In the third such report in 7 years, a scientific panel appointed by the British government announced yesterday that there is no evidence that silicone gel breast implants cause disease. The panel recommended that all U.K. women who undergo implant operations enroll in the National Breast Implant Registry, to provide a database for future studies.
The panel, headed by rheumatologist Roger Sturrock of the University of Glasgow, was tasked in June 1997 to review evidence for possible health risks of silicone gel breast implants. Set up in response to women's concerns about these risks, the panel interviewed patients, industry workers, researchers, and lawyers and reviewed the scientific literature. The implants "are not associated with any greater health risk than other surgical implants," the panel concluded.
The panel also specifically tested the hypothesis that silicone escapes from implants and breaks down into a form, silica, that could trigger autoimmune diseases such as rheumatoid arthritis. This idea, developed by Radford Shanklin of the University of Tennessee, has been cited by patient advocacy groups. In a review of Shanklin's photomicrographs of tissue specimens, researchers at the University of Manchester Medical School found silicone, but no silica. Shanklin was traveling and could not be reached for comment. But the findings have angered patient groups. Laurence Gerlis, a physician advising the Silicone Support Group UK, says there is still no good explanation for the fact that a small number of implant recipients have clearly suffered adverse reactions.
Meanwhile in the United States, which has had a moratorium on silicone implants since 1992, two more reports are forthcoming. One panel, headed by epidemiologist Barbara Hulker of the University of North Carolina, Chapel Hill, is expected to report in September on a court-ordered investigation of alleged systemic effects. And an Institute of Medicine panel is preparing what staff director Roger Herdman hopes will be the "definitive" word in a report due in July 1999.