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Lack of evidence of systemic inflammatory rheumatic disorders in symptomatic women with breast implants

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By Blackburn WD Jr, Grotting JC, Everson MP • • April 15, 1997

Breast implants containing silicone have been used for approximately
30 years for breast augmentation or reconstruction. In
general, the implants have been well tolerated and reports
have indicated a high degree of patient satisfaction.
Nonetheless, there have been anecdotal reports of patients
with musculoskeletal complaints that have been attributed to
silicone breast implants. To investigate this further, we
prospectively examined 70 women with silicone breast implants
who had complaints that they or their referring physicians
thought were related to their implants. On clinical
examination, the majority of the patients had fibromyalgia,
osteoarthritis, or soft-tissue rheumatism. One patient had
rheumatoid arthritis, which predated her implants, and one had
Sjogren's syndrome. Because many of our patients had myalgic
symptoms, we further evaluated these patients by measuring
circulating levels of soluble factors including
interleukin-6, interleukin-8, tumor necrosis factor-alpha,
soluble intercellular adhesion molecule-1, and soluble
interleukin-2 receptor, which have been previously found to be
elevated in patients with inflammatory diseases. We found
that the levels of these molecules in women with silicone
breast implants were not different from those seen in normal
subjects and were significantly less than those seen when
examining chronic inflammatory disorders such as rheumatoid
arthritis or systemic lupus erythematosus. In summary, our
clinical and laboratory evaluation of symptomatic breast
implant patients argues against an association of silicone
breast implants with a distinctive rheumatic disease or a
systemic inflammatory disorder. Given these findings and the
clinical picture, it is our impression that most symptomatic
women with silicone breast implants have well-delineated
noninflammatory musculoskeletal syndromes. Moreover, these
data fail to support the concept that their symptoms are due
to a systemic inflammatory response related to their

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