CONNECTIVE-TISSUE DISEASE AND OTHER RHEUMATIC CONDITIONS FOLLOWING BREAST IMPLANTS IN DENMARK

To investigate the risks of connective tissue diseases (CTDs) followin g breast implants we used the nationwide Danish Hospital Discharge Reg ister (HDR) to identify 2,570 women who received breast implants, eith er for cosmetic reasons (N = 1,135) or for breast reconstruction (N = 1,435), between 1977 and 1992. Two additional cohorts of women having either breast reduction surgery (N = 7,071) or breast cancer without i mplants (N = 3,952) were identified for comparison. observed-to-expect ed (O/E) cases of CTDs and other rheumatic conditions were calculated based on national hospital discharge rates. The calculated O/E ratio f or definite CTDs was 1.1 (95% confidence interval [Cl], 0.2-3.4) among women with cosmetic breast implants, and 1.3 (95% Cl, 0.5-2.6) among women receiving implants for breast reconstruction. No CTD excesses we re seen in the breast reduction or breast-cancer-without-implant cohor ts. Statistically significant risks for muscular rheumatism (a nonspec ific discharge diagnosis) were observed in all four patient cohorts: c osmetic (O/E ratio, 2.5; 95% Cl, 1.7-3.6), breast reconstruction (O/E ratio, 2.5; 95% Cl, 1.7-3.4), breast reduction (O/E ratio, 2.0; 95% Cl , 1.6-2.3), and breast cancer without implants (O/E ratio, 1.4; 95% Cl , 1.0-1.9). In conclusion, breast implants showed little association w ith definite CTDs. Breast surgery per se, however, was associated with an apparent increase in muscular rheumatism.