The case against breast enhancement

By Dave Schwab - Light Business Editor (3/23/00)

Not everyone is satisfied with the contention that there is no causal relationship between breast implants and auto-immune and other systemic health disorders.

Crown Point resident Ilena Rosenthal spearheads an Internet newsgroup, alt.support.breast-implant, which she claims continues to receive – and document - testimony from women worldwide on the tangible health dangers breast implants pose. "Women aren't given all the true risks," contends Rosenthal. "No implant to date has been approved (for use) by the FDA (Food & Drug Administration). Since breast implants came out in 1963, there have been no federal regulations governing their use." Rosenthal said more than 200,000 women have reported complications from having undergone breast augmentation surgery.

The debate over the probability of health risks posed by implants continues to rage in the courts and elsewhere in society. In 1997, the nation's first class-action lawsuit trial over silicone breast implants ended inconclusively. A jury decided Dow Chemical, part-owner of Dow Corning, one of the biggest breast implant manufacturers, was negligent in testing silicone for implants, lied about the possible risk, and plotted to hide potential health dangers. A judge, however, ruled that only the eight original plaintiffs in the case, not the 1,800 women who were once part of the lawsuit, could try to win damages from Dow Chemical Co. Implant defendants claimed silicone seeped through the implants' flexible wall, or popped out of ruptured implants, causing immune system-related illnesses that brought on aches, pains and fatigue. Silicone implants were banned from general use by the federal government in 1992.

Breast implant proponets have argued that litigation flies in the face of years of growing evidence, in scores of studies involving tens of thousands of patiens and published in the most respected medical journals, that there is no causal link between implants and auto-immune diseases. Rosenthal believes the claims of the safety of implants can be traced directly to plastic surgeons financially benefiting from their use. Rosenthal's heard testimony from women complaining of complications from all different types of implant procedures, no matter what material is used in the procedure.

Breast implants are far from perfect - or permanent - according to Rosenthal, who added the risk of implants' rupturing, or wearing out over time and needing to be replaced, is great. "Women must be warned that multiple surgeries are practically assured, each with many risks," she said. "Even the best implants will have to be replaced." Rosenthal said women have reported high rates of bacterial and fungal infections following implant surgery. An argument is also being made that implants make it much more dificult to adquately read a mammogram scanning a woman for breast cancer.

Also, physical rejection, argues Rosenthal, is an all-too-frequent consequence of breast implants. "The body's natural reaction is to try and reject a foreign object," she pointed out. "This will result in pain, disfigurement and repeated surgeries."

Health risks posed by breast implants are indicative of the fact that insurers typically refuse to cover the cost of implant surgery.

Rosenthal feels more regulations need to be enacted to protect women from the dangers of implants. She claims women as young as age 15 are undergoing the procedure.

"Silicone manufacturers have spent millions annually covering up the true damage of implants," contends Rosenthal, "mislabeling doctors and scientists who dare to report the problems as 'junk scientists.' ''

Plastic surgeons are getting rich off breast augmentation, claims Rosenthal. She added there's a concerted effort being made by some plastic surgeons to discredit legitimate claims of women of the dangers of breast implants.

"Women, when presenting their common problems to plastic surgeons, have been told they were crazy," Rosenthal said. "That is the way women have been disempowered."

The jury is still very much out on the long-term effects of breast implants, concludes Rosenthal. "Studies done to date have been too short, too small, and looking for the wrong diseases," she stated. "It is too early to close the door on the connection between silicone and disease. Silicone Science is still in its infancy. To date, no studies have been done on the potential harm to children of women with breast implants."

Covering up the breast

The National Cancer Institute decides not to publicize the results of a publicly funded implant study. What's the deal?

By Denise Dowling
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October 09, 2000 | This is a story about breasts. And about a federal agency going out of its way to not alert journalists to a major publicly funded cancer study.

There was, to be sure, a press release. "In one of the largest studies on the long-term health effects of silicone breast implants, researchers from the National Cancer Institute (NCI) in Bethesda, Md., found no association between breast implants and the subsequent risk of breast cancer," it began.


But even if you have breast implants, you undoubtedly haven't heard about this study -- unless you somehow stumbled across the release buried in the NCI Web site. NCI press officer Brian Vastag says that -- in a peculiar deviation from normal procedures -- he was "forbidden" from alerting journalists to the online release. In an up-yours gesture to his superiors (motivated, perhaps, by the fact that he'd already given notice to quit), Vastag last week forwarded the link for the press release to a listserv for members of the National Association of Science Writers.

"It makes me crazy when tax-funded public health research doesn't make it to the public," Vastag wrote in his e-mail. "So here's the lead from the press release for anyone who's interested."

According to Vastag, NCI would routinely notify about 500 Science writers about such studies by faxing or -- with a few keystrokes -- e-mailing them a press release. "These are the results of eight years of research," Vastag explained about the $4 million study conducted by Dr. Louise Brinton, the principal investigator from NCI's Division of Epidemiology and Genetics. "Brinton's is the definitive study."

Other researchers may or may not agree with that assessment, but Science writers who received Vastag's e-mail also found NCI's behavior highly perplexing. "It's very odd for a public agency to know about a major, publicly-funded study and choose not to release it in the normal manner," noted science writer and NASW listserv coordinator Robert Finn. "What's strangest is not the results of the study but that the NCI went to the trouble of preparing a press release -- and then they were not allowed to release it to journalists."

However, Pat Newman, chief of NCI's mass media division, said the agency decided not to alert journalists because Cancer Causes and Control, the European-based journal that is publishing Brinton's study in its November issue, embargoed it from distribution in hard copy -- even though the journal has already posted an electronic version on its Web site and no one was asking NCI to disseminate hard copies in advance of publication.

"We felt a commitment to post that the study was out, but we couldn't in good faith promote the information available in the journal until it was available in hard copy," said Newman. However, she seemed surprised when asked if NCI plans to tout the study come November. "We've already posted the press release, so why would we distribute old news?" she said.


Brinton's study is not the first to declare that silicone breast implants are not linked to breast cancer, but it is believed to be the most comprehensive. Unlike previous studies that tracked the effects of implants for less than a decade, Brinton's followed nearly 14,000 women who had implant surgery for cosmetic reasons in both breasts for 13 years. In addition to refuting some earlier findings that appeared to link cancer to implants, Brinton's study also counters other research suggesting an actual reduction in risk for implant recipients, a finding that perplexed researchers.

So given the estimated 1.5 million women with breast implants -- and the huge number considering having them -- why not tout the results to journalists who could disseminate the information to a mass audience? The reason, according to Vastag, is that Brinton herself wanted NCI to play mum -- even though she herself has touted the project as "the most comprehensive epidemiological study of breast implants to date."

Vastag said that Brinton was concerned because in the past she has been criticized by competing interests on all sides of the issue, especially lawyers defending the implant industry. Brinton herself denied that she asked the NCI not to publicize the findings. But she did acknowledge that the breast implant issue is so emotional that it sometimes appears impossible to satisfy anyone.

Throughout nine years of research, she says she was scrutinized by people who worried that her report might provide ammunition to anti-implant advocates. She said she has met with those on all sides of the issue -- breast implant survivor groups as well as plastic surgeons and implant manufacturers. "If I talk to one contingent, another contingent uses that as evidence that I'm siding with that group," she explained.

According to Breast Cancer expert and author Dr. Susan Love, since Brinton's research confirms earlier findings it is ultimately a ripple, not a rupture, on the field of Breast Cancer research -- but reading or hearing about it would help those most affected. "Maybe women with implants can feel more comfortable now," she said.

salon.com
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About the writer
Denise Dowling is a freelance writer and former editor at Salon.

http://dir.salon.com/health/feature/2000/10/09/breast_cancer/index....