This study was designed to assess the relationship between
breast implants and certain rheumatologic diseases (
rheumatoid arthritis and diffuse
connective tissue diseases). The study base was a rheumatological practice in Atlanta, Georgia that started in 1982 and began computerizing its records in 1985. The computerized records through May 1992 included 4229 women patients, 150 with
breast implants and 721 with a diagnosis of
rheumatoid arthritis (RA) and/or one of the
connective tissue diseases (
CTDs). Of the 721 patients who had been diagnosed as having
rheumatoid arthritis (RA) and/or one of the
connective tissue diseases (
CTDs), 392 had
rheumatoid arthritis, 344 had
connective tissue disease, 15 had both
rheumatoid arthritis and a
connective tissue disease, and 33 had more than one
connective tissue disease. Of the patients with
connective tissue disease, 179 had
systemic lupus erythematosus, 64 had scleroderma, 49 had Sjögren's syndrome, 36 had
dermatomyositis or
polymyositis, and 49 had
mixed connective tissue disease. Data were analyzed by univariate and multivariate techniques including logistic regression. Significant variables included age at first visit, income strata, and period of first visit. Analyses were performed for each clinical diagnosis, for all
connective tissue diseases together (
CTDs), and for those with
rheumatoid arthritis and/or
connective tissue disease (RA/CTD). Analyses were performed on the total data base and on the records of new patients (1986-1992). The adjusted odds ratio for
breast implants among women who entered the practice in 1986-1992 and were diagnosed as having
rheumatoid arthritis and/or one of the
connective tissue diseases (RA/
CTDs) was 0.45 (0.22-0.90), for those with
rheumatoid arthritis was 0.61 (0.28-1.49), for those with any of these specific diffuse
connective tissue diseases was 0.34 (0.11-1.06) compared to those without the disease. For
systemic lupus erythematosus, the odds ratio of 0.24 (0.03-1.75) was based on a single case who had the disease 5 yr before the implant. For Sjögren's syndrome, the odds ratio was 1.67 (0.39-7.13) based on two cases, one of whom had the disease 5 yr before the implant. The calculated odds ratios for scleroderma,
dermatomyositis/
polymyositis, and
mixed connective tissue disease were zero since no cases were diagnosed among the patients with
breast implants. This study found no evidence that women with
breast implants are at an increased risk for having
rheumatoid arthritis or other diffuse
connective tissue disease.