Mortality Among Augmentation Mammoplasty Patients Louise A Brinton; Jay H. I. Lubin; Mary Cay Burich; Theodore Colton; Robert N. Hoover From the Epidemiology and Biostatistics Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD; Abt Associates, Inc, Chicago, IL; and Department of Epidemiology and Biostatistics, Boston University, Boston, MA.

Much attention has focused on disease risks among women receiving silicone breast implants, but there has been little evaluation of their mortality experience. We undertook a retrospective cohort study of 13,488 women receiving cosmetic implants and 3,936 patients with other types of plastic surgery at 18 plastic surgery practices.

After an average of 13 years of follow-up, deficits in overall mortality were found as compared with the general population (U.S. rates) for both implant [225 deaths; standardized mortality ratio (SMR) = 0.69, 95% confidence interval (CI) = 0.6-0.8] and comparison subjects [125 deaths; SMR = 0.58, 95% CI = 0.5-0.7]. These findings indicate that patients seeking plastic surgery are in general healthier than their peers. Implant patients, however, experience excess risks of death compared with the general population for brain cancer (SMR = 2.45) and suicide (SMR = 1.54).

Internal analyses showed a higher overall mortality among the implant patients than among the comparison patients (relative risk = 1.27, 95% CI = 1.0-1.6). This overall excess reflected increases for respiratory tract (SMR = 3.03) and brain (SMR = 2.25) cancers, and for suicide (SMR = 4.24).

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