen, “Evolution of Infant and Young Child Feeding: Implications for Contemporary Public Health,” Annual Review of Nutrition, vol. 27 (2007), pp. 123-148.

“a pattern known to be optimal”: Daniel W. Sellen, Canada Research Chair in Human Ecology and Public Health Nutrition, University of Toronto, author interview, October 2010.

a recent paper of his: Sellen, “Evolution and Infant Young Child Feeding.”

the very stuff itself is oddly compromised: For an interesting discussion of how the profile of milk fats has changed due to the omega-6-dominant Western diet, see Erin E. Mosley, Anne L. Wright, Michelle K. McGuire, and Mark A. McGuire, “Trans Fatty Acids in Milk Produced by Women in the United States,” American Journal of Clinical Nutrition, vol. 82, no. 6 (2005), pp. 1292-1297.

CHAPTER 10 • SOUR MILK

“To recognize milk which is bad”: Ebers Papyrus, quoted in Valerie Fildes, Breasts, Bottles and Babies: A History of Infant Feeding (Edinburgh: Edinburgh University Press, 1986), p. 5.

“Today, polyurethanes can be found in virtually everything”: “History,” Centers for the Polyurethanes Industry, Polyeurethane. org, available at http://www.polyurethane.org/s_api/sec.asp?cid=853&did=3487 (accessed October 2011).

A typical home filled with polyurethane products”: Bob Luedeka, executive director, Polyurethane Foam Association, author interview, August 2011.

It’s questionable whether or not these substances: Y. Babrauskas et al., “Flame Retardants in Furniture Foam: Benefits and Risks,” Fire Safety Science Proceedings, 10th International Symposium, International Association for Fire Safety Science (2011, pending publication).

Most deaths in fires are caused: Centers for Disease Control and Prevention, “Fire Deaths and Injuries: Fact Sheet,” October 1, 2010, available at www.cdc.gov/HomeandRecreationalSafety/Fire-Prevention/fires-factsheet.html.

They accumulate more toxins than other organs: France P. Labreche, “Exposure to Organic Solvents and Breast Cancer in Women: A Hypothesis,” American Journal of Industrial Medicine, vol. 32 (1997), pp. 1-14.

Morton Biskind examined a pregnant woman: Morton Biskind et al., “DDT Poisoning: A New Syndrome with Neuropsychiatric Manifestations,” American Journal of Psychotherapy, vol. 3, no. 2 (1949), pp. 261-270; Morton S. Biskind, “Statement on Clinical Intoxication from DDT and Other New Insecticides,” presented before the Select Committee to Investigate the Use of Chemicals in Food Products, United States House of Representatives, December 12, 1950, Westport, Conn., published in the Journal of Insurance Medicine, vol. 6, no. 2 (March-May 1951), pp. 5-12.

finding DDT in the milk: For a great overview of the problem, see Steingraber, Having Faith, p. 252. The 1951 study by E. P. Laug is recounted in “DDT and Its Derivatives,” published by the United Nations Environmental Programme and the World Health Organization in 1979, available at http://www.inchem.org/documents/ehc/ehc/ehc009.htm.

Researchers in the Great Lakes region: one of the most famous studies is Joseph L. Jacobson and Sandra W. Jacobson, “Intellectual Impairment in Children Exposed to Polychlorinated Biphenyls in Utero,” New England Journal of Medicine, vol. 335 (1996), pp. 783-789.

animal poisoning in Michigan in 1974:Åke Bergman, “The Abysmal Failure of Preventing Human and Environmental Exposure to Persistent Brominated Flame Retardants: A Brief Historical Review of BRFs,” in Mehran Alaee et al. (eds.), Commemorating 25 Years of Dioxin Symposia (Toronto: Twenty-fifth Dioxin Committee, 2005), pp. 32-40. Also see Joyce Egginton, The Poisoning of Michigan (East Lansing: Michigan State University Press, 1980).

In the years that followed: For the long-term effects in the people exposed in the Michigan case, see Heidi Michels Blanck et al., “Age at Menarche and Tanner Stage in Girls Exposed in Utero and Postnatally to Polybrominated Biphenyl,” Epidemiology, vol. 11, no. 6 (2000), pp. 641-671. Also, Michele Marcus, Pediatric Environmental Health Specialty Unit, Rollins School of Public Health, Emory University, author interview, November 2010.

at 36 parts per billion: Arnold Schecter, professor of environmental and occupational health sciences, University of Texas School of Public Health, author interview, September 2004.

In humans as well as rodents: For example, see Ami R. Zota, “Polybrominated Diphenyl Ethers (PBDEs), Hydroxylated PBDEs (OH-PBDEs), and Measures of Thyroid Function in Second Trimester Pregnant Women in California,” Environmental Science and Technology, published online, August 10, 2011.

In 2010, researchers in New York found: Julie Herbstman, “Prenatal Exposure to PBDEs and Neurodevelopment,” Environmental Health Perspectives, vol. 118, no. 5 (May 2010), pp. 712-719.

A recent study found that California women: Kim G. Harley et al., “PBDE Concentrations in Women’s Serum and Fecundability,” Environmental Health Perspectives, vol. 118, no. 5 (May 2010), pp. 699-704.

A Danish study showed an association: Katharina Maria Main et al., “Flame Retardants in Placenta and Breast Milk and Cryptorchidism in Newborn Boys,” Environmental Health Perspectives, vol. 115, no. 10 (October 2007), pp. 1519-1526.

breast-fed infants and toddlers have considerably higher levels: Daniel Carrizo et al., “Influence of Breastfeeding in the Accumulation of Polybromodiphenyl Ethers during the First Years of Child Growth,” Environmental Science and Technology, vol. 41, no. 14 (2007), pp. 4907-4912.

Some studies have found that breast-fed babies: For example, see Jacobson and Jacobson, “Intellectual Impairment in Children Exposed to Polychlorinated Biphenyls in Utero,” pp. 783-789.

Recent studies show that lactating mothers off-load: Kim Hooper et al., “Depuration of Polybrominated Diphenyl Ethers (PBDEs) and Polychlorinated Biphenyls (PCBs) in Breast Milk from California First-Time Mothers (Primiparae),” Environmental Health Perspectives, vol. 115, no. 9 (September 2007), pp. 1271-1275.

For other chemicals, the dump rate is even higher: As cited in Hooper et al., “Depuration of Polybrominated Diphenyl Ethers.”

Mothers who breast-feed for a year: Cathrine Thomsen et al., “Changes in Concentrations of Perfluorinated Compounds, Poly brominated Diphenyl Ethers, and Polychlorinated Biphenyls in Norwegian Breast-Milk during Twelve Months of Lactation,” Environmental Science and Technology, vol. 44, no. 24 (2010), pp. 9550-9556.

“likely to be carcinogenic in humans”: Kyle Steenland et al., “Epidemiologic Evidence on the Health Effects of Perfluorooctanoic Acid (PFOA),” Environmental Health Perspectives, vol. 118, no. 8 (August 2010), pp. 1100-1108.

Adult female striped and bottlenose dolphins are actually the “purest”: Jennifer E. Yordy et al., “Life History as a Source of Variation for Persistent Organic Pollutant (POP) Patterns in a Community of Common Bottlenose Dolphins (Tursiops truncatus) Resident to Sarasota Bay, FL,” Science of the Total Environment, vol. 408, no. 9 (2010), pp. 2163-2172.

I decided to start with my house dust: Chemical analysis of my house dust was done by Heather Stapleton, assistant professor of environmental chemistry, Nicholas School of the Environment and Earth Sciences, Duke University; author interview, December 2010.

seventy-six new and suspect flame-retardants: Jacob de Boer, “Editorial: Special Issue: Contaminants in Food—Brominated Flame Retardants,” Molecular Nutrition and Food Research, vol. 52, no. 2 (2008), pp. 185-186.

CHAPTER 11 • AN UNFAMILIAR WILDERNESS

“Brave new world”: American Heritage Dictionary of the English Language, 4th ed., available at http://www.wordnik.com/words/brave%20new%20world (accessed October 2011).

“Walking today in an unfamiliar biochemical wilderness”: James S. Olson, Bathsheba’s Breast: Women, Cancer, and History (Baltimore: Johns Hopkins University Press, 2002), p. 240.

Globally, breast cancer is the leading cause: F. Kamangar et al., “Patterns of Cancer Incidence, Mortality, and Prevalence across Five Continents: Defining Priorities to Reduce Cancer Disparities in Different Geographic Regions of the World,” Journal of Clinical Oncology, vol. 24 (2006), pp. 2137-2150.

“omnis cellula e cellula”: Rudolf Ludwig Karl Virchow, Die Cellularpathologie in ihrer Begründung auf physiologische und pathologische Gewebelehre (Berlin: A. Hirschwald, 1858).

Humans are just about the only free-ranging animal: Susan Love, clinical professor of surgery, David Geffen School of Medicine, University of California, Los Angeles, and president, Dr. Susan Love Research Foundation, author interview, March 2009.

Domestic pets, if not spayed, get it: Mel Greaves, Cancer: The Evolutionary Legacy (New York: Oxford University Press, 2001), p. 210.

Among the Kaingang women in Paraná, Brazil: This is according to Edimara Patrícia da Silva et al., “Exploring Breast Cancer Risk Factors in Kaingáng Women in the Faxinal Indigenous Territory, Paraná State, Brazil, 2008,” Cadernos de Saúde Pública, vol. 25, no. 7 (2009), pp. 1493-1500.

One papyrus recommends applying a plaster: James V. Ricci, The Genealogy of Gynaecology: History of the Development of Gynaecology through the Ages (Philadelphia: Blakiston, 1943), p. 20, as cited in Marilyn Yalom, A History of the Breast (New York: Knopf, 1997), p. 206.

Anne of Austria, the mother of King Louis XIV: Yalom, History of the Breast, p. 217.

De Morbis Artificum Diatriba: Bernardino Ramazzini, De Morbis Artificum Diatriba (London: Printed for Andrew Bell et al., 1705), pp. 122-123.

“Childless women get it / And men when they retire”: W. H.

Auden, “Miss Gee” (1937), published in Another Time (New York: Random House, 1940).

woman’s tumor was sometimes a different size: Olson, Bathsheba’s Breast, p. 77.

“I am satisfied that in the ovary”: George Thomas Beatson, quoted in Olson, Bathsheba’s Breast, p. 78.

breast cancer rates in the United States: For breast cancer statistics, see “SEER Stat Fact Sheets: Breast,” at http://seer.cancer.gov/statfacts/html/breast.html.

he headed to Hiroshima: For an excellent description of Malcolm Pike in Hiroshima, see Malcolm Gladwell, “John Rock’s Error,” New Yorker, March 13, 2000, pp. 52-63.

As early as the 1930s, scientists: Olson, Bathsheba’s Breast, p. 178.

tufted-ear marmosets: See Sarah Blaffer Hrdy, Mothers and Others: The Evolutionary Origins of Mutual Understanding (Cambridge, Mass.: Belknap Press, 2009), pp. 92-97.

“Not in our wildest dreams”: Carl Djerassi, The Pill, Pygmy Chimps and Degas’ Horse (New York: Basic Books, 1992), p. 58.

“Estrogen is to cancer what fertilizer”: Roy Hertz, quoted in Olson, Bathsheba’s Breast, p. 178.

“Your problems are too complicated”: Djerassi, Pill, Pygmy Chimps and Degas’ Horse, p. 135.

to make human breast cancer cells grow faster: Brian E. Henderson et al., “Endogenous Hormones as a Major Factor in Human Cancer,” Cancer Research, vol. 42 (1982), pp. 3232-3239.

progesterone is just as bad, and possibly worse: Sandra Haslam, a physiologist from Michigan State University, has been studying the nefarious effects of progesterone on mammary glands for years. “We’ve been pointing the finger at the wrong hormone all these years,” she told me (author interview, July 2011).

They ovulate approximately one hundred times: Beverly I. Strassmann, “Menstrual Cycling and Breast Cancer: An Evolutionary Perspective,” Journal of Women’s Health, vol. 8, no. 2 (March 1999), pp. 193-202.

Today in America, nearly 20 percent of women: Jane Lawler Dye, “Fertility of American Women: 2006,” Current Population Reports, U.S. Census Bureau, August 2008, available at www.census.gov/prod/2008pubs/p20-558.pdf.

a marketing article from the University of Southern California: Alfred Kildow, “The Dashing Malcolm Pike,” USC Health Magazine, Summer 1996, available at http://www.usc.edu/hsc/info/pr/hmm/96summer/pike.html (accessed October 2011).

Captive tigers and lions also suffer: Greaves, Cancer, p. 210.

By 1992, Premarin: Kathryn Huang and Megan Van Aelstyn, presentation of a Notre Dame case study, “Hormone Replacement Therapy and Wyeth,” available at http://www.awpagesociety.com/images/uploads/Wyeth-Powerpoint.ppt (accessed October 2011).

“I think of the menopause as a deficiency disease”: Quoted in Jane E. Brody, “Physicians’ Views Unchanged on Use of Estrogen Therapy,” New York Times, December 5, 1975.

“living decay”: Robert Wilson, quoted in Gary Null and Barbara Seaman, For Women Only (Toronto: Seven Stories Press, 1999), p. 751.

women “rich in estrogen”: Robert Wilson, from Feminine Forever (1966), as quoted in Olson, Bathsheba’s Breast, p. 181.

anthropologist Sarah Blaffer Hrdy: On caloric requirements of children, see Hrdy, Mothers and Others, p. 31. For a discussion of the grandmother hypothesis, see pp. 241-243.

Estrogen, miracle hormone that it is: Karen J. Carlson, Stephanie A. Eisenstat, and Terra Ziporyn, The New Harvard Guide to Women’s Health (Cambridge, Mass.: Belknap Press, 2004), p. 375.

Million Women Study: For general information on the Million Women Study, see http://www.millionwomenstudy.org/.

The main culprit appeared to be progesterone: The risk of estrogen alone to breast cancer is confusing and under discussion. While the Million Women Study found a 66 percent higher risk for women taking estrogen alone, a more recent study found that it was actually moderately protective against breast cancer in women with hysterectomies. It still, however, found an increased risk of stroke. See A. Z. LaCroix et al., “Health Outcomes after Stopping Conjugated Equine Estrogens among Postmenopausal Women with Prior Hysterectomy: A Randomized Controlled Trial,” Journal of the American Medical Association, vol. 305 (2011), pp. 1305-1314.

Overall, hormone therapy in Britain caused: V. Beral et al., “Breast Cancer and Hormone-Replacement Therapy in the Million Women Study,” Lancet, no. 362 (2003), pp. 419-427.

CHAPTER 12 • THE FEW. THE PROUD. THE AFFLICTED.

“Do unto those downstream”: Wendell Berry, Citizenship Papers (Berkeley: Shoemaker & Hoard, 2003), p. 214.

Although the military knew: Agency for Toxic Substances and Disease Registry, “Analyses and Historical Reconstruction of Groundwater Flow, Contaminant Fate and Transport, and Distribution of Drinking Water within the Service Areas of the Hadnot Point and Holcomb Boulevard Water Treatment Plants and Vicinities, U.S. Marine Corps Base Camp Lejeune, North Carolina, Chapter C: Occurrence of Selected Contaminants in Groundwater at Installation Restoration Program Sites,” October 2010, p. C7.

At that time, analysis from one well: Agency for Toxic Substances and Disease Registry, “Analyses and Historical Reconstruction of Groundwater Flow, Contaminant Fate and Transport, and Distribution of Drinking Water,” p. C94.

Tap water at the elementary school: Camp Lejeune Water System analysis document for dichloroethylene and trichloroethylene, North Carolina Department of Human Resources, Division of Health Services, Occupational Health Laboratory, February 4, 1985, analyzed and signed by John L. Neal.

TCE alone has been detected: Agency for Toxic Substances and Disease Registry, “Toxic Substances Portal—Trichloroethylene (TCE),” July 2003, at http://www.atsdr.cdc.gov/toxfaqs/tf.asp?id=172&tid=30.

present in 34 percent of the nation’s drinking water: President’s Cancer Panel, Reducing Environmental Cancer Risk: What We Can Do Now, 2008-2009 Annual Report, National Cancer Institute, April 2010, p. 33, available at http://deainfo.nci.nih.gov/advisory/pcp/annualReports/index.htm.

In September 2011, the EPA formally reclassified TCE: For the EPA’s assessment report, released September 29, 2011, see http://www.epa.gov/iris/supdocs/0199index.html.

is still used by most dry-cleaners: Ray Smith, “The New Dirt on Dry Cleaners,” Wall Street Journal, July 28, 2011.

once used as an aftershave: Christopher Portier, director, Agency for Toxic Substances and Disease Registry, author interview, July 2011.

One recent European study: Sara Villeneuve et al., “Occupation and Occupational Exposure to Endocrine Disrupting Chemicals in Male Breast Cancer: A Case—Control Study in Europe,” Occupational and Environmental Medicine, vol. 67, no. 12 (2010), pp. 837-844.

Vinyl chloride has been linked to breast cancer: Peter F. Infante et al., “A Historical Perspective of Some Occupationally Related Diseases in Women,” Journal of Occupational and Environmental Medicine, vol. 36, no. 8 (1994), pp. 826-831. See also S. Villeneuve, “Breast Cancer Risk by Occupation and Industry: Analysis of the CECILE Study, a Population-Based Case-Control Study in France,” American Journal of Industrial Medicine, vol. 54, no. 7 (2011), pp. 499-509.

Another study found a very moderately increased risk: A. Blair et al., “Mortality and Cancer Incidence of Aircraft Maintenance Workers Exposed to Trichloroethylene and Other Organic Solvents and Chemicals: Extended Follow Up,” Journal of Occupational and Environmental Medicine, vol. 55, no. 3 (1998), pp. 161-171.

Some studies found that dry-cleaning workers: P. R. Band et al., “Identification of Occupational Cancer Risks in British Columbia,” Journal of Occupational and Environmental Medicine, vol. 42, no. 3 (2000), pp. 284-310.

other studies found a lower incidence: A. Blair et al., “Cancer and Other Causes of Death among a Cohort of Dry Cleaners,” British Journal of Industrial Medicine, vol. 47, no. 3 (1990), pp. 162-168.

A 1999 study looking at Danish women: Johnni Hansen, “Breast Cancer Risk among Relatively Young Women Employed in Solvent-Using Industries,” American Journal of Industrial Medicine, vol. 36, no. 1 (1999), pp. 43-47.

a set of studies looked at women on Cape Cod: Ann Aschengrau et al., “Perchloroethylene-Contaminated Drinking Water and the Risk of Breast Cancer: Additional Results from Cape Cod, Massachusetts, USA,” Environmental Health Perspectives, vol. 111, no. 2 (February 2003), pp. 167-173.

The American Cancer Society attributes only 2 to 6 percent: Brett Israel, “How Many Cancers Are Caused by the Environment?” Scientific American, May 21, 2010, accessed at http://www.scientificamerican.com/article.cfm?id=how-many-cancers-are-caused-by-the-environment; see also Elizabeth T.H. Fontham, “American Cancer Society Perspectives on Environmental Factors and Cancer,” CA: A Cancer Journal for Clinicians, vol. 59, no. 6 (2009), pp. 343-351.

hot spots for breast cancer: J. Griffith et al., “Cancer Mortality in US Counties with Hazardous-Waste Sites and Ground-Water Pollution,” Archives of Environmental Health, vol. 44 (1989), pp. 69-74.

report released in April 2010: President’s Cancer Panel, Reducing Environmental Cancer Risk.

cancers caused by chemicals have been “grossly underestimated”: Podcast interview with Margaret Kripke, professor of immunology and executive vice president and chief academic officer, University of Texas MD Anderson Cancer Center, February 7, 2011, available at http://www.commonweal.org/new-school/audiofiles/podcast/97_m_kripke_final_w_intro.mp3.

Most of the major breast cancer organizations say: Denise Grady, “U.S. Panel Criticized as Overstating Cancer Risks,” New York Times, May 6, 2010.

they account for little over half of all breast cancers: Hansen, “Breast Cancer Risk among Relatively Young Women.”

CHAPTER 13 • ARE YOU DENSE?

“Death in old age is inevitable”: Richard Doll, quoted in Siddhartha Mukherjee, The Emperor of Maladies (New York: Scribner, 2010), p. 462. Original quote from Richard Peto et al., “Mortality from Smoking Worldwide,” British Medical Bulletin, vol. 52, no. 1 (1996), pp. 12-21.

BRCA genes are most commonly found: Marie E. Wood, “A Clinician’s Guide to Breast Cancer Risk Assessment,” Sexuality, Reproduction and Menopause, vol. 8, no. 1 (2010), pp. 15-20.

Or my grandmothers could have inherited: Susan L. Neuhausen, “Founder Populations and Their Uses for Breast Cancer Genetics,” Breast Cancer Research, vol. 2, no. 2 (2000), pp. 77-81.

In families with histories of breast and ovarian cancer: Greg Gibson, It Takes a Genome: How a Clash between Our Genes and Modern Life Is Making Us Sick (Upper Saddle River, N.J.: FT Press, 2009), p. 30.

The average lifetime risk of breast cancer: “Breast Cancer Risk Assessment Tool,” National Cancer Institute, at http://www.cancer.gov/bcrisktool/RiskAssessment.aspx?current_age=42&age_at_menarche=10&age_at_first_live_birth=30&ever_had_biopsy= 0&previous_biopsies=0&biopsy_with_hyperplasia=0&related_ with_breast_cancer=0&race=1 (accessed October 2011).

mammograms wouldn’t miss 20 percent: National Cancer Institute Factsheet, “Mammograms,” available at http://www.cancer.gov/cancertopics/factsheet/detection/mammograms, accessed October 2011.

Menopausal women taking hormone replacement therapy: Norman Boyd, “Mammographic Density and Breast Cancer Risk: Evaluation of a Novel Method of Measuring Breast Tissue Volumes,” Cancer Epidemiology, Biomarkers and Prevention, vol. 18, no. 6 (2009), pp. 1756-1762.

Some studies show that wine drinkers: C. M. Vachon et al., “Association of Diet and Mammographic Breast Density in the Minnesota Breast Cancer Family Cohort,” Cancer Epidemiology, Biomarkers and Prevention, vol. 9, no. 2 (2000), pp. 151-160.

the equivalent of about two additional breast cancers per year: Denise Grady, “Breast Cancer Seen as Riskier with Hormones,” New York Times, October 19, 2010; see also Peter B. Bach, “Postmenopausal Hormone Therapy and Breast Cancer: An Uncertain Trade-off,” Journal of the American Medical Association, vol. 15, no. 304 (2010), pp. 1719-1720; and Rowan T. Chlebowski et al., “Breast Cancer in Postmenopausal Women after Hormone Therapy—Reply,” Journal of the American Medical Association, vol. 5, no. 305 (2011), pp. 466-467.

“Traditional medicine and public health practices”: Nancy Langston, Toxic Bodies: Hormone Disruptors and the Legacy of DES (New Haven, Conn.: Yale University Press, 2010), p. 149.

Mammograms might work pretty well: Even this statement is open to debate. We assume it to be true, but a recent large study in Europe found little change in mortality in women who received regular mammograms and women who didn’t, and these women were over fifty. Death rates over both categories had improved, but the researchers attributed the change to better treatment, not to better screening. See P. Autier et al., “Breast Cancer Mortality in Neighbouring European Countries with Different Levels of Screening but Similar Access to Treatment: Trend Analysis of WHO Mortality Database,” British Medical Journal, published online, July 29, 2011, available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3145837/.

U.S. Preventive Services Task Force: For the task force’s recommendations, see U.S. Preventive Services Task Force, “Screening for Breast Cancer,” December 2009, at http://www.ahrq.gov/clinic/USpstf/uspsbrca.htm.

in Colorado, fully one-third of all breast cancers: Lori Jensen, “A Local Look at Mammograms for Women under 50,” Boulder Daily Camera, February 28, 2010.

It’s a well-recognized fact that most breast cancers: The 2003 National Health Interview Survey looked at 361 women diagnosed with breast cancer between 1980 and 2003. Results revealed that 57 percent found their cancers on their own, either by self-examination or by accident. M. Y. Roth et al., “Self-Detection Remains a Key Method of Breast Cancer Detection for U.S. Women,” Journal of Women’s Health, vol. 20, no. 8 (August 20, 2011), pp. 1135-1139.

women in China received inadequate training: Lee Wilke, associate professor and director, UW Breast Center, University of Wisconsin School of Medicine and Public Health, author interview, February 2010.

one in Canada, which did find: Anthony B. Miller et al., “Canadian National Breast Screening Study 2: 13-Year Results of a Randomized Trial in Women Aged 50-59 Years,” Journal of the National Cancer Institute, vol. 92, no. 18 (2000), pp. 1490-1499.

A recent study from Duke University: Lee Wilke et al., “Breast Self-Examination: Defining a Cohort Still in Need,” Proceedings of American Society of Breast Surgeons (2009).

BRCA genes make breast cells more sensitive: A. Broeks et al., “Identification of Women with an Increased Risk of Developing Radiation-Induced Breast Cancer: A Case Only Study,” Breast Cancer Research, vol. 9 (2007), pp. 106-114.

CHAPTER 14 • THE FUTURE OF BREASTS

“The world is too much with us”: William Wordsworth, ca. 1806, from Jack Stillinger, ed., Selected Poems and Prefaces by William Wordsworth (Boston: Houghton Mifflin, 1965), p. 183.

Susan Love: Love likes to say, “We know how to cure breast cancer really well in a mouse. The problem is, we don’t know much about how cancer works in women” (author interview, April 2009). In hopes of conducting more research with women and less with rodents, the Army of Women, a partnership between the Dr. Susan Love Research Foundation and Avon Foundation for Women, aims to enlist one million women study volunteers from diverse backgrounds. For more information, see www.armyofwomen.org.

The medical community is getting better: Heide Splete, “10-Year Breast Cancer Survival Rates Improve,” Internal Medicine News Digital Network, September 29, 2010, available at http://www.internalmedicinenews.com/specialty-focus/women-s-health/single -article-page/10-year-breast-cancer-survival-rates-improve.html.

Yet surprisingly few national research dollars: Tiffany O’Callaghan, “The Prevention Agenda,” Nature, vol. 471, no. 7339 (March 24, 2011), pp. s2-s4.

breast cancer will, on average, shave thirteen years off a woman’s life: Tomas J. Aragon et al., “Calculating Expected Years of Life Lost for Assessing Local Ethnic Disparities in Causes of Premature Death,” BMC Public Health, vol. 8 (2008), p. 116.

Decades ago, microbiologist-turned-humanist René Dubos argued: René Dubos, Mirage of Health: Utopias, Progress, and Biological Change (New York: Harper, 1959), pp. 29, 110-111.