Rheumatic Manifestations in Danish Women with Silicone Breast Implants

Jensen, Bo; Bliddal, Henning; Kjøller, Kim; Wittrup, Irene Hechmann; Friis, Søren; Høier‐Madsen, Mimi; Røgind, Henrik; McLaughlin, Joseph K.; Lipworth, Loren; Danneskiold‐Samsøe, Bente; Olsen, Jørgen H.

doi:10.1007/s100670170024

Cited by 17 publications

(6 citation statements)

References 34 publications

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“…5 Following the ban, case-control and cohort studies were conducted over the next several years to investigate whether breast implants did indeed increase the risks of CTDs. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Overall, these studies indicated no increased risks of CTDs among women with breast implants, compared with non-implanted women. 1,[26][27][28] A meta-analysis of 13 studies published in 2000 estimated an adjusted summary rate ratio (RR) of 0.80 [95% confidence interval (CI) 0.62-1.04] for CTDs associated with breast implants.…”

Section: Introductionmentioning

confidence: 96%

Prospective cohort study of breast implants and the risk of connective-tissue diseases

Lee¹,

Cook²,

Shadick³

et al. 2010

International Journal of Epidemiology

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Although this prospective cohort study represented a stronger design than the retrospective cohort study, the present data should still be viewed cautiously because of remaining methodological limitations, including the potential for differential self-reporting of CTD and CTD symptoms among women with and without breast implants, the difficulty of obtaining medical records for women reporting CTD and the low and possibly differential confirmation of self-reported disease against medical records. A reasonable conclusion is the lack of a large increase in CTD risk (e.g. ≥2-fold) associated with breast implants.

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Section: Introductionmentioning

confidence: 96%

Prospective cohort study of breast implants and the risk of connective-tissue diseases

Lee¹,

Cook²,

Shadick³

et al. 2010

International Journal of Epidemiology

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“…For a long time, silicone was considered an inert material, but increasing evidence undermines this assumption 1. Multiple cohort studies observed a higher prevalence of autoimmune diseases such as Sjögren’s disease, systemic sclerosis and rheumatoid arthritis in women with SBI, raising concerns about a possible association 1–4. However, as other cohort studies and a meta-analysis found contradicting results, the evidence remains inconclusive 5–8.…”

Section: Introductionmentioning

confidence: 99%

Patient-reported systemic symptoms in women with silicone breast implants: a descriptive cohort study

et al. 2022

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ObjectiveAn unknown portion of women with silicone breast implants (SBI) report development of systemic symptoms, recently named as ‘breast implant illness (BII)’. We aim to describe the symptoms and characteristics of women with SBI reporting these systemic symptoms and compare the clinical course of women who chose to keep their implants, to women who had their implants removed.DesignObservational cohort study.SettingSpecialised BII out-patient clinic at Amsterdam UMC, the Netherlands, from 2011 to 2020.ParticipantsAll women presenting to the BII clinic with SBI and systemic symptoms.Results467 women were included for baseline analyses and 398 women for follow-up. Most frequently reported systemic symptoms at baseline included fatigue (88%), arthralgia (71%), morning stiffness (59%), myalgia (48%), cognitive impairment (33%), peripheral neurological symptoms (30%) and lymphadenopathy (22%). Furthermore, 56% reported pre-existing allergies at baseline and positive antinuclear antibodies were observed in 23%. At follow-up with a median of 3.3 years (IQR 2–4), 152 women had their implants removed on clinical grounds. Symptoms improved significantly in 65 women (43%), improved moderately in 37 women (24%), did not change in 37 women (24%) and deteriorated in 13 women (9%). Women who underwent explantation showed more improvement of their systemic symptoms compared with women who did not (OR 2.9, 95% CI 1.3 to 6.2). Additionally, women who underwent explantation within 10 years after implantation improved significantly better than women who got the implants removed after 10 years (p=0.007). Lastly, local symptoms decreased from 75% to 34% after implant removal (p<0.0001).ConclusionMost women with SBI who developed systemic symptoms experienced improvement after explantation, especially when removed within 10 years after implantation. Early recognition of the pattern of systemic symptoms in women with SBI is important and implant removal should be considered.

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“…15 Since publication of the review by Tugwell et al, 13 several additional epidemiologic studies have investigated the possibility of associations between cosmetic breast implants and any individual CTD or all CTDs combined 16 -20 or atypical connective tissue or rheumatic disease. [17][18][19][21][22][23] The results of these studies are summarized below.…”

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confidence: 98%

Silicone Breast Implants and Connective Tissue Disease

Lipworth¹,

Tarone²,

McLaughlin³

2004

Annals of Plastic Surgery

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Numerous meta-analyses, weight-of-the-evidence, and critical reviews have summarized data from case-control and cohort studies, published through 1999, which have been conducted to evaluate the potential association between cosmetic silicone breast implants and the occurrence of well-defined connective tissue diseases, as well as a hypothesized new atypical disease, which does not fulfill established diagnostic criteria for any known connective tissue disease. These reviews have unanimously concluded that there is no evidence of an association between breast implants and any of the traditional connective tissue diseases evaluated individually or combined or atypical connective tissue disease. We have performed an updated review of the results of epidemiologic studies published since 1999. Two long-term follow-up studies of women with breast implants in Denmark and a retrospective cohort study in Australia found no excess of definite connective tissue disease, including rheumatoid arthritis, systemic sclerosis, systemic lupus erythematosus and Sjogren's syndrome, among women with cosmetic breast implants compared with breast reduction or other plastic surgery controls or women in the general population. No consistent evidence was observed of increased risk of definite connective tissue disease in women with extracapsular ruptures in 2 studies which evaluated risk by rupture status among women with cosmetic breast implants. The results of several studies provide no evidence of a higher frequency of undefined connective tissue disease among women with cosmetic breast implants or of a rheumatic symptom profile unique to these women and/or indicative of a specific atypical connective tissue disease. In conclusion, the most recent epidemiologic investigations have been remarkably consistent with earlier epidemiologic studies in finding no evidence of an excess of any individual connective tissue disease or all connective tissue diseases combined, including both established and atypical or undefined connective tissue disease, among women with cosmetic silicone breast implants. Thus, the conclusions reached in earlier independent reviews have not changed based on data published during the subsequent years.

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Rheumatic Manifestations in Danish Women with Silicone Breast Implants

Cited by 17 publications

References 34 publications

Prospective cohort study of breast implants and the risk of connective-tissue diseases

Prospective cohort study of breast implants and the risk of connective-tissue diseases

Patient-reported systemic symptoms in women with silicone breast implants: a descriptive cohort study

Silicone Breast Implants and Connective Tissue Disease

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