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QUESTION: Are silicone breast implants associated with an increased risk for connective tissue diseases (rheumatoid arthritis, systemic lupus erythematosus, scleroderma or systemic sclerosis, the Sjögren syndrome, dermatomyositis or polymyositis, all definite connective tissue diseases, or other autoimmune or rheumatic conditions)?
Studies were identified by searching Medline, TOXLINE, Current Contents Online, and Dissertations Abstracts Online with terms related to breast implants and connective tissue diseases.
Studies were selected if internal comparison groups were evaluated and sufficient data were available for analysis of women (not disease events) using 2 × 2 tables for categories of disease and implants.
Data were extracted on year and country of publication; funding; study design; population characteristics and numbers; type, date, and reason for implant; disease characteristics; time from implantation to symptoms; and confounding …