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May 28, 1997

More Breast Implant Prose and Cons: Contractures and Confounding: The Controversy Continues

Author Affiliations

From the Research Service, Veterans Affairs Medical Center, Houston, Tex.

JAMA. 1997;277(20):1643-1644. doi:10.1001/jama.1997.03540440077037

Considering the all too familiar history of conflicting evidence from independent epidemiologic studies of the health effects following exposures to various medical interventions (eg, studies of breast cancer following reserpine use1 and of the development of rheumatoid arthritis among oral contraceptive users2), results from studies of the occurrence of connective tissue disease following breast implantation have been surprisingly consistent.3-17 Despite the remarkable agreement showing little to no increased risk of the established connective tissue disease syndromes, the breast implant controversy has gained its own inexorable momentum. Early case reports of the development of autoimmunelike disease in women who had silicone injections directly into their breast tissue and in women who had silicone gel-filled breast implants aroused fears of a causal relationship. The fears set off a complex chain reaction of speculation about biologically plausible mechanisms, abrupt changes in Food and Drug Administration (FDA) regulatory policy, a groundswell