Risk of connective tissue disease & related disorders among women with breast implants: a nation-wide retrospective cohort study in Sweden

OBJECTIVE: To examine the relation between connective tissue

disease and related conditions and breast implants.


Retrospective cohort study of all women in the Swedish

national inpatient registry who underwent breast augmentation

surgery with artificial implants during 1964-93, compared with

women who underwent breast reduction surgery during the same


SETTING: Sweden.

SUBJECTS: 7442 women with implants

for cosmetic reasons or for reconstruction after breast cancer

surgery and 3353 women with breast reduction surgery.


OUTCOME MEASURES: Subsequent hospitalisation for definite

connective tissue diseases (rheumatoid arthritis, systemic

lupus erythematosus, systemic sclerosis, dermatomyositis, and

Sjogren’s syndrome) or related disorders.

RESULTS: 29 women

with implants were hospitalised for definite connective tissue

disease compared with 25.5 expected based on general

population rates (standardised hospitalisation ratio 1.1 (95%

confidence interval 0.8 to 1.6)). There were no diagnoses of

systemic sclerosis, and no significant excess in risk for

polymyalgia rheumatica, fibromyalgia, and several related

disorders. Among women who underwent breast reduction surgery,

14 were hospitalised for definite connective tissue disease

compared with 10.5 expected (standardised hospitalisation

ratio 1.3 (0.7 to 2.2)). Compared with the breast reduction

group, women with breast implants showed a slight reduction

for all definite connective tissue disease (relative risk 0.8

(95% confidence interval 0.5 to 1.4)).


nationwide cohort study shows no evidence of association

between breast implants and connective tissue disease.

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