Skip navigation

Are breast implants safe?

Capsular contraction
Implant rupture
Cancer
Interference with breast cancer detection
Autoimmune disease
Comment

About 80% of silicone breast implants are for cosmetic purposes, and 20% for breast reconstruction after surgery, mainly for cancer. A review of their safety [1] does not include details of any formal searching. Women who have breast implants, perhaps reflecting the fact that they are predominantly for cosmetic purposes, are different from their sisters who do not have implants. They are much less likely to be obese, drink more, be younger at first pregnancy and first birth, have a history of terminated pregnancies, to have used oral contraceptives, have more sexual partners and use hair dyes.

The finding of high levels of silicone in women with implants does not substantiate a causal relationship between silicone and reported disease. Silicone is a common mineral, and is used in food, beverage and cosmetic industries. It is used in medicine, and over a lifetime an insulin-requiring diabetic may inject up to 50 grams of silicone, and have substantial bodily exposure to silicone. Some of the suspected problems with silicone breast implants have been looked at in detail:

Capsular contraction


Formation of a capsule around an implant is part of the inflammatory response to a foreign body. Contracture of the capsule results in moderate to extreme hardening of the breast, tightness, pain or deformity. The overall incidence was 17% in 1454 breasts in 749 women, with five-year rates of 12%, 34% and 30% for cosmetic, cancer or cancer prophylactic surgery. It also occurs with saline implants.

Implant rupture


The proportion of implants expected to be intact is 89% after eight years, falling to 5% after 20 years (Figure).


Cancer


No epidemiological study has found an increased risk of breast cancer in women with breast implants compared to those without.

Interference with breast cancer detection


Current advice from the American College of Radiology says that adequate breast examinations can be achieved with currently available mammographic techniques.

Autoimmune disease


The paper examines the association of silicone with immunological reactions and links with connective tissue disorders. The epidemiological information was almost universally negative. One, large, study of health professionals found a very small, statistically significant increased risk of connective tissue diseases in women with breast implants. The weight of evidence was against the implants causing any generalised disease.

Comment


This paper is let down because it does not have a search strategy, although there are 77 references. For anyone wanting to find the best information for themselves or patients on risks associated with breast implants, this would be a good place to start.

Reference:

  1. PC Gerszten. A formal risk assessment of silicone breast implants. Biomaterials 1999 20: 1063-1069.
previous story in this issue