Clinical Briefs-By Louis Kuritzky, MD

Meta-Analyses of the Relation Between Silicone Breast Implants and the Risk of Connective Tissue Disease

Alleged association of sili-cone breast implants (SBI) with a variety of consequences, including connective tissue/autoimmune diseases, has sparked substantial medical and legal debate. Though three other meta-analyses of breast implants exculpated them, study characteristics were felt to still leave the issue inconclusive. Janowsky and colleagues performed a meta-analysis specifically to conclusively address whether SBI is associated with these adverse outcomes. Substrate for their report included 20 different studies.

No evidence of an association between SBI and connective tissue diseases was discerned. A trend toward increased risk of Sjogren’s syndrome was not statistically significant. One method of analysis suggested that the frequency of all connective tissue diseases combined, and Sjogrens syndrome, were slightly elevated, though the clinical relevance of this increase appears dubious. With the exception of the effect induced by a single study, which when included suggests a minimal increased risk, Janowsky and colleagues demonstrate that data accrued thus far do not support any important relationship between SBI and connective tissue diseases.

Janowsky EC, et al. Meta-analyses of the relation between silicone breast implants and the risk of connective-tissue diseases. N Engl J Med 2000; 342(11):781-790.