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- <text id=92TT0130>
- <title>
- Jan. 20, 1992: A Strike Against Silicone
- </title>
- <history>
- TIME--The Weekly Newsmagazine--1992
- Jan. 20, 1992 Why Are Men and Women Different?
- </history>
- <article>
- <source>Time Magazine</source>
- <hdr>
- MEDICINE, Page 40
- A Strike Against Silicone
- </hdr><body>
- <p>The FDA, citing new safety worries, clamps down on breast
- implants
- </p>
- <p>By Andrew Purvis--With reporting by Elaine Lafferty/Los Angeles
- </p>
- <p> Since silicone breast implants were introduced 30 years
- ago, millions of women have sworn by their results. For most,
- the ample gel-filled sacs provided a welcome boost in
- self-esteem. For 1 out of 4 recipients, they brought a return
- to normality after the trauma of mastectomy. So when anecdotal
- reports of health problems associated with the devices began
- cropping up over the past several years, women were first
- alarmed, then hugely relieved when surgeons asserted that the
- stories were groundless. Now their confidence has once again
- been shaken.
- </p>
- <p> Citing new evidence of health risks, Food and Drug
- Administration chief David Kessler last week declared a
- moratorium on silicone implants. He urged manufacturers to halt
- marketing the devices and surgeons to stop inserting them in
- women. In Spain and Australia health officials quickly followed
- suit; Canada, Britain and France are reviewing their policies.
- The decision stunned millions of women worldwide. "They are
- angry, frustrated and concerned," said Dr. Norman Cole,
- president of the American Society of Plastic and Reconstructive
- Surgeons. "They want to know what is going on."
- </p>
- <p> Kessler's decision is based on evidence--some of it
- still sealed under court order--that has come to light since
- the FDA last reviewed safety information in November. At that
- time, an advisory committee recommended that the implants be
- left on the market. But studies released in the course of
- recent legal proceedings against Dow Corning Wright, the largest
- U.S. implant manufacturer, suggest that the company may have
- known about safety problems for years and kept them under wraps.
- Kessler said he has also received a number of case reports from
- rheumatologists linking the device to autoimmune disorders. The
- moratorium is in place until an expert advisory panel can review
- the new information; a final verdict from the agency is due this
- spring. Saline-filled implants, though less popular, are still
- available.
- </p>
- <p> The latest information adds weight to several reports
- about the dangers of silicone gel, a substance also sold as a
- sealant and Silly Putty. If it stayed inside its envelope, the
- gel would pose little danger. But doctors have found that over
- the years it can leak into the surrounding breast tissue. In
- some cases, especially in poorer-quality implants manufactured
- between 1975 and 1985, the sacs rupture, spilling their contents
- into the body. The immune system's attempt to wall off this
- foreign chemical can cause inflammation and severe chest pain.
- Worse, the silicone can migrate to the lungs, liver and lymph
- nodes.
- </p>
- <p> Once there, some experts fear, the gel may trigger a
- variety of autoimmune disorders as the body tries to protect
- itself from the perceived invader. These include scleroderma,
- which thickens and stiffens the skin and causes a buildup of
- fibrous tissue in the lungs and other organs; lupus
- erythematosus, which causes chronic joint pain and rashes; and
- rheumatoid arthritis.
- </p>
- <p> The suspect gel has been linked to cancer in laboratory
- rats, according to a 1988 report. One type of implant, which has
- a polyurethane coating designed to prevent scar-tissue
- formation, poses a special danger, and was withdrawn from the
- market last April. The marshmallow-like foam coating has been
- shown to break down into a chemical called TDA (2-toluene
- diamine), which is known to cause cancer in animals.
- </p>
- <p> Frightening anecdotes abound. Kali Korn, 41, of Los
- Angeles came down with scleroderma last year, a decade after she
- had silicone implants inserted for cosmetic reasons. The skin
- has so constricted around her fingers that she is virtually
- unable to move them. Doctors removed the implants in March, and
- she now says, "I feel much better. I wish I had realized 10
- years ago that how I looked was fine."
- </p>
- <p> But despite similar accounts from hundreds of women,
- scientists have yet to prove conclusively that implants are
- responsible for their woes. Critics of last week's FDA ruling,
- including many doctors, contend that the agency may have
- needlessly raised women's fears before convincing evidence was
- in. Cole feels that despite the court order, Kessler should have
- released the new information to the medical community before
- calling the moratorium. "We're getting hundreds of calls from
- women who want to know what this new information is, what it
- means," he said, adding that some women may avoid getting
- suspicious breast lumps checked for fear that there are no
- viable options for reconstruction.
- </p>
- <p> Women are clearly worried--and angry. Sheila Swanson,
- 49, of Saratoga, Calif., had implants inserted three years ago
- after a double mastectomy for breast cancer. Now she says, "I'm
- frightened. At this point, emotionally, I don't know how I could
- take another operation." Cindy Pearson, of the National Women's
- Health Network in Washington, has been pushing the FDA to act
- on this issue since 1983, and she is livid: "They've allowed
- over half a million women to get into this horrible quandary
- because they didn't order long-term studies earlier. If this
- were heart valves, or anything used by both sexes, the FDA
- wouldn't have gotten away with it."
- </p>
- <p> For now, women who have implants are being urged to see a
- doctor only if they are experiencing suspicious symptoms.
- Kessler recommends that women check their breasts regularly for
- any sudden change in consistency or shape that might indicate
- a rupture. The commissioner emphasizes that the slight risk of
- removing the implants probably outweighs any potential danger
- from leaving them in. That is some comfort. But for women who
- have grown to cherish their new breasts as a part of themselves,
- it doubtlessly is not enough.
- </p>
-
- </body></article>
- </text>
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