Connective tissue disease & other rheumatic conditions following breast implants in Denmark

To investigate the risks of connective tissue diseases (CTDs)
following breast implants we used the nationwide Danish
Hospital Discharge Register (HDR) to identify 2,570 women who
received breast implants, either for cosmetic reasons (N =
1,135) or for breast reconstruction (N = 1,435), between 1977
and 1992. Two additional cohorts of women having either breast
reduction surgery (N = 7,071) or breast cancer without
implants (N = 3,952) were identified for comparison.

Observed-to-expected (O/E) cases of CTDs and other rheumatic
conditions were calculated based on national hospital
discharge rates. The calculated O/E ratio for definite CTDs
was 1.1 (95% confidence interval [CI], 0.2-3.4) among women
with cosmetic breast implants, and 1.3 (95% CI, 0.5-2.6) among
women receiving implants for breast reconstruction. No CTD
excesses were seen in the breast reduction or
breast-cancer-without-implant cohorts. Statistically
significant risks for muscular rheumatism (a nonspecific
discharge diagnosis) were observed in all four patient
cohorts: cosmetic (O/E ratio, 2.5; 95% CI, 1.7-3.6), breast
reconstruction (O/E ratio, 2.5; 95% CI, 1.7-3.4), breast
reduction (O/E ratio, 2.0; 95% CI, 1.6-2.3), and breast cancer
without implants (O/E ratio, 1.4; 95% CI, 1.0-1.9).

In conclusion, breast implants showed little association with
definite CTDs. Breast surgery per so, however, was associated
with an apparent increase in muscular rheumatism.

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