Fw: Response to article about implants in the British Medical Journal

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Sent: Thursday, June 12, 2003 9:53 PM

Subject: Response to article about implants in the British Medical Journal

British Medical Journal 2003;326:1266 (7 June)

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Letter

Mortality in Swedish women with cosmetic breast implants

Study found increased risk of suicides and cancer deaths EDITOR—The increased suicides and lung cancers among implant patients reported by Koot et al is consistent with a study by Brinton et al at the US National Cancer Institute.1 2 However, Brinton et al found an increased risk of suicides and cancer deaths compared with other patients having plastic surgery.

If plastic surgery patients have more psychological problems than the general population, as Koot suggests, that would not explain the difference between suicide rates of breast augmentation patients compared with other plastic surgery patients. There are other, more likely explanations. Notably, unlike most other plastic surgery patients, implant patients suffer from well documented complications such as chronic pain and implant breakage that increase in likelihood every year. Our centre receives letters every week from women whose implants are broken and who cannot afford explant surgery. Many of these women are quite desperate, especially when silicone is migrating to other organs or causing pain or deformities. Even in countries with national health care, these problems can be difficult to remedy and could potentially cause an increase in suicides.

A flaw of the Koot et al study is that it included women who had breast implants for less than one year, which weakens the statistical power. In contrast, the Brinton et al study included women who had breast implants for at least eight years and found increases in deaths from suicide, lung cancer, and brain cancer compared with plastic surgery patients who reported similar smoking and lifestyle habits.

Zuckerman, president National Center for Policy Research for Women and Families, 1901 Pennsylvania Avenue, NW Suite 901, Washington, DC 20006, 202 223-4000, USA dz@...

Competing interests: None declared.

References

Koot VCM, s PHM, Granath F, Grobbee DE, Nyren O. Total and cause specific mortality among Swedish women with cosmetic breast implants: prospective study. BMJ 2003;326: 527-8. (8 March.)[Free Full Text]

Brinton LA, Lubin JH, Burich MC, Colton T, Hoover RN. Mortality among augmentation mammoplasty patients. Epidemiology 2001;12: 321-6.[CrossRef][iSI][Medline]

Other related articles in BMJ:

PAPERSTotal and cause specific mortality among Swedish women with cosmetic breast implants: prospective study. V C M Koot, P H M Peeters, F Granath, D E Grobbee, and O NyrenBMJ 2003 326: 527-528. [Full text]