To the Editor.
—Although the findings of Dr Hennekens and colleagues1 are indeed interesting and thought-provoking, there are other latent connective-tissue problems that may occur among recipients of silicone breast implants.Soft-tissue rheumatic problems may explain many of the symptoms of silicone breast implant recipients. In the United States, an estimated 10% to 25% of patients referred to rheumatologists have fibromyalgia.2 Many of the major studies being quoted regarding the silicone breast implant controversy do not consider soft-tissue rheumatic conditions as sequelae of silicone breast implants in some patients. This is understandable because many large studies are retrospective. If the patient had not been evaluated for fibromyalgia previously, there would be no way to know whether or not the patient in question had that disorder; it simply would not be found in a chart review.In my rheumatology practice I recently evaluated 272 women with a history of silicone breast implants
Romano TJ. Breast Implants and Connective-Tissue Disease. JAMA. 1996;276(2):102. doi:10.1001/jama.1996.03540020024018