Monoclonal gammopathy of undetermined significance and exposure to breast implants.
BACKGROUND
Animal studies and uncontrolled case series in humans have suggested a possible association between breast implant exposure and monoclonal gammopathy.


OBJECTIVE
To assess whether there is an increased risk of monoclonal gammopathy in women with silicone breast implants, we conducted a retrospective study of women exposed to breast implants and matched nonexposed women nested within a prospective cohort study (the Nurses' Health Study).


METHODS
We used serum protein electrophoresis and immunoglobulin subtype by immunofixation to test 288 women exposed to breast implants and 288 age-matched, nonexposed women who previously had provided a blood sample (1989-1990) for monoclonal proteins.


RESULTS
Among the women exposed to breast implants, 5 had monoclonal gammopathy of undetermined significance (MGUS) compared with 4 women among those not exposed (odds ratio, 1.25; 95% confidence interval, 0.27-6.39). The distribution of isotypes was similar across exposure groups. The exposed women with MGUS tended to be older than the nonexposed women (mean age, 60.4 years vs 52.5 years, respectively; P =.03). None of the 9 women with MGUS had reported multiple myeloma or other hematologic malignancies up through 1996.


CONCLUSIONS
We find little evidence to support a substantial increased risk of MGUS in women exposed to breast implants. Larger studies are needed to determine if a more modest relationship exists.
Harvard Medical School, Boston, MA 02115. ekarlson@rics.bwh.harvard.edu
E W
EW
Karlson
M
M
Tanasijevic
S E
SE
Hankinson
M H
MH
Liang
G A
GA
Colditz
F E
FE
Speizer
P H
PH
Schur
D000367:Age Factors; D000368:Aged; D018427:Breast Implants / Q000009:adverse effects*; D015180:Electrophoresis, Gel, Two-Dimensional; D005260:Female; D006801:Humans; D008875:Middle Aged; D010265:Paraproteinemias / Q000139:chemically induced*; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D020034:Silicone Gels / Q000009:adverse effects*
D020034:Silicone Gels