| Ilena Rose 2006-10-15, 9:33 pm |
| Plast Reconstr Surg. 2004 Jul;114(1):204-14; discussion 215-6.
http://www.ncbi.nlm.nih.gov/entrez/...t_uids=15220594
Untreated silicone breast implant rupture.Holmich LR, Vejborg IM,
Conrad C, Sletting S, Hoier-Madsen M, Fryzek JP, McLaughlin JK,
Kjoller K, Wiik A, Friis S.
Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen,
Denmark. lisbet@cancer.dk
Implant rupture is a well-known complication of breast implant surgery
that can pass unnoticed by both patient and physician. To date, no
prospective study has addressed the possible health implications of
silicone breast implant rupture. The aim of the present study was to
evaluate whether untreated ruptures are associated with changes over
time in magnetic resonance imaging findings, serologic markers, or
self-reported breast symptoms. A baseline magnetic resonance imaging
examination was performed in 1999 on 271 women who were randomly
chosen from a larger cohort of women having cosmetic breast implants
for a median period of 12 years (range, 3 to 25 years). A follow-up
magnetic resonance imaging examination was carried out in 2001,
excluding women who underwent explantation in the period between the
two magnetic resonance imaging examinations (n = 44). On the basis of
these examinations, the authors identified 64 women who had at least
one ruptured implant at the first magnetic resonance imaging
examination and, for comparison, all women who had intact implants at
both examinations (n = 98). Magnetic resonance images from the two
examinations were compared and changes in rupture configuration were
evaluated. Comparisons were also made for self-reported breast
symptoms occurring during the study period and for changes in serum
values of antinuclear antibodies, rheumatoid factor, and cardiolipin
antibodies immunoglobulin G and immunoglobulin M. The majority of the
women with implant rupture had no visible magnetic resonance imaging
changes of their ruptured implants. For 11 implants (11 percent) in 10
women, the authors observed progression of silicone seepage, either as
a conversion from intracapsular into extracapsular rupture (n = 7), as
progression of extra-capsular silicone (n = 3), or as increasing
herniation of the silicone within the fibrous capsule (n = 1);
however, in most cases, these changes were minor. Some changes could
be ascribed to trauma, but others seemed spontaneous. There was no
increase in levels of autoantibodies during the study period in either
study group. Women with untreated implant ruptures reported a
significant increase in nonspecific breast changes (odds ratio, 2.1;
95 percent confidence interval, 1.2 to 3.8) compared with women
without ruptures. On the basis of this first study of women with
untreated silicone breast implant rupture, the authors conclude that
implant rupture is a relatively harmless condition, which only rarely
progresses and gives rise to notable symptoms. Even so, because of a
small risk of silicone spread, the authors suggest that women with
implant ruptures be followed clinically, if not operated on. Because
implant ruptures often occur asymptomatically, any woman with silicone
implants, regardless of rupture status, should be evaluated at regular
intervals.
PMID: 15220594 [PubMed - indexed for MEDLINE]
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