BREAST IMPLANTS, RHEUMATOID-ARTHRITIS, AND CONNECTIVE-TISSUE DISEASESIN A CLINICAL-PRACTICE

This study was designed to assess the relationship between breast impl ants and certain rheumatologic diseases (rheumatoid arthritis and diff use connective tissue diseases). The study base was a rheumatological practice in Atlanta, Georgia that started in 1982 and began computeriz ing its records in 1985. The computerized records through May 1992 inc luded 4229 women patients, 150 with breast implants and 721 with a dia gnosis of rheumatoid arthritis (RA) and/or one of the connective tissu e diseases (CTDs). Of the 721 patients who had been diagnosed as havin g rheumatoid arthritis (RA) and/or one of the connective tissue diseas es (CTDs), 392 had rheumatoid arthritis, 344 had connective tissue dis ease, 15 had both rheumatoid arthritis and a connective tissue disease , and 33 had more than one connective tissue disease. Of the patients with connective tissue disease, 179 had systemic lupus erythematosus, 64 had scleroderma, 49 had Sjogren's syndrome, 36 had dermatomyositis or polymyositis, and 49 had mixed connective tissue disease. Data were analyzed by univariate and multivariate techniques including logistic regression. Significant variables included age at first visit, income strata, and period of first visit. Analyses were performed for each c linical diagnosis, for all connective tissue diseases together (CTDs), and for those with rheumatoid arthritis and/or connective tissue dise ase (RA/CTD). Analyses were performed on the total data base and on th e records of new patients (1986-1992). The adjusted odds ratio for bre ast implants among women who entered the practice in 1986-1992 and wer e diagnosed as having rheumatoid arthritis and/or one of the connectiv e tissue diseases (RA/CTDs) was 0.45 (0.22-0.90), for those with rheum atoid arthritis was 0.61 (0.28-1.49), for those with any of these spec ific diffuse connective tissue diseases was 0.34 (0.11-1.06) compared to those without the disease. For systemic lupus erythematosus, the od ds ratio of 0.24 (0.03-1.75) was based on a single case who had the di sease 5 yr before the implant. For Sjogren's syndrome, the odds ratio was 1.67 (0.39-7.13) based on two cases, one of whom had the disease 5 yr before the implant. The calculated odds ratios for scleroderma, de rmatomyositis/polymyositis, and mixed connective tissue disease were z ero since no cases were diagnosed among the patients with breast impla nts. This study found no evidence that women with breast implants are at an increased risk for having rheumatoid arthritis or other diffuse connective tissue disease.