The Prevalence of Self-Reported Health Complaints and Health-Related Quality of Life in Women With Breast Implants

Abstract

Background Millions of women have silicone breast implants (SBI). Some report a pattern of systemic complaints, also referred to as ASIA syndrome. However, the association between these complaints and breast implants remains uncertain. Objectives This study aimed to evaluate the prevalence of complaints in women with breast implants and healthy controls, and to compare their health-related quality of life (HRQoL). Methods Four groups of subjects were requested to fill in a general and a diagnostic questionnaire, and the Short Form 36. Group 1 was recruited from the Dutch foundation for breast implant illness (BII). Two groups were recruited from Dutch hospitals, where they were augmented or reconstructed with SBI (group 2) or saline-filled and hydrogel implants (group 3). A control group without breast implants was recruited from friends of subjects from group 2 and 3. Results In total, 238 women completed the questionnaires. ASIA manifestations appeared in the majority of the respondents (72.3-98.8%), with a latency period of 0-35 years. Adjusted for age, smoking, and comorbidities, typical symptoms only occurred significantly more frequent in group 1. The presence of a chronic disease was an independent predictor for ASIA syndrome. HRQoL was lower in women with SBI than in women without breast implants. Conclusions The adjusted prevalence of BII manifestations is not significantly higher in women with SBI compared to women without implants. The findings of this study suggest that results on BII are subject to selection bias. Further studies are needed to prove an association between self-reported complaints and SBI.

Breast-related and body-related quality of life following autologous breast reconstruction is superior to implant-based breast reconstruction - A long-term follow-up study

“…Worrying statements in journalism, such as in ‘The implant files', contribute to unrest among women with breast implants [ [29] , [30] , [31] ]. In very few cases, the use of breast implants can lead to breast implant illness [ [32] , [33] , [34] ]. Removal of the implants improves health complaints in half of the patients [ 35 ].…”

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“…Remarkably, a comparative study on the prevalence of health complaints in SBI patients showed that health complaints were only higher in a group of selfreported women who made their complaints public in an online platform compared to controls. 10 The adjusted prevalence of self-reported health complaints were not found to be significantly higher in SBI patients who did not made their complaints public in comparison to control patients without SBI. 10 Women who reported their complaints online (e.g.…”

“…10 The adjusted prevalence of self-reported health complaints were not found to be significantly higher in SBI patients who did not made their complaints public in comparison to control patients without SBI. 10 Women who reported their complaints online (e.g. social media and internet worrying patients) are expected to have the most severe complaints and thus do not constitute a representative control group for the entire SBI population due to selection bias.…”

“…Many women still undergo a breast augmentation with SBI in aesthetic and reconstructive surgeries, i.e., after mastectomy [6][7][8]. SBI are supposed to be associated with atypical systemic symptoms such as myalgia, arthralgia, fatigue, fever, dry eyes and/or dry mouth (sicca), as well as cognitive disturbances [9,10], termed as the condition ''Autoimmune/inflammatory syndrome induced by adjuvants'' (ASIA) [11]. They were also supposed to be associated with an increased risk of developing inflammatory and autoimmune reactions [12,13].…”

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“…Moreover, observational studies including appropriate comparison groups do not show a difference in prevalence of non-specific complaints between women with and without SBIs. 6 , 7 Meticulous studies in large, unselected groups of women need to either confirm or refute the existence of the controversial syndrome that breast implant illness is. In the Netherlands, several hospitals are currently collaborating to provide more insight into these important questions.…”