title: Long-Term Health Outcomes in Women With Silicone Gel Breast Implants: A Systematic Review.
abstract: BACKGROUND
  Silicone gel breast implants were removed from the U.S. market for cosmetic use in 1992 owing to safety concerns. They were reintroduced in 2006, with a call for improved surveillance of clinical outcomes.
  
  
  OBJECTIVE
  To systematically review the literature regarding specific long-term health outcomes in women with silicone gel breast implants, including cancer; connective tissue, rheumatologic, and autoimmune diseases; neurologic diseases; reproductive issues, including lactation; offspring issues; and mental health issues (depression and suicide).
  
  
  METHODS
  MEDLINE, EMBASE, and Ovid Healthstar (inception through 30 June 2015), and the Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (through the first quarter of 2015).
  
  
  METHODS
  4 researchers double-screened articles for longitudinal studies that compared women with and without breast implants and reported long-term health outcomes of interest.
  
  
  METHODS
  4 researchers extracted data on participant and implant characteristics, analytic methods, and results.
  
  
  RESULTS
  32 studies (in 58 publications) met eligibility criteria. Random-effects model meta-analyses of effect sizes were conducted when feasible. For most outcomes, there was at most only a single adequately adjusted study, which usually found no significant associations. There were possible associations with decreased risk for primary breast and endometrial cancers and increased risks for lung cancer, rheumatoid arthritis, Sjögren syndrome, and Raynaud syndrome. Evidence on breast implants and other outcomes either was limited or did not exist.
  
  
  CONCLUSIONS
  The evidence was most frequently not specific to silicone gel implants, and studies were rarely adequately adjusted for potential confounders.
  
  
  CONCLUSIONS
  The evidence remains inconclusive about any association between silicone gel implants and long-term health outcomes. Better evidence is needed from existing large studies, which can be reanalyzed to clarify the strength of associations between silicone gel implants and health outcomes.
  
  
  BACKGROUND
  The Plastic Surgery Foundation.
authors.forename: Ethan M
authors.initials: EM
authors.lastname: Balk
authors.forename: Amy
authors.initials: A
authors.lastname: Earley
authors.forename: Esther A
authors.initials: EA
authors.lastname: Avendano
authors.forename: Gowri
authors.initials: G
authors.lastname: Raman
mesh_terms: D001172:Arthritis, Rheumatoid / Q000453:epidemiology; D001327:Autoimmune Diseases / Q000453:epidemiology; D018427:Breast Implants / Q000009:adverse effects; D003240:Connective Tissue Diseases / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D007775:Lactation Disorders; D008603:Mental Health; D009369:Neoplasms / Q000453:epidemiology; D011928:Raynaud Disease / Q000453:epidemiology; D060728:Reproductive Health; D012307:Risk Factors; D020034:Silicone Gels; D012859:Sjogren's Syndrome / Q000453:epidemiology
chemical_list: D020034:Silicone Gels