Adjuvant breast disease: an evaluation of 100 symptomatic women with breast implants or silicone fluid injections.
We evaluated 100 referred women with breast implants (n = 97) or silicone fluid injections (n = 3) into breasts who developed various symptoms. All reported symptoms occurred at a median latency period of 6 years (range 0-24 years) after implantation or injection of silicone. Commonest symptoms were weakness (95%), fatigability (95%), myalgia (90%), morning stiffness (89%), arthralgia (81%), memory loss (81%), sensory loss (77%), headache (73%) and dry eyes and dry mouth (72%). Laboratory results revealed abnormal levels of serum immunoglobulins or complement in 57% and autoantibodies in 78%. Sural nerve biopsy was abnormal in 80% with the major finding of loss of myelinated fibers in 79%. Biceps muscle biopsy was abnormal in 58% with the major finding of neurogenic atrophy in 27%. Ninety-six patients underwent implant removal; 60% of the patients were found to have one or both implants ruptured with silicone spilled into tissue. At time of removal, a pectoralis major muscle biopsy was taken which was abnormal in 89% with the major finding of neurogenic atrophy in 55%. Biopsy of implant capsule was abnormal in 94% showing foreign body giant cells containing refractile material consistent with silicone in 69% whether or not the elastomer shell was ruptured. Silicone can cause a systemic autoimmune disease with a variety of symptoms probably due to a global activation of the immune system. Since our patients had objective laboratory and histologic findings together with a high rate of mechanical implant failure, further investigations are necessary.
Shoaib
B O
BO
Department of Neurology, Baylor College of Medicine, Houston, TX 77030-3498.
Patten
B M
BM
Calkins
D S
DS
D000328:Adult; D001327:Autoimmune Diseases / Q000139:chemically induced*; D001941:Breast Diseases / Q000139:chemically induced / Q000276:immunology* / Q000473:pathology; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007267:Injections; D008875:Middle Aged; D019736:Prostheses and Implants / Q000009:adverse effects*; D012189:Retrospective Studies; D012828:Silicones / Q000009:adverse effects*
D012828:Silicones