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Breast Implant Silicone And Rheumatic Disorders Not Connected

Implant integrity has no major impact on rheumatic symptoms in women with silicone breast implants, according to a study.

This finding adds weight to the likelihood that silicone from implants causes neither a specific connective tissue disease nor any other distinct disease entity.

Still, moderate increases in incidences of positive antinuclear antibodies (ANA) and neuropathy-associated symptoms seen in women in this study require explanation, suggest M. Gaubitz and colleagues from the University of Munster, Munster, Germany.

These researchers studied the correlation between implant ruptures, silicone presence in the liver, antibody status and clinical symptoms in women with silicon breast implants (SBIs). Participants were 90 women who were seen consecutively and examined via magnetic resonance imaging (MRI) to assess the integrity of the implants. Magnetic resonance spectroscopy (MRS) was used to estimate presence of silicone in the liver.

These results were then correlated with patients' complaints, as evaluated by a standardized questionnaire and physical examination by a rheumatologist and antibody screening.

Defects were found by breast MRI in 24 (26.6 percent) patients; in 13 (54.2 percent) of these women, MRS detected silicone in the liver. Of the 66 patients whose implants were estimated by MRI to be intact, 15 (22.7 percent) had apparent silicone in the liver. This argued for gel bleeding, note the authors.

Clinically, two of the patients had rheumatoid arthritis before they received their implants; the remaining patients showed no typical symptoms of arthritis or connective tissue disease (CTD).

Women with MRS evidence of silicone in the liver did not differ significantly in their complaints, except for the most frequent symptom, tingling/numbness of the fingers. There was a positive pattern of ANA in 13 of the 28 MRS-positive patients (46.4 percent) and 15 of the 62 MRS-negative patients (24.2 percent).

A specific weak antibody titre against SS-A was detected in only one of the 28 ANA-positive patients.
Rheumatology 2002; 41: 129-135. "Silicone breast implants: correlation between implant ruptures, magnetic resonance spectroscopically estimated silicone presence in the liver, antibody status and clinical symptoms"

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