Breast implants systemic lupus erythematosus

There have been case-reports of a confirmed diagnosis of systemic sclerosis, rheumatoid arthritis, or systemic lupus erythematosus in patients with silicone breast implants (Silverstein et al., 1992 Sanchez-Guerrero et al., 1994 Cuellar et al., 1995 Field Bridges, 1996). However, no association between silicone breast implants and connective tissue disease has been seen in more than... 

Although systemic sclerosis is the most commonly reported disorder occurring following silicone breast implantation, there have also been reports of systemic lupus erythematosus [43,44,46,50], Sjogren s syndrome [45], keratoconjunctivitis sicca [45], rheumatoid arthritis [4,34,43], polymyositis [43], overlap syndromes (including human adjuvant disease) [34,43,46,50,51], morphea [35,43], Hashimoto s thyroiditis [43,52], anticar-diolipin antibody syndrome [53], primary biliary cirrhosis [45] and toxic shock syndrome [54]. Unfortunately, it is impossible to tell, on the basis of case reports, whether the frequency of these events is greater than might be expected on the basis of chance alone (Table 7.1). 

In June of 1994, a population-based retrospective cohort study was published which examined the risk of a variety of connective tissue diseases and other disorders after breast implantation [65]. In this study, all women in Olmsted County, Minnesota who received a breast implant between 1 January 1964 and 31 December 1991 (the case subjects) were studied. For each case subject, two women of the same age (within three years) from the same population who had not received a breast implant and who underwent a medical evaluation within two years of the date of the implantation in the case subject were selected as control subjects. Each woman s complete inpatient and outpatient medical records were interviewed for the occurrence of various connective tissue diseases (i.e., rheumatoid arthritis, systemic lupus erythematosus, Sjogren s syndrome, dermatomyositis, polymyositis, systemic sclerosis, ankylosing spondylitis. 

Strom, B.L., Reidenberg, M.M., Freundlich, B. et al (1994) Breast silicone implants and risk of systemic lupus erythematosus. J. Clin. Epidemiol (in press). 

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