title: A clinical study of the relationship between silicone breast implants and connective tissue disease.
abstract: OBJECTIVE
  This study was a blinded, concurrent assessment of a historical cohort derived from a provincial registry (1978 to 1986) of breast implant recipients (cosmetic, not reconstructive) and controls (other cosmetic surgery) to test the hypothesis that connective tissue disease (CTD) is increased in breast implant recipients.
  
  
  METHODS
  Women who underwent breast implant or other cosmetic surgery during the interval from 1978 to 1986 were contacted confidentially by Alberta Health and asked to participate in the study. Those willing to participate completed an extensive questionnaire and supplied a blood sample, subsequent to which all surgical records were reviewed to confirm implant type(s) or cosmetic surgery(ies). All participants with any suggestion of rheumatic disease were assessed blindly by a rheumatologist for CTD.
  
  
  RESULTS
  One thousand five hundred seventy-six breast implant recipients were recruited, including 1112 who had received silicone gel-filled implants (> 13,500 person yrs exposure). Seven hundred twenty-six controls were recruited. Prevalence rates adjusted for sex and age for rheumatoid arthritis, systemic lupus erythematosus, scleroderma, and Sjögren's syndrome (the principal targeted conditions) were consistent with published reports for Caucasian women. While breast implant recipients self-reported significantly greater rates of symptoms than controls, post-surgical diagnoses of the principal targeted conditions did not indicate an increased incidence of typical or atypical CTD.
  
  
  CONCLUSIONS
  The results of the study do not support the hypothesis that silicone gel-filled implants induce or promote CTD.
authors.affiliation: Faculty of Medicine, The University of Calgary, McCaig Centre for Joint Injury and Arthritis Research, Alberta, Canada.
authors.forename: S M
authors.initials: SM
authors.lastname: Edworthy
authors.forename: L
authors.initials: L
authors.lastname: Martin
authors.forename: S G
authors.initials: SG
authors.lastname: Barr
authors.forename: D C
authors.initials: DC
authors.lastname: Birdsell
authors.forename: R F
authors.initials: RF
authors.lastname: Brant
authors.forename: M J
authors.initials: MJ
authors.lastname: Fritzler
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000453:epidemiology / Q000209:etiology; D018427:Breast Implants / Q000009:adverse effects*; D015331:Cohort Studies; D003240:Connective Tissue Diseases / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000453:epidemiology / Q000209:etiology; D012828:Silicones / Q000009:adverse effects*; D012859:Sjogren's Syndrome / Q000453:epidemiology / Q000209:etiology; D013518:Surgery, Plastic / Q000009:adverse effects
chemical_list: D012828:Silicones