title: Self-reported musculoskeletal symptoms among Danish women with cosmetic breast implants.
abstract: BACKGROUND
  No epidemiological evidence of an association between silicone breast implants and connective tissue disease has been found. Based on case reports, it has been hypothesized that silicone breast implants may be associated with a unique rheumatic symptom cluster termed "atypical connective tissue disease."
  
  
  METHODS
  We have evaluated self-reported rheumatic symptoms among women who received breast implants between 1977 and 1997 at 2 private plastic surgery clinics in Denmark. Women with other cosmetic surgery, including breast reduction, as well as women from the general population, were identified as controls.
  
  
  RESULTS
  No statistically significant differences in mild (odds ratio [OR] = 0.9; 95% confidence interval [CI] = 0.6-1.3), moderate (OR = 0.7; 95% CI = 0.4-1.2), or severe (OR = 1.1; 95% CI = 0.6-2.1) musculoskeletal symptoms were observed when women with breast implants were compared with women with other cosmetic surgery. Compared with women from the general population, women with breast implants were statistically significantly less likely to have mild or moderate musculoskeletal symptoms (OR = 0.5; 95% CI = 0.3-0.7 and OR = 0.3; 95% CI = 0.2-0.5, respectively); for severe symptoms the deficit was not statistically significant (OR = 0.7; 95% CI = 0.3-1.3). For individual symptom groups, there was no consistent pattern of reporting among women with implants.
  
  
  CONCLUSIONS
  We did not find an excess of rheumatic symptoms or symptom clusters among women with breast implants. In fact, the occurrence of mild, moderate, and severe musculoskeletal symptoms was generally lower among women with implants compared with women with other cosmetic surgery and women in the general population.
authors.affiliation: Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark. helle@cancer.dk
authors.forename: Kim
authors.initials: K
authors.lastname: Kjøller
authors.forename: Lisbet Rosenkrantz
authors.initials: LR
authors.lastname: Hölmich
authors.forename: Jon P
authors.initials: JP
authors.lastname: Fryzek
authors.forename: Poul Harboe
authors.initials: PH
authors.lastname: Jacobsen
authors.forename: Søren
authors.initials: S
authors.lastname: Friis
authors.forename: Joseph K
authors.initials: JK
authors.lastname: McLaughlin
authors.forename: Loren
authors.initials: L
authors.lastname: Lipworth
authors.forename: Trine Foged
authors.initials: TF
authors.lastname: Henriksen
authors.forename: Mimi
authors.initials: M
authors.lastname: Høier-Madsen
authors.forename: Allan
authors.initials: A
authors.lastname: Wiik
authors.forename: Jørgen H
authors.initials: JH
authors.lastname: Olsen
mesh_terms: D000328:Adult; D018427:Breast Implants / Q000009:adverse effects*; D003240:Connective Tissue Diseases / Q000453:epidemiology* / Q000209:etiology; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D012828:Silicones; D011795:Surveys and Questionnaires
chemical_list: D012828:Silicones