title: Risk of connective tissue disease and related disorders among women with breast implants: a nation-wide retrospective cohort study in Sweden.
abstract: OBJECTIVE
  To examine the relation between connective tissue disease and related conditions and breast implants.
  
  
  METHODS
  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 period.
  
  
  METHODS
  Sweden.
  
  
  METHODS
  7442 women with implants for cosmetic reasons or for reconstruction after breast cancer surgery and 3353 women with breast reduction surgery.
  
  
  METHODS
  Subsequent hospitalisation for definite connective tissue diseases (rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, dermatomyositis, and Sjögren'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)).
  
  
  CONCLUSIONS
  This large nationwide cohort study shows no evidence of association between breast implants and connective tissue disease.
authors.affiliation: Department of Medical Epidemiology, Karolinska Institute, Stockholm, Sweden. Olof.Nyren@mep.ki.se
authors.forename: O
authors.initials: O
authors.lastname: Nyrén
authors.forename: L
authors.initials: L
authors.lastname: Yin
authors.forename: S
authors.initials: S
authors.lastname: Josefsson
authors.forename: J K
authors.initials: JK
authors.lastname: McLaughlin
authors.forename: W J
authors.initials: WJ
authors.lastname: Blot
authors.forename: M
authors.initials: M
authors.lastname: Engqvist
authors.forename: L
authors.initials: L
authors.lastname: Hakelius
authors.forename: J D
authors.initials: JD
authors.lastname: Boice
authors.forename: H O
authors.initials: HO
authors.lastname: Adami
mesh_terms: D000328:Adult; D000368:Aged; D018427:Breast Implants / Q000009:adverse effects*; D015331:Cohort Studies; D003240:Connective Tissue Diseases / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012828:Silicones / Q000009:adverse effects*; D013518:Surgery, Plastic; D013548:Sweden / Q000453:epidemiology
chemical_list: D012828:Silicones