Can you get sick from breast implants? A large study among women who have had breast cancer shows that women who received silicone prostheses during their treatment have no higher risk of Breast Implant Illnessthe term for a range of complaints. But that does not mean that women with implants cannot get those complaints.
The term breast implant illness (bii) is used for various complaints in women with silicone breast implants. A clear definition is missing, bii is an umbrella for a list of symptoms, ranging from fatigue and a dry mouth, to joint pain, brain fog and hair loss. Unlike the local complaints with which they can go together, such as pain or inflammation in the chest, bii complaints cannot be explained medically.
From the early nineties, women with this kind of complaints have come to the doctor in the Netherlands. In 2012, the first silicone clinic opened in Amsterdam – resulting in a huge crowd. RIVM now coordinates a wide research program according to the health problems of women with silicone breast implants.
Silicone breast implants have an estimated 200,000 women in the Netherlands. 30 percent due to a breast reconstruction, 70 percent are cosmetic. It is certain that there are women with breast implants that have complaints. But how much exactly? And is it because of the implants?
Fatigue and brain fog
The Antoni van Leeuwenhoek led a large examination of six hospitals among women treated for breast cancer. The results published today Journal of the National Cancer Instituteshed new light on the silicone store.
Ten thousand women, treated for breast cancer between 2000 and 2015, were asked to participate in a study of their health. That resulted in more than six thousand participants, of an average of 58 years old. Almost a third had opted for silicone breast implants after a breast amputation.
The participants were presented with eighteen frequently mentioned complaints, without being explicitly mentioned. About 20 percent of women with implants had serious complaints: a good number from the list and then also to a strong extent.
But it turned out: as many women without silicone implants had these complaints. In women who had had a breast-saving operation, a reconstruction with their own fatty tissue or an amputation without reconstruction also reported around 20 percent symptoms such as fatigue, muscle and joint pain, fears and brain fog.
Also when clustering the complaints – for example, where the emotional or rheumatic complaints were taken together – there were hardly any differences between the two groups. “So we don’t think there is a generally sick mechanism, or a toxic effect,” says physician-researcher Jonathan Spoor. He emphasizes ‘General’. “Because this says nothing about individual women with complaints.”
What is special is that this research covers a large group of women who come from the same source: they all had breast cancer and have not chosen it. That makes them more similar to each other than when you compare women who choose a cosmetic breast augmentation with women from the entire population.
Although breast cancer patients with or without prostheses are not one on one, says Spoor: “For example, women who choose implants are on average younger.” But because there was a lot of information about the participants, the researchers could see that other factors also resulted in any differences between the two groups.
The researchers also looked at breast cancer patients who had had implants, but had had them removed. Maybe they did this because they had bii-related complaints? “It was only a small part of the 356 women who, for that reason, opted for explantation, less than 3 percent.” They did that much more often because of local complaints.
“Some women with implants do have complaints,” emphasizes Spoor. But it is about complaints that are also common in women without implants, and in women who have not had breast cancer.
The complaints are real, but there is no connection with the implants, the researchers conclude. Or as the last sentence in the scientific publication is: “Our outcomes question the idea that Bii is a stand -alone condition, with a pathogenic effect in the body caused by silicone.”
“Don’t make me sick?”
This research, expects Spoor, can help oncological surgeons to talk to patients about the question: implants yes or no? “Often women ask: I don’t get sick? That this does not happen more often with silicone breast implants can reassure.”
The study is methodologically well carried out, says internist Pabath Nanayakkara. He started the first silicone clinic in 2012 in the VU hospital. He is also in the RIVM consortium that is investigating Bii, but was not involved in breast cancer study.
Yet not all questions have yet been answered, according to Nanayakkara. Do women with reconstructive implants become less often sick from the prostheses than women who did not have breast cancer, or do they accept the symptoms easier because they have already undergone a serious disease? Questions that do not influence the results of this study according to Spoor, because both groups were seriously ill, and women did not know that bii was being investigated.
Although much less is known about the cosmetic group than about breast cancer patients, there is an important difference, says Nanayakkara. Women who have had breast cancer have their implants replaced more often due to local complaints than women in the cosmetic population-would they also develop fewer bii complaints?
Nanayakkara said earlier in NRC All that he has difficulty with words such as ‘misunderstood’ and ‘subjective’ complaints: “Complaints are always subjective. That we don’t understand them does not mean that they do not exist.” Women with complaints after a cosmetic breast augmentation can feel put away by the question marks in the conclusion about bii as an isolated condition.
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Also read: Who understands the misunderstood complaints of women with breast implants?
Worry about other risks
Whether women can be reassured by the new study must still be apparent. As chairman of the Foundation for Women with Silicone implants, Marga van Amersfoort was unable to read this latest study for publication, but has already been updated by Spoor. She is still worried about other risks. For example, she believes that there should be more research into toxic substances in silicone breast implants. “And I am also worried about Bia-Alcl,” a rare form of lymph node cancer.
The women in this breast cancer study received implants of Eurosilicone and Allergan. Legal cases are still running against the manufacturer of the latter, because certain models, which are now of the market, gave an increased risk on BIA-Alcl.
Jonathan Spoor is aware of the sensitivities and says that doctors should take every patient seriously with any complaint and must investigate the cause. “We certainly don’t want to silence women.” And it is possible, he says, even without diagnosis to remove the implants. “Sometimes you still see improvement.”