Gabriel S E, O'Fallon W M, Kurland L T, Beard C M, Woods J E, Melton L J
Department of Health Sciences Research, Mayo Clinic, Rochester, Minn. 55905.
N Engl J Med. 1994 Jun 16;330(24):1697-702. doi: 10.1056/NEJM199406163302401.
We conducted a population-based, retrospective study to examine the risk of a variety of connective-tissue diseases and other disorders after breast implantation.
All women in Olmsted County, Minnesota, who received a breast implant between January 1, 1964, and December 31, 1991 (the case subjects), were studied. For each case subject, two women of the same age (within three years) from the same population who had not received a breast implant and who underwent a medical evaluation within two years of the date of the implantation in the case subject were selected as control subjects. Each woman's inpatient and outpatient medical record was reviewed for the occurrence of various connective-tissue diseases, certain other disorders thought to have an autoimmune pathogenesis (e.g., Hashimoto's thyroiditis), and cancer other than breast cancer, as well as related symptoms and abnormal results of laboratory tests. The case subjects were categorized according to whether they received implants for cosmetic reasons, for reconstruction after mastectomy for breast cancer, or for reconstruction after subcutaneous mastectomy for cancer prophylaxis. Additional control subjects (women treated for breast cancer who did not have breast reconstruction) were studied for comparison with the case subjects.
A total of 749 women who had received a breast implant were followed for a mean of 7.8 years, and 1498 community controls were followed for a mean of 8.3 years. In 5 case subjects, as compared with 10 subjects in the control group, one of the specified connective-tissue diseases was diagnosed (relative risk, 1.06; 95 percent confidence interval, 0.34 to 2.97). Twenty-five case subjects had signs or symptoms of arthritis, as compared with 39 control subjects (relative risk, 1.35; 95 percent confidence interval, 0.81 to 2.23). Among the various signs or symptoms examined, only morning stiffness was significantly increased among the women who had received a breast implant (relative risk, 1.81; 95 percent confidence interval, 1.11 to 2.95).
We found no association between breast implants and the connective-tissue diseases and other disorders that were studied.
我们进行了一项基于人群的回顾性研究,以调查乳房植入术后发生各种结缔组织疾病和其他病症的风险。
对明尼苏达州奥尔姆斯特德县在1964年1月1日至1991年12月31日期间接受乳房植入的所有女性(病例组)进行研究。对于每例病例组女性,从同一人群中选取两名年龄相同(相差不超过三岁)且未接受乳房植入且在病例组女性植入日期的两年内接受过医学评估的女性作为对照组。查阅每位女性的住院和门诊病历,以了解各种结缔组织疾病、某些被认为具有自身免疫发病机制的其他病症(如桥本甲状腺炎)、非乳腺癌的癌症以及相关症状和实验室检查异常结果的发生情况。病例组女性根据接受植入的原因分为因美容、乳腺癌乳房切除术后重建或皮下乳房切除术后重建以预防癌症。还研究了额外的对照组(接受乳腺癌治疗但未进行乳房重建的女性)以与病例组进行比较。
共有749名接受乳房植入的女性平均随访了7.8年,1498名社区对照组女性平均随访了8.3年。在病例组中有5名女性被诊断出患有特定的结缔组织疾病之一,而对照组中有10名女性(相对风险为1.06;95%置信区间为0.34至2.97)。25名病例组女性有关节炎的体征或症状,而对照组中有39名女性(相对风险为1.35;95%置信区间为0.81至2.23)。在检查的各种体征或症状中,只有接受乳房植入的女性晨僵明显增加(相对风险为1.81;95%置信区间为1.11至2.95)。
我们发现乳房植入与所研究的结缔组织疾病和其他病症之间没有关联。