| |
Wednesday, October 29, 2003
Women who had breast implants were also more
likely to visit doctors and specialists and were four times
more likely to be hospitalized than women without the devices,
the study found.
It is estimated that up to 200,000 women in Canada have breast
implants. About 80% are performed for cosmetic augmentation,
the remainder for reconstruction following breast-cancer surgery.
"This [cosmetic breast surgery] is a privately funded
intervention -- women pay for it initially -- but when there
are complications,
it's the public system that bears the brunt of the financial
burden," says Aleina Tweed, a surveillance epidemiologist
with the B.C. Centre for Disease Control and lead author of
the study, which was supported by the British Columbia Centre
of Excellence for Women's Health.
Dr. Tweed stressed the study does not prove a cause-and-effect
link. "This wasn't a study to lead us to say that because
women got breast implants, they got sick, or they had problems.
But, there is obviously something going on that is affecting
their health, or women whose health does not support having
a breast implant are still being given them."
The study comes as critics brace for the possible return of
silicone-gel filled breast implants to the open market in Canada,
and at a time when breast implants appear to be more popular
than ever.
Two weeks ago, a U.S. Food and Drug Administration advisory
panel voted in favour of lifting a ban on silicone-gel breast
implants.
The controversial devices were pulled from the market in the
United States and Canada in 1992, following reports linking
them to arthritis, vascular disease and a range of autoimmune
disorders. Currently, the implants are available in Canada
only through the government's special access program, but at
least one manufacturer is seeking Health Canada approval to
make its implants widely available.
"We're very concerned because we know Health Canada
pays attention to what goes on at the FDA," says Kathleen O'Grady, of
the Canadian Women's Health Network.
The B.C. researchers are calling on Health Canada to create
a national breast implant registry to track the long-term health
risks of the surgery and to more quickly alert women to potentially
faulty devices. Several countries, including the United States
and the U.K., have such registries.
Dr. Tweed checked the health records of 147 consenting women
in B.C. who had breast implant surgery using either a saline
or silicone-gel implant. Almost two-thirds had silicone-gel
implants as their first set of implants.
The women were compared with 583 women in B.C. whose anonymous
health records were chosen at random and who were believed
not to have had implants.
Dr. Tweed found women with breast implants were about four
times more likely to be admitted to hospital over the 11-year
study period, and significantly more likely to see doctors,
chiropractors, massage therapists, anesthesiologists and other
specialists.
Women with implants were more likely to be hospitalized "electively," as
compared with an urgent or emergency case, and they were more
likely to see general and plastic surgeons when they went into
hospital. For example, 21% of the women with implants saw a
plastic surgeon, versus 2% for women without implants.
Of the breast-implant group, 92 women agreed to answer questions
about their experience. Half reported having one additional
breast-implant related surgery; 23% had two; 28% had three
or more. Thirty-seven of the women, or 40%, had their implants
permanently removed.
"It's an astonishingly high number," Dr. Tweed says.
Scar capsules can form around breast implants, which can cause
breast hardness and pain. Implants can also deflate, rupture
or leak.
There were no significant differences in hospitalizations between
the women who had saline implants and those with gel-filled
implants.
Most of the women who completed the questionnaires rated their
health as "excellent" or "good" compared
with other women their age.
However, half had been diagnosed with at least one chronic
illness, and one-third "felt that they had lost or quit
their job or reduced their hours because of health problems," the
study says. Most said the problems started after they got their
breast implants.
Ottawa plastic surgeon Dr. Bryan Callaghan, who has been in
practice for more than 20 years, says it is "very uncommon" for
cosmetic surgery patients to have their implants removed. "It's
an extremely small number."
He also noted that, during the "silicone-gel phobia" in
the early 1990s, many women had their silicone implants replaced
with saline ones, "largely for peace of mind."
©æCopyright æ2003æNational
Post
|
