Correspondence

Still More on Breast Implants and Connective-Tissue Diseases

N Engl J Med 1995; 333:526August 24, 1995

Article

To the Editor:

Solomon et al. state that a “new disease,” formerly called “human adjuvant disease,” is present in many symptomatic patients with silicone breast implants (May 11 issue).1 They then state, “This disease is included as a nosologic entity in the 1993 edition of a standard rheumatology textbook,” and refer to our chapter.2

That statement misrepresents what we said in our chapter. We pointed out that symptomatic women with breast implants usually present with features consistent with fibromyalgia — probably the most common musculoskeletal symptom complex that brings patients to rheumatologists. Recognizing the difficulties imposed by the absence of a comprehensive registry of implant recipients, we called for careful epidemiologic studies. Several such studies have now been conducted, and none show a relation between implants and any defined disease. In addition, when symptoms in women with this putative new disease were compared with symptoms in women undergoing cosmetic surgery not involving silicone, there was no evidence of any new disease due to silicone.3-5

Howard Fuchs, M.D.
John S. Johnson, M.D.
John S. Sergent, M.D.
Vanderbilt University School of Medicine, Nashville, TN 37202

5 References

1. 1

   Solomon G, Silverman S, Espinoza L. More on breast implants and connective-tissue diseases. N Engl J Med 1995;332:1306-1307
   Full Text | Web of Science

2. 2

   Sergent JS, Fuchs H, Johnson JS. Silicone implants and rheumatic diseases. In: Kelley WN, Harris ED Jr, Ruddy S, Sledge CB, eds. Textbook of rheumatology. 4th ed. Update 4. Philadelphia: W.B. Saunders, 1993:1-13.
   

3. 3

   Gabriel SE, O'Fallon WM, Kurland LT, Beard CM, Woods JE, Melton LS III. Risk of connective-tissue diseases and other disorders after breast implantation. N Engl J Med 1994;330:1697-1702
   Full Text | Web of Science | Medline

4. 4

   Wells KE, Cruse CW, Baker JL Jr, et al. The health status of women following cosmetic surgery. Plast Reconstr Surg 1994;93:907-912
   CrossRef | Web of Science | Medline

5. 5

   Sanchez-Guerrero J, Colditz GA, Karlson EW, Hunter DJ, Speizer FE, Liang MH. Silicone breast implants and the risk of connective-tissue diseases and symptoms. N Engl J Med 1995;332:1666-1670
   Full Text | Web of Science | Medline

Citing Articles (1)

Citing Articles

1. 1

   Jack W. Snyder. (1997) Silicone breast implants. Journal of Legal Medicine 18:2, 133-220
   CrossRef