Meta-Analysis Shows No Association Between Breast Implants and Connective-Tissue Disease
Janowsky, et al (NEJM 342(11):781-790, 2000) included 20 studies in a comprehensive meta-analysis to investigate the possible relation between silicone breast implants and the risk of autoimmune conditions or connective-tissue diseases. Study inclusion criteria included the presence of an internal comparison group and the availability of numbers for the construction of two-by-two tables to establish categories of disease and implants. The diseases included in the analyses were rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), scleroderma or systemic sclerosis, Sjgrens syndrome (SS), dermatomyositis or polymyositis, all definite connective-tissue diseases combined, and other autoimmune or rheumatic conditions such as undifferentiated connective-tissue disease or mixed connective-tissue disease.
Using both unadjusted and adjusted analysis techniques, no evidence of a significantly increased risk of any specific connective-tissue disease, all definite connective-tissue diseases combined, or other autoimmune or rheumatic conditions was associated with breast implants.
| Disease | Relative Risk |
95% confidence interval |
| Rheumatoid Arthritis | 1.04 | 0.72 to 1.51 |
| SLE | 0.65 | 0.35 to 1.23 |
| Scleroderma | 1.01 | 0.50 to 1.73 |
| Sjgren’s Syndrome* | 1.42 | 0.65 to 3.11 |
| Definite connective-tissue | 0.8 | 0.62 to 1.04 |
| Other autoimmune/rheumatoid | 0.96 | 0.74 to 1.25 |
*It is unknown whether salivary-gland biopsies were performed, a requirement for the diagnosis of Sjgrens syndrome. Therefore, there may be a bias in the size of the estimated adjusted risk due to misclassification of the disease.
