RISK OF CONNECTIVE-TISSUE DISEASE AND RELATED DISORDERS AMONG WOMEN WITH BREAST IMPLANTS - A NATIONWIDE RETROSPECTIVE COHORT STUDY IN SWEDEN

Objective: To examine the relation between connective tissue disease a nd related conditions and breast implants. Design: Retrospective cohor t study of all women in the Swedish national inpatient registry who un derwent breast augmentation surgery with artificial implants during 19 64-93, compared with women who underwent breast reduction surgery duri ng the same period. Setting: Sweden. Subjects: 7442 women with implant s for cosmetic reasons or for reconstruction after breast cancer surge ry and 3353 women with breast reduction surgery. Main outcome measures : Subsequent hospitalisation for definite connective tissue diseases ( rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis , dermatomyositis, and Sjogren's syndrome) or related disorders. Resul ts: 29 women with implants were hospitalised for definite connective t issue disease compared with 25.5 expected based on general population rates (standardised hospitalisation ratio 1.1 (95% confidence interval 0.8 to 1.6)). There were no diagnoses of systemic sclerosis, and no s ignificant excess in risk for polymyalgia rheumatica, fibromyalgia, an d several related disorders. Among women who underwent breast reductio n surgery, 14 were hospitalised for definite connective tissue disease compared with 10.5 expected (standardised hospitalisation ratio 1.3 ( 0.7 to 2.2)). Compared with the breast reduction group, women with bre ast implants showed a slight reduction for all definite connective tis sue disease (relative risk 0.8 (95% confidence interval 0.5 to 1.4)). Conclusions: This large nationwide cohort study shows no evidence of a ssociation between breast implants and connective tissue disease.