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| |  Lifestyle Must Be Considered In Evaluating Breast Implant Safety CHICAGO -- May 27, 1997 --To accurately assess the safety of breast implants, researchers need to factor in lifestyle characteristics that may contribute to the risk of developing an illness, according to an article in this week's issue of the Journal of the American Medical Association (JAMA). Linda S. Cook, Ph.D., of the Fred Hutchinson Cancer Research Center, Seattle, Wash., and colleagues compared selected characteristics of 3,570 women with and without breast augmentation to identify differences between these two groups of women. Of the group, 80 had breast augmentation. "We found that some demographic, lifestyle, reproductive, and medical characteristics of women with breast augmentation were notably different than those among women in general in our sample population,” the authors write. “Other characteristics (e.g., diet, occupation, family history of disease other than breast cancer) that were not evaluated in the present analysis may also differ between women with and without breast implants. These differences between women with implants and those without are important insofar as they influence the risk of a given disease." When compared to other women, the researchers found that women with breast implants were: --nearly three times more likely to drink seven or more alcoholic drinks per week. Breast implants, particularly silicone gel-filled implants, have been hypothesized to predispose women to several types of illness, including connective tissue disease, rheumatic complaints and cancer. The authors say that, to date, the majority of epidemiologic studies have found little, if any, adverse health effects of implants. The researchers cite information that hair dyes have been associated with connective tissue diseases. "Our results highlight the importance of careful consideration and evaluation of potential confounding variables when investigating the impact of breast augmentation on the risk of subsequent disease," the researchers write. Importance of Including Confounding Factors in Studies "... investigators who follow the advice of Cook and colleagues will have the distinct advantage of being able to evaluate the independent and joint contributions of a number of potentially important disease risk factors,” writes Deborah J. del Junco, Ph.D., from the Research Service, Veterans Affairs Medical Center, Houston, Texas, in an accompanying editorial in this week's JAMA. “Using stratification in the data analyses, for example, investigators would be able to examine whether a particular factor has a confounding or a modifying effect on the breast implant-disease association of interest." Del Junco adds that the work by Cook and colleagues "brings us back, full circle, to the original question of the long-term health risks associated with breast implant surgery. Only this time, we are asked to consider alternative explanations for the association (or lack of association, as the case may be) between breast implants and the disease outcomes of interest." The author continues, "The emerging story of the breast implant controversy has broad implications that should inspire enlightened scientific and political discourse. With any luck, those so enlightened will help guide the rest of us toward higher standards of research design, interpretation of evidence, and formulation of appropriate health policy."
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