title: Breast implants and lymphoma risk: a review of the epidemiologic evidence through 2008.
abstract: BACKGROUND
  In the past, concerns about lymphoma among women with breast implants have been raised by anecdotal observations. A recent report of a case-control study from The Netherlands reported an association of breast implants with anaplastic large T-cell lymphoma, but limitations inherent in the study design and the restriction of the association to saline implants preclude any causal evaluation.
  
  
  METHODS
  To determine whether lymphoma risk is in fact elevated in women with breast implants, the authors have reviewed the evidence from five long-term follow-up studies comprising over 43,000 women with cosmetic breast implants followed for up to 37 years, which reported results specifically regarding the incidence of non-Hodgkin's lymphoma, among other cancers.
  
  
  RESULTS
  Overall, there were 48 observed incident cases of non-Hodgkin's lymphoma compared with 53.9 cases expected, yielding a summary standardized incidence ratio of 0.89 (95 percent confidence interval, 0.67 to 1.18). None of the epidemiologic cohort studies reported a primary lymphoma originating in the breast.
  
  
  CONCLUSIONS
  To date, there is no credible evidence of an increase of non-Hodgkin's lymphoma regardless of site or specifically originating in the breast among women with cosmetic breast implants.
authors.affiliation: Rockville, Md.; and Nashville, Tenn. From the International Epidemiology Institute, Vanderbilt University Medical Center, and Vanderbilt-Ingram Cancer Center.
authors.forename: Loren
authors.initials: L
authors.lastname: Lipworth
authors.forename: Robert E
authors.initials: RE
authors.lastname: Tarone
authors.forename: Joseph K
authors.initials: JK
authors.lastname: McLaughlin