INCIDENCE OF AUTOIMMUNE-DISEASE IN PATIENTS AFTER BREAST RECONSTRUCTION WITH SILICONE GEL IMPLANTS VERSUS AUTOGENOUS TISSUE - A PRELIMINARY-REPORT

Objective: To test the hypothesis that there is a higher incidence of autoimmune disorders in patients who have undergone breast reconstruct ion with silicone gel implants rather than autogenous tissue. Design: Prospective study. Setting: Tertiary referral center dealing exclusive ly with cancer. Patients: All female breast cancer patients who underw ent breast reconstruction between January 1986 and March 1992. Patient s were nonrandomly assigned to breast reconstruction with one of the f ollowing four methods: (1) silicone gel implant only, (2) latissimus d orsi flap with implant, (3) latissimus dorsi flap without implant, and (4) transverse rectus abdominis flap. The first two groups made up th e implant cohort and the last two groups the autogenous tissue cohort. Selection of reconstructive method was made on clinical grounds and w as based on both physician and patient preference. Main outcome measur es: Documented diagnosis of autoimmune disorder by Board-certified rhe umatologist. Results: Three hundred eight implants were used in 250 pa tients, and 408 reconstructions with tissue were performed on 353 pati ents. The two groups were similar in age and tumor stage. The two grou ps contributed 615.8 and 663.4 person-years of follow-up, respectively . One patient from each group (<0.5%) had a documented occurrence of a n autoimmune syndrome requiring therapy. Both cases were considered mi ld, and after initial low-dose steroid therapy, both patients are now off steroids. Conclusion: The incidence of autoimmune disease in maste ctomy patients receiving silicone gel implants is not different than i n patients who had reconstruction with autogenous tissue.