THE BREAST IMPLANT CONTROVERSY: A SNAPSHOT IN DOCUMENTS AND POINTERS

Do breast implants cause autoimmune disease? As Marcia Angell remarks in her book, Science on Trial: The Clash of Medical Evidence and the Law in the Breast Implant Case, thirty years of clinical experience give us a reasonable idea that if the answer is yes, the silicone factor is a relatively weak one.

Nevertheless, silicone gel implants are a foreign body, and foreign bodies cause reactions in the body, whether localized or systemic. Besides which, silicone gel implants leak and sometimes rupture, and silicone media injected directly into the body are known to cause severe adverse effects.

The FDA finally required that breast implant manufacturers provide safety data in the 1980s, and in the past five years, large retrospective studies have been published that undertook to locate women with breast implants and measure their rates of autoimmune disease against those of properly matched controls. The studies that have been published are small enough that their results could mask a tripling in the rate of autoimmune disease among women who have had silicone breast implants.

No clear answers have emerged, but the FDA imposed a ban on silicone gel implants, a few lawyers drummed up some serious business, a few expert witnesses were called, and a large corporation once worth nearly $1 billion has sought bankruptcy protection.

Science on Trial: The Clash of Medical Evidence and the Law in the Breast Implant Case is reviewed in the August 16, 1996, edition of The Net Net. Marcia Angell is Executive Editor of the New England Journal of Medicine.

The Body's Edge: Our Cultural Obsession with Skin, by Marc Lappe, Ph.D., was reviewed in the August 9th edition. Marc Lappe is a pathologist and ethicist who has testified on behalf of plaintiffs in breast implant product liability cases.

The following links identify some of the large institutions involved in the breast implant controversy and point to some representative information available about it. This is a very partial listing. If you know of a page that would enhance this snapshot of the breast implant controversy, please let The 60-Minute Intellectual know.

INSTITUTIONS

• The FDA
• The Mayo Clinic
• The Morbidity and Mortality Weekly Report
• The New England Journal of Medicine
• The American Medical Assocation -- the site supports searches in JAMA archives
• Independent Review Group
• National Academy Press publication on the safety of silicone breast implants
• National Center For Policy Research For Women and Families: Breast Implants

ARTICLES AVAILABLE ONLINE

• Breast Implant chronology, from public broadcasting affiliate WGBH
• Silicone in the System, by Gary Taubes, printed in Discover
• Fatal Litigation, by Joseph Nocera, printed in Fortune
• WebMD Article on Reconstruction
• WebMD Article on Implants
• Doctor's Guide: Lifestyle Must Be Considered In Evaluating Breast Implant Safety. This site has a searchable database of articles.
• Mother Jones Article on Implants
• The Breast Implant Imbroglio, an article from Reputation Management (May/June 1996), available at www.prcentral.com
• Implant Tests Cashing in on Junk Science

COMPANIES

• Dow Chemical
• Mentor Corporation -- don't miss the "Choosing Augmentation" article in the plastic surgery section. "Breast augmentation is not only a medical decision - it is a personal one. The perception we have of ourselves defines who we are and how we introduce ourselves to the world...."
• McGhan Medical (Inamed)

MAINSTREAM BREAST PROSTHESIS/IMPLANT RESOURCES

• Study of Children Breastfed by Women with Breast Implants, January 1994 FDA press release about JAMA article.
• FDA Update on Breast Implants, November 1995
• FDA Search engine for info junkies.
• American Cancer Society Breast Cancer Network
• Rhode Island Cancer Council Prosthesis Resources

ADVOCACY ORGANIZATIONS

• List of Support Groups
• Support in Silicone, Inc., List of Links, quite a lengthy and far-ranging list that encompasses and expands on much of what is here.
• Coalition of Silicone Survivors
• Micheline B. Lambert site
• Idaho Veterans of Toxic Exposure, part of a "Silicone Webring"

LAWYERS AND LAW

• MegaLaw.com - "Lawyers' Window to the Web"
• Joe D'Addario's CyberLaw Page: Products Liability, an interesting mix of definitions, news stories and pointers.
• Court TV
• Legal Issues Concerning Silicone Breast Implants, student paper from Golden Gate University

PERSONALITIES

Nir Kossovsky is a scientist whose research finds harm from breasts implants. He has been an active witness in hearings and lawsuits. He is discussed in the Discover article linked above. He's even been slashdotted.

• pl-x.com -- what Nir Kossovsky is up to now
• An article about pl-x.com
• Silicone Arthritis and Related Diseases

Marc Lappe, Ph.D., another frequent witness. He takes an interest in ecology issues in general, including genetically modified foods and immunity, as well as pathology subjects.

• Center for Ethics & Toxics

Dan Bolton, Esquire, called "the truest of the true believers" that silicone breast implants cause auto-immune disease (in Joseph Nocera's article, linked above). He discovered Dow Corning documents that helped him win cases, documents that he passed on to the FDA -- shortly after which, Kessler called for the moratorium on distribution or implantation of breast implants.

What do you think? Tell The 60-Minute Intellectual!

Modified September 2000.