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

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

implants.

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