Abstract
Purpose: To study the possible association of silicone-breast-implant exposure and
immunologic abnormalities within the Nurses’ Health Study, an ongoing prospective
cohort study of women.
Subjects and Methods: From this cohort, we randomly selected 200 women who had been
exposed to silicone breast implants and who had never reported connective tissue diseases
during 14 years of follow-up, and 500 age-matched, nonexposed women, including 100
with definite connective tissue diseases validated by medical record review, 100 with
at least one symptom of a connective tissue disease, 100 with diabetes, and 200 healthy
controls. Assays for antinuclear antibodies (ANA), including anti-dsDNA, anti-ssDNA,
anti-Sm/RNP/Ro/La, and anti-Scl-70, rheumatoid factor, immunoglobulins, serum complement,
and C-reactive protein level, and anticardiolipin, antithyroglobulin, antithyroid
microsomal, and antisilicone antibodies were performed by standard techniques in blood
samples collected in 1989 or 1990 before collection of silicone-breast-implant exposure
data in 1992.
Results: ANA was positive (≥1:40) in 14% of women with silicone breast implants compared
with 20% of healthy women (P = 0.11). Rheumatoid factor was positive (≥1:40) in 5% of women with silicone breast
implants and 2% of healthy women (P = 0.16). Women with silicone breast implants had a significantly higher frequency
of anti-ssDNA antibodies than healthy women (41% and 29%, P = 0.012). Duration of implant was associated with a higher frequency of anti-ssDNA
antibodies (P = 0.03) but not with ANA or rheumatoid factor. No other significant differences in
the frequencies of autoantibodies were observed in silicone breast implant–exposed
women. Antisilicone antibodies were not found in any sample.
Conclusion: We found no increased frequency of any immunologic abnormalities in women
exposed to silicone breast implants, except for anti-ssDNA, which has unknown clinical
relevance.
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Article info
Publication history
Published online: August 16, 2004
Accepted:
August 26,
1998
Received in revised form:
August 26,
1998
Received:
February 11,
1998
Footnotes
☆Supported by grants from the Public Health Service (AR42630, CA40356, CA49449, and AR36308). Dr. Karlson is supported by an Arthritis Foundation Postdoctoral Fellowship. Dr. Sanchez-Guerrero was supported by a Research Fellowship Award from the Fogarty International Center (TW04573).
Identification
Copyright
© 1999 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
