Association between Silicone Breast Implants and Autoimmune Diseases Associação entre Implantes de Silicone Mamários e Doenças Autoimunes

Abstract

BACKGROUND AND AIM: Silicone breast implants have, for a long time, been considered as biologically inert and harmless. However the relationship between silicone breast implants and the risk of autoimmune diseases has generated intense medical interest. The aim of our review is to summarize the data linking silicone breast implants and autoimmune diseases, including the most recent association with autoimmune/inflammatory syndrome induced by adjuvants (ASIA).
METHODS: The clinical research included articles from the last 16 years using the MeSH terms “breast implants” and “autoimmune diseases” and also the following terms: “autoimmune/inflammatory syndrome induced by adjuvants” and “Shoenfeld’s syndrome”. The Oxford 2011 Levels of Evidence was used to assign a level-of-evidence.
Eligible articles included those who described a population of adult women (>17 years), which have breast implants versus women without implants. The clinical outcome measured was the development of an autoimmune disease.
RESULTS: Of the 268 obtained articles, five matched eligibility criteria (one meta-analysis, two systematic reviews and two cohort studies). Results show that although studies could not confirm an association between silicone breast implants and classical autoimmune diseases, a few studies demonstrated an association between implants
and undefined symptoms such as fatigue, arthralgia, myalgia and cognitive symptoms, which resembled a newly introduced syndrome, known as ASIA.
CONCLUSIONS: Evidence remains inconclusive about any association between silicone breast implants and classical autoimmune diseases. ASIA seems to be linked to previous exposition to an adjuvant such as silicone. However, we will need better evidence from large studies with accurate methodology to determine whether any true association exists between ASIA syndrome and silicone breast implants.