women with breast implants seem to have an elevated rate of suicide

[Guest guest]

http://news./s/nm/20060413/hl_nm/implants_suicide_dc_1

NEW YORK (Reuters Health) - A new study adds to

evidence that while women with breast implants are not

at greater risk of breast cancer, they do seem to have

an elevated rate of suicide.

The reason for the suicide risk is unclear, but

several studies have now come to similar conclusions.

Some researchers believe the link is explained by

higher rates of depression, anxiety and low

self-esteem among women who undergo breast

augmentation.

Supporting that theory, one recent study found that

women who received cosmetic breast implants were more

likely to have a history of psychiatric

hospitalization than those who underwent other types

of plastic surgery.

Based on such findings, some experts have recommended

that women be screened for past and present

psychiatric disorders before they receive breast

implants.

The current study, published in the journal

Epidemiology, included 12,144 U.S. women who'd

received breast implants between 1960 and 1988, and

3,614 women who'd undergone other types of cosmetic

surgery during the same period.

Researchers compared the two groups' rates of death

from various causes over an average of 20 years; the

rates in each group were also compared with statistics

for women in the general population.

Overall, the study found, women who'd received

implants had a lower risk of death from most causes

when compared with the general population.

That included a lower risk of dying from breast

cancer, a disease that has been a concern among breast

implant recipients. Though research has failed to show

that the implants contribute to breast cancer

development, there is evidence that implants can

interfere with mammography screening for breast

tumors.

In this study, however, women with implants were only

half as likely as those in the general population to

die of breast cancer, according to the researchers,

led by Dr. Louise A. Brinton of the National

Cancer Institute in Bethesda, land.

Women who'd received implants did, however, have a

higher-than-average risk of suicide. And they were

more than twice as likely as women who'd had other

cosmetic procedures to take their own lives.

Between the two surgery groups, implant recipients

were also more likely to die of respiratory cancer or

brain cancer. However, few women in either group died

of a brain tumor, and it's not clear that there's a

cause-and-effect relationship between breast implants

and either form of cancer, according to Brinton and

her colleagues.

The elevated suicide risk, however, " remains of

concern, " the researchers conclude.

In an unexpected finding, they note, women with

implants were also more likely than those who'd had

other cosmetic procedures to die in a car accident.

Coupled with the suicide findings, Brinton and her

colleagues write, this suggests that some of those

traffic deaths were not accidental.

SOURCE: Epidemiology, March 2006.

[Guest guest]

Thanks Rogene ... here are some comments several of us made when the

British Medical Journal reported another study with similar findings

and conclusions:

http://bmj.bmjjournals.com/cgi/eletters/326/7388/527

This was an earlier discussion on suicide and breast implants in the

British Medical Journal ...

Rapid Responses to:

PAPERS:

V C M Koot, P H M Peeters, F Granath, D E Grobbee, and O Nyren

Total and cause specific mortality among Swedish women with cosmetic

breast implants: prospective study

BMJ 2003; 326: 527-528 [Full text] Rapid Responses: Submit a

response to this article

Rapid Responses published:

To soothe the savage breast

P. Bruning (7 March 2003)

Cause for suicide?

Rogene Schorer (7 March 2003)

Implants, Suicide, and Cancer

M. Zuckerman (9 March 2003)

Breast Implants: hype and realities.

Kamal Kumar Mahawar (9 March 2003)

Pyschopathic or normal response to illness?

Patty Faussett (10 March 2003)

Response to implants and suicide study

Ruby Rahn, Parkville, MO 64152, USA (11 March 2003)

One womans 15 years experience with silicone breast implants

L Reynolds (11 March 2003)

Cosmetic breast implants

Carolyn R Wolf (13 March 2003)

Breast Implants: Promoting Good Mental Health

Kathleen VF Nye (13 March 2003)

Authors miss most important clue

Ilena Rosenthal (14 March 2003)

Re: Breast Implants: hype and realities.

Carolyn R. Wolf (14 March 2003)

Body Dysmorphic Disorder?

Jordan Klesmer (25 March 2003)

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To soothe the savage breast 7 March 2003

P. Bruning,

author, breast cancer survivor, patient advocate

250 Cabrini Blvd. , NY, NY 10003

Send response to journal:

Re: To soothe the savage breast

I can't help but wonder if the excess suicide in women with breast

implants might be related not to some pre-implant psychological

condition but to a condition induced by failed implants. I have met

many women with terrible results due to local complications, who

require multiple follow up corrective surgeries which are often not

successful. Systemic reactions are still being debated, but there is

irrefuatble evidence that serious local complications occur

frequently and as a result, women may be worse off than before the

cosmetic surgery. Perhaps it is the realization that they will need

to spend the rest of their lives living with scarred, misshapen

breasts, and perhaps local pain as well that makes suicide an

option.

Competing interests: Author of " Breast Implants: Everything You

Need to Know, " Hunter House Publishing Co., 2003

Cause for suicide? 7 March 2003

Rogene Schorer,

no appointment - speaking an implant woman

U.S. A. 71909

Send response to journal:

Re: Cause for suicide?

In my opinion, one reason so many implant women commit suicide is

the general denial, an inability to treat our illnesses, on the part

of the medical profession. Our symptoms are so strange and diverse

they are extremely hard to diagnose in the brief period doctors have

to spend with a patient.

This disregard for implant women extends from the medical profession

to the media and government agencies. As a result the families of

implant women do not understand the gravity of our situation and

often lose patience.

Accompanying the lose of health is the loss of career, health

insurance, savings, home, self-esteem, and often family. . . All

this for something touted by the plastic surgery industry as a

device to improved self-esteem (at their gain and our loss).

The loss of family and community support is the most devastating of

all . . . suicide becomes a poor, but attractive, solution.

Competing interests: None declared

Implants, Suicide, and Cancer 9 March 2003

M. Zuckerman,

President

National Center for Policy Research for Women & Families, 1901

Pennsylvania Ave, NW, Washington, DC

Send response to journal:

Re: Implants, Suicide, and Cancer

The findings provide an interesting comparison and are for the most

part consistent with a study by the National Cancer Institute in the

U.S. conducted by Dr. Louise Brinton et al. However, the Brinton et

al study found an increase in suicides and some cancers compared to

other plastic surgery patients. If women who undergo plastic surgery

have more psychological problems than the general population, that

would not explain the difference between suicide rates of breast

augmentation patients compared to other women who underwent

liposuction, rhinoplasty, and other plastic surgery at a similar

age.

The Brinton results suggest that the increased vulnerability of

plastic surgery patients is not the only explanation for the

increased risk of suicide. Compared to most other plastic surgery

patients, implant patients suffer from complications that tend to

increase over time. Implant manufacturers report that many implant

patients need additional surgery within the first three years, and

that ruptures and other complications continue to increase over

time. Our Center receives letters every week from women whose

implants are broken and who are unable to afford to have them

removed. Many of these women are quite desperate, especially in

cases where silicone is migrating to other organs. Other women

describe deformities and pain caused by their implants. Although

Swedish women apparently have better access to medical care if

complications arise, some of these complications are extremely

difficult to fix. It is certainly possible that such problems may

cause an increase in suicides.

It is also important to note that the Brinton study found that

augmentation patients were three times as likely to die from lung

cancer and other respiratory diseases compared to other plastic

surgery patients, even though augmentation patients were no more

likely to smoke than other plastic surgery patients. Although the

augmentation patients who died of lung cancer were all smokers,

augmentation patients who smoked were more likely to die than other

plastic surgery patients who smoked. Since silica exposure is linked

to lung cancer, it is possible that leakage from silicone implants

increases the risk of lung cancer among smokers by irritating or

damaging the lungs. It is unfortunate that the Koot et al study

apparently did not statistically control for smoking, because it is

possible that they too would have found an increased risk of lung

cancer linked to breast implants, even among smokers.

A flaw of the Koot et al study is that it included women who had

breast implants for less than one year. This certainly weakens the

power of the statistical analysis, since one would not expect

implants to cause mortality in such a short time. In contrast, the

Brinton et al study included women who had breast implants for at

least 8 years. Even that is not ideal; it would be more appropriate

for a study of implants and cancer to only include women who had

breast implants for at least 10-15 years.

Zuckerman, Ph.D. President National Center for Policy Research

(CPR) for Women & Families 1901 Pennsylvania Avenue, NW Suite 901

Washington, DC 20006 202 223-4000 www.center4policy.org

Competing interests: None declared

Breast Implants: hype and realities. 9 March 2003

Kamal Kumar Mahawar,

Senior House Officer

Caithness General Hospital, Wick KW1 5NS

Send response to journal:

Re: Breast Implants: hype and realities.

Dear Sir/Madam, I think it has something to do with all the hype

surrounding breast implants. Many of these women are suffering

from " poor self image " and are easily attracted by the media created

hype. They start thinking that it is the end of all their problems,

which however is not true. Not unexpectedly, implants fall short of

their expectactions. We know that implants are not a solution to

this problem. More effort should be concentrated on helping them

improve their self image and not in reinforcing the myth. They

should be actively discouraged from choosing this option and must

instead be taught to respect their " body " .

Competing interests: None declared

Pyschopathic or normal response to illness? 10 March 2003

Patty Faussett,

Management

89052

Send response to journal:

Re: Pyschopathic or normal response to illness?

I hope this study will help to confirm the fact that implants carry

more serious risks than now thought. However, this comment really

gets to me.

" Given the well documented link between psychiatric disorders and a

desire for cosmetic surgery, the increased risk for death from

suicide may reflect a greater prevalence of psychopathology rather

than a causal association between implant surgery and suicide.3 "

I have seen this allusion several times in regards to the women who

have committed suicide after getting implants. Of course, we may not

know the real reasons the women have killed themselves, but I can

tell you that almost every single one of the women I have spoken to

or communicated with that was sick has thought of suicide at one

time or another. I think that most women don't carry out the actual

act of killing, and so the numbers of suicidal women are way higher

than these studies show. I speak from personal experience, as I was

often suicidal, or had thoughts of wanting to die during my illness.

Since I no longer feel that way, I take exception to the idea that I

am psychopathic to begin with. That is simply not the case. I am a

normal, average human being. The plain and simple truth is that the

illness we suffer from, when our immune systems are destroyed and we

cannot even function, is what causes us to have suicidal thoughts.

We no longer feel the desire to struggle through each day. We no

longer have motivation to live. We feel no hope or way out. We want

our suffering to end. We don't see an end in sight, when doctors

keep telling us that our illness is in our heads when we know darn

well that there is something wrong but no one can tell us what or

why or how to get better. I have had discussions with other women

that confirms this tendency to suicidal thought, and I am astounded

at how many have said they wanted to commit suicide because of their

illness, but have not done so because of husbands, children or

parents. This idea that we are psychopaths already and that is why

there are more suicides is just plain wrong! It is the illness that

makes us want to die, not a mental dysfunction that was already in

place. How can we get that idea across? How can we make others

understand just how devastating this illness is to us when all the

other tests come out normal? How can this suicidal tendency from

breast implants be quantified? This is one piece of the puzzle that

needs answering, so professionals can understand just how

devastating breast implants are for those that become ill, because

all we ever hear is how much of a confidence builder breast implants

are--and THAT IS TRUE UNTIL WE GET SICK. I had much more confidence

in myself after I got breast implants. I was happier than I had ever

been in my life. I was not a psychopath! But my illness at its worst

took away my desire to live, and I felt like a social paraiah. I

remember those dark days well, though I would rather forget.

Thankfully, I am doing so well today that I am almost back to

normal. I do have Hashimoto's, thanks to implants. I will have to

take thyroid meds for the rest of my life, and go back regularly for

blood work to tweek my dosages. It isn't fun. But I think I walked

away from my breast implant nightmare a lucky lady, relatively

speaking. It was only by the grace of God that I didn't commit

suicide and become one of those numbers.

Competing interests: Founder of Saline Support breast implant

support group on

Response to implants and suicide study 11 March 2003

Ruby Rahn,

self employed

5740 NW Union Chapel Rd.,

Parkville, MO 64152, USA

Send response to journal:

Re: Response to implants and suicide study

To the Editor of the British Medical Journal:

I am responding to the recent study, Total and cause specific

mortality among Swedish women with cosmetic breast implants:

prospective study, published in the March 8, 2003 edition of the in

the British Medical Journal.

http://bmj.com/cgi/content/full/326/7388/527?eaf

Finding fault with those who have been harmed is a strategy used to

discredit the injured. It is the same strategy used by trial lawyers

to discredit women injured by other harmful acts like rape. If this

study is to be taken seriously, then one has to believe that

millions of women from around the world, who have had implants, must

all have low self-esteem or be mentality unstable.

We live in a world society where " image is everything " and that

message is constantly being fed to us in news reports, on

billboards, perfume and clothing ads in every magazine and

newspaper. Doctors and surgeons, in their direct advertising to the

public, are also selling and promoting their latest and greatest

technology, which they assert helps you feel better about being you.

We see extreme makeovers on television where the recipients of

plastic surgery exclaim how happy they are with the results and

proudly tell the world what a boost to their confidence the surgery

gave them. Everyone I know desires, to some degree, to improve their

appearance, does that make everyone mentally unstable?

The results of this study appear to me as a maneuver to deflect the

attention from some of the real problems of breast implants and

other medical devices. A few of the problems I have with the study

are as follows:

1.The study only included women who had breast implants for less

than one year. This is a major statistical flaw that impairs and

prevents factual analysis and accurate results. Suicide from having

breast implants does not happen within one year but over a period of

years.

2.The fact that women have to endure multiple surgeries to correct

common complications as a result of ruptures and contractures and

that these complications increase over time would should be included

in a study on suicide and wasn't here.

3.Elastomers particles from the shell and silicone gel leaking from

ruptured implants migrate to distant organs include the lungs and

liver. A foreign body reaction to these materials and other

complications like cancer were also overlooked.

Perhaps the increase incident of suicide, once women have received

implants, was from exposure to platinum or other chemicals used in

the manufacturer and leach out from aging and degrading implants

over a period of time?

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd

=Retrieve & db=PubMed & list_uids=12589499 & dopt=Abstract

If the women were mentally unstable before receiving implants, then

what does that say about the judgment and ethical conduct of the

doctors who put these products into unstable women? Couldn't that be

viewed as exploiting vulnerable women for profit?

I cannot help but see this study for what it is, just another tactic

in the ongoing discrimination to trivialize, discredit and demean

women injured by breast implants.

Sincerely,

Ruby Rahn

5740 NW Union Chapel Road, Parkville, MO 64152

rubyrm@...

Competing interests: I was harmed by breast implants

One womans 15 years experience with silicone breast implants 11

March 2003

L Reynolds,

n/a

disabled

Send response to journal:

Re: One womans 15 years experience with silicone breast implants

I decided to get silcone breast implants in 1978 at the age of 29

because I was not happy with my small " B " size breasts. After

receiving the implants, I was elated by the way I looked in my

cloths and without cloths. Around 1984, I was experiencing a host of

different health problems like, unexplained rashes, a constant low-

grade fever, joint pain, hair loss and fatigue. I seen over 20

doctors in an 18 month time period, hoping one of them could find

out what was happening to me. But none of them could.

By 1990, my health problems continued to grow worse and included

constant infections, muscle weakness,numbness and tingling in

extremities, gastrointestinal problems, dry eyes and mouth, cold

sensitivity, tender-points on my body,cognitive problems such as

memory loss, inability to concentrate, and even clumsiness. My

breasts were hard and painful.I was told I might have Lupus. I was

relieved, I finally had a diagnoses of my symptoms.

In 1993, I was unable to hold a job because of missing too much work

for my health problems. It was like having the flu everyday. Both my

breasts were hard and had mis-shapened, one was moving up toward my

shoulder and had what felt like a bubble on the side near my armpit.

In November 1993 I had the implants removed. Both implants were

grossly ruptured as well as the scar capsules that surrounded the

implants, spilling silicone into my chest cavity. My natural breast

tissue had to be removed because silicone was inter-mingled

throughout my breast tissues and planes. Because I wanted and got

breast implants, I was left with no breasts at all and the deformity

is simliar to having breast cancer.I did have a nipple

reconstruction because silicone had to be scraped out from behind

them, leaving them folded over and sunkin into my chest. My health

has gradually returned to almost normal except now my lungs are

turning fibrosis causing difficulty in breathing and a heavy feeling

in my chest. I have never smoked cigarettes. I am 53 years old now

and at a new place in my life, older and wise enough to know that

breast size really doesn't matter. Having bigger breasts are not

really important in life, good health and loving relationships are

what really matters. I just wish I would have realized that when I

was 29.

Sincerely,

Reynolds

Competing interests: Personal experience of a woman that had

silicone breast implants for 15 years.

Cosmetic breast implants 13 March 2003

Carolyn R Wolf,

Retired

22152

Send response to journal:

Re: Cosmetic breast implants

Perhaps these good doctors will take the word of those women who

have had breast implants for more than 20 years; most of the studies

done in the US have been bought and paid for by manufacturers and

plastic surgeons -- those who profit monetarily from trumped up

studies covering only those women who had the implants for less than

8 years..Had they included women who had the implants for 15 years

or more, AND had they told the truth, the published story would be a

totally different one. As one who has recently been diagnosed

with " silicone induced multiple sclerosis " , and one who has had

these symptoms for several years, and been told by doctors that

everything is " okay " - and when I finally was allowed to have an

MRI, was untruthfully told that there were some lesions on the

brain, but a normal amount for someone my age (72 years -- 28 years

with implants); another doctor (looking at the same film) has now

told me there are more than 20 lesions, far more than a " normal

amount " .Is this cause for depression??

Lets stop the cover up and lies! Those are the reasons there are so

many suicides -- because doctors seem to be afraid to tell the

truth; we are constantly being lied to -- or offered

tranquilizers..Will making us tranquilized zombies solve the

problem?? I think not - they only deepen the depression and cause

more suicides.

Competing interests: I am a silicone survivor

Breast Implants: Promoting Good Mental Health 13 March 2003

Kathleen VF Nye,

PSY. student

Reading Area Community College

Send response to journal:

Re: Breast Implants: Promoting Good Mental Health

I could not help but be interested in the article about suicide and

breast implants.

As a psychology student I am interested in all areas of clinical

depression. The article associate breast implants and suicide,

suggesting a connections. I agree on this point, but I think the

suicides come after the disappointing results and repeated surgeries

and the frustration of not being taken seriously when giving

symptoms to the physicians. After and not before the implantation,

does the depression set in.

I also write as a silicone survivor, implanted in 1968 after a

bilateral mastectomy(age 22). With 14 implants in 18 years behind

me, I speak from experience. The depression came after the promise

of " newer, better implants " and the " won't get hard " line.

The high suicide rate does not surprise me. What does surprise me is

that the medical community still thinks that stuffing sacks of

silicone into women's chest is a procedure that will promote good

mental health.

Competing interests: None declared

Authors miss most important clue 14 March 2003

Ilena Rosenthal,

Director, Non Profit foundation

San Diego, CA 92109

Send response to journal:

Re: Authors miss most important clue

This study's authors miss the most important clue to the reasons a

disproportionately large number of women with breast implants choose

suicide.

Most breast implants fail over time, even though for decades they

were sold as a " lifetime " device.

With this extremely high rupture rate comes additional surgeries,

infections, and frequently the ultimate loss of the implant along

with breast tissue. Commonly, women suffer from the very painful

fibromyalgia and other often undefined diseases.

The denial of the medical profession as to their illnesses as well

as families experiencing their once healthy and vibrant mother,

wife, sister, or daughter now in chronic pain with no medical

solution in sight, leaves the women feeling more isolated and

desperate.

She often then loses her job, her insurance, and the downward spiral

continues.

To ignore the enormous physical harm from ruptured implants and

drawing the fuzzy psychological conclusions the authors have, makes

me wonder about their open minded scientific approach to this

growing medical tragedy.

Ilena Rosenthal

Director, Humantics Foundation for Women

http://www.BreastImplantAwareness.org

FDA Rupture Studies

http://www.fda.gov/cdrh/breastimplants/extracapstudy.html

http://www.fda.gov/cdrh/breastimplants/studies/biinterview.html

Competing interests: Author: Breast Implants: The Myths, The

Facts, The Women Founder of Support group: Breast Implants: Recovery

& Discovery

Re: Breast Implants: hype and realities. 14 March 2003

Carolyn R. Wolf,

Retired

22152

Send response to journal:

Re: Re: Breast Implants: hype and realities.

Perhaps one of the reasons for low self esteem might be a plastic

surgeon inorming you (after double mastectomies!) that " you don't

have to go through life looking like THIS " . Those of us with no

problems with our self esteem started thinking something horrible

was wrong with us; then to be assured, and reassured, that the

implants were/are safe, and " no, you are not being used as a guinea

pig. " Which is exactly what we were/are being used for.

When I found one breast collapsed (both implants were ruptured, but

only one scar tissue capsule had collapsed), three plastic surgeons

tried to " sell " me on replacements with saline filled implants--

only they did not use the correct designation: silicone implants

with saline filling, rather than with silicone gel filling!!

This world needs a few doctors willing to emulate Raoul Westenberg

(remember him from World War II?)-- to try to find some answers to

this chemical poisoning that we have been subjected to..Worldwide,

there are millions of us..

Competing interests: Silicone implant survivor

Body Dysmorphic Disorder? 25 March 2003

Jordan Klesmer,

Assistant Professor of Psychiatry, NYU School of Medicine

North Shore University Hospital, 400 Community Drive, Manhasset, New

York 11030

Send response to journal:

Re: Body Dysmorphic Disorder?

To Whom It May Concern,

Koot et. al. recently reported an increased risk of suicide amongst

patients who received cosmetic breast implants (1). The Somatoform

Disorder known as Body Dysmorphic Disorder involves a preoccupation

with a defect in appearance and the defect is either imagined, or,

if a slight physical defect is present, the patient's concern is

markedly excessive with subsequent impairment of social or

occupational functioning (2). The patient's distress may lead to

suicidal ideation, suicide attempts, and completed suicide (2,3). It

has been estimated that between 6% to 15% of cosmetic surgery and

dermatology patients suffer from this disorder (2).

Consequently, it behooves cosmetic surgeons to seek psychiatric

consultations preoperatively for the purpose of ruling out Body

Dysmorphic Disorder and have it treated if present. Perhaps only

then can the elevated suicide rate associated with breast implants

be diminished.

References

1.Koot VCM, s PHM, Granath F, Grobbee DE, and Nyren O. Total

and cause specific mortality among Swedish women with cosmetic

breast implants: prospective study. British Medical Journal. 326:527-

528.

2.Diagnostic and Statistical Manual of Mental Disorders, Fourth

edition, Text Revision. American Psychiatric Association. American

Psychiatric Press. Washington, D.C. 2000

3. KA, McElroy SL, Keck PE, Pope HG, Hudson JI. Body

Dysmorphic Disorder: 30 Cases of Imagined Ugliness. American Journal

of Psychiatry. 150:2 302-308.

Competing interests: None declared