A 26-year-old woman comes to the physician for routine health maintenance examination. She states that she is very dissatisfied with her general physical appearance and is planning to have breast implant surgery. However, she is worried because she read on the Internet about an association between silicone breast implants and the development of diseases and wants her physician's opinion.
Item 1 of 4
Which of the following is the most appropriate response to address her concerns about breast implant surgery?

Question

Quizplus · Accepted Answer

Explanation: The two main types of breast implants are silicone and saline. Saline or silicone gel is used to fill the inside of the implant, and a silicone elastometer is typically used to make the outer shell of both types of implants. It is also possible to have a double-lumen implant with saline on the outside and silicone on the inside. Breast implants are most often used by women to "improve" their physical appearance (breast augmentation). They are also used for breast reconstruction in women who have had a unilateral or bilateral mastectomy for various reasons, including breast cancer. There have been a lot of questions and concerns about the safety of silicone breast implants. Silicone breast implants have been a source of a lot of media attention due to some claims regarding their alleged association with systemic disorders. Some women have claimed that silicone implants can and have caused connective tissue and autoimmune disorders (i.e., rheumatoid arthritis and systemic lupus erythematosus), as well as increase the risk of breast carcinoma and neurologic diseases; however, no evidence to support such statements currently exists. On the contrary, women who have received breast implants have had postoperative complications in the form of capsular contracture (resulting in pain), distortion of shape, implant deflation, and rupture. Surgical removal of the implant may be needed in these instances. These local complications are the most common cause of morbidity associated with breast implants. (Choices A and B) Contrary to some claims, the general consensus is that silicone breast implants do not cause any major connective tissue or autoimmune disease. There is no evidence of an increase in the incidence of rheumatoid arthritis, lupus, Raynaud disease, or scleroderma in women who have had breast implant surgery. (Choice C) There is no evidence that silicone breast implants cause or increase the incidence of primary or recurrent breast carcinoma. However, there are reports that women with silicone breast implants are at an increased, albeit extremely low, risk of developing anaplastic T-cell lymphoma compared to the general population. (Choice D) There is no reported evidence that early- or late-onset dementia is associated with silicone implants. Educational objective: Silicone breast implants do not cause any major rheumatologic, autoimmune, or neurologic disorder. Most morbidity from silicone breast implants is associated with local complications, such as capsular contracture, implant deflation, and rupture.

A 26-Year-Old Woman Comes to the Physician for Routine Health