Posted on 03/07/2003 6:52:58 AM PST by Pharmboy
Total and cause specific mortality among Swedish women with cosmetic breast implants: prospective study
V C M Koot, clinician a, P H M Peeters, associate professor a, F Granath, associate professor b, D E Grobbee, professor a, O Nyren, professor b.
a Julius Centre for Health Sciences and Primary Care, University Medical Centre, Box 85500, 3508 GA Utrecht, Netherlands, b Department of Medical Epidemiology, Karolinska Institute, Box 281, S-171 77 Stockholm, Sweden
Correspondence to: V C M Kuck-Koot, Comprehensive Cancer Centre Middle Netherlands, PO Box 19079, 3501 DB Utrecht, Netherlands kuckkoot@ikmn.nl
The potential health hazards of breast implants have been heavily debated for the past decade, yet only one study has reported on long term mortality among women with such implants, and around one fifth of the participants were lost to follow up. 1 2 We assessed total and cause specific mortality among Swedish women who underwent augmentation mammoplasty between 1965 and 1993. As a desire for cosmetic surgery represents underlying psychopathology in some patients, we hypothesised that deaths due to suicide may be over-represented.3
Details about accrual of the cohort have been given elsewhere.4 We obtained records from the Swedish Inpatient Register of all 15-69 year old women who had had breast implants (n=7585) in 1965-93. We identified records with erroneous registration numbers or where emigration or death occurred before surgery through linkages with registers held by Statistics Sweden, using the unique national registration numbers. We excluded such records and records where surgery occurred at hospitals without surgical services (n=138). We also excluded women who had received an implant after surgery for breast cancer (n=3926), identified through the cancer register. The final study cohort comprised 3521 women, with a mean age of 31.6 (SD 8.6) years.
Follow up started on the day of first implantation surgery and stopped at date of emigration, death, or end of follow up (31 December 1994), whichever occurred first. The cohort members were followed for an average of 11.3 (range 0.3-29.9) years, corresponding to 39 735 person years at risk. We compared the observed number of deaths with the expected number of deaths, the ratio of these two numbers giving the standardised mortality ratio. We obtained the expected number of deaths by multiplying the observed number of person years at risk in the cohort, divided into 5 year age strata and 1 calendar year strata, by the stratum specific mortality rates, derived from official Swedish death statistics. The standardised mortality ratio can therefore be viewed as a measure of relative risk, with the Swedish female population matched for age and calendar year serving as reference. We calculated 95% confidence intervals, assuming that the number of observed events followed a Poisson distribution. We coded underlying causes of death according to the international classification of diseases (7th, 8th, and 9th revisions) into suicide, unintentional injury, cardiovascular diseases, malignancies, and other causes.
Although 58.7 deaths were expected, 85 women died (standardised mortality ratio 1.5, 1.2 to 1.8; table). Fifteen women committed suicide, compared with 5.2 expected deaths (2.9, 1.6 to 4.8). Excess deaths were also due to malignant disease (1.4, 1.0 to 1.9), mainly lung cancer. The number of deaths for all other causes was close to expected.
Comment
Women who undergo cosmetic surgery for breast augmentation are more likely to commit suicide than women from the general population. The 50% excess mortality found by us in our prospective study of 3000 Swedish women contrasts with the decreased mortality reported from the United States.2 This may reflect different reasons for self selection for plastic surgery or may be an effect of losses to follow up in the American study. Both the American study and our study did, however, show an increased risk for suicide in women opting for breast augmentation. Our excess mortality was explained by the excess of suicides and deaths from malignant disease. Deaths due to malignancy were mainly linked to smoking, previously shown as common in our cohort.5 Given the well documented link between psychiatric disorders and a desire for cosmetic surgery, the increased risk for death from suicide may reflect a greater prevalence of psychopathology rather than a causal association between implant surgery and suicide.3 Surgeons evaluating candidates for breast implant surgery need to be vigilant for subtle signs of psychiatric problems.
I would think it's because that's what the researchers chose to study. All studies need to study something, and most could have multiple subjects. Studies often find both related and unrelated information leading to other studies, they's why they are conducted.
Because the study simply involved those who had had breast implants. That was the population they studied. That's what statistics does. It studies certain populations for certain statistical characteristics. You can "say" that "people who do not like their bodies have more emotional problems.....", but you can study certain populations to see if there is statistical evidence of what you say. The study is just evidence, that's all. It looks like any other normal research to me from the article information given.
Some people don't like the results of statistical studies of populations for their own reasons, but if the research was done properly and ethically and interpreted properly, then what's the legitimate complaint?
Wrong, it's the cry of the Christian. It is socialistic selfishness that generates the covetousness in socialist liberals that makes them want to be robinhood with everyones wealth. A Selfless Christian isn't offended by the wealth of the wealthy.
"made fun of her whole life" Oh please. Even that statement is totally self centered. By the way, most guys I know hate implants because they look phony and stupid. Natural A-cups clobber fake D-cups any day.
Absolutely! Anything more than a mouthful is wasted. And nothing beats the slender elegant look of a gravity-defying A-cup bustline. I give you "My Fair Lady" as a prime exahm-ple.
BTW, you'll notice on reality shows such as "The Bachelor" that the gals with the fake tits are always the first to be eliminated.
Michael
I think you got a bit ahead of yourself here DC. At the beginning of the article it says, "it could be linked to problems such as lack of self-esteem or poor body image". It makes a certain amount of sense that many people who want to improve their body image have psychological problems associated with that, thinking that this change will bring about significant change in their lives. When it doesn't . . .
Well, the simple answer is because they found a correlation between breast implants and suicide, and are reporting on it. Do you think they should have mentioned a propensity for dog-kicking, just to keep things even?
The article is very careful to state that the correlation is probably due to pre-existing psychological problems.
I was thinking of all the slender bodies that usually accompany a-cups. I usually notice a nice pair of D-cups and then look for the "hip penalty" which is usually pretty... hefty
You only put them under suicide watch if you want to prevent it.
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