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- MEDICINE, Page 81Reprieve for Breast Implants
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- Their safety is unproved, but it's tough to ban something already
- used by 2 million U.S. women
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- Should a product sold for nearly 30 years to millions of
- satisfied customers be abruptly taken off the market? That was
- the question before an advisory panel of the Food and Drug
- Administration last week as it held hearings on the emotionally
- charged issue of the safety of silicone breast implants.
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- The testimony was impassioned on both sides. Implant
- manufacturers brought out reams of safety-test data, claiming
- their products were essentially harmless. Some users spoke of
- gaining self-esteem by reshaping their bodies, and of a
- psychological boost in battles against breast cancer. But others
- told stories of pain from internal scar tissue, diseases they
- attributed to the implants, and deformities suffered when the
- prostheses ruptured or shifted. In the end, though, the panel
- voted unanimously to recommend that implants stay on the market,
- and FDA Commissioner David Kessler is expected to concur.
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- That is not the same as giving implants a clean bill of
- health. The panel also concluded that safety testing conducted
- by the four largest manufacturers of implants was inadequate,
- and called for continued tests. Said panel member Mary Davis,
- associate professor of pharmacology and toxicology at West
- Virginia University: "This should send the manufacturers a
- message that it is no longer business as usual."
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- In the three decades that breast implants have been on the
- market, the FDA has never before considered their safety. It did
- not have the authority to do so until 1976, and the agency took
- until 1988 to put the implants on its list of medical devices
- requiring the strictest scrutiny. The companies had until last
- July to document the implants' safety, but could not satisfy the
- FDA's experts.
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- However, 2 million women are using the devices, mostly for
- cosmetic purposes but also for breast reconstruction after
- surgery. Implants can deteriorate or spring leaks, and a
- manufacturing ban could leave these women no way to get a
- replacement. That was undoubtedly a major factor behind the
- panel's vote. The companies will still have to prove their
- products' safety, but without clear proof that the implants are
- unsafe, they will stay available to women who want them.
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- By Michael D. Lemonick.
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- WEIGHING THE RISKS
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- Most implants are essentially bags made of thick plastic,
- filled with gelatinous silicone. Manufacturers claim that side
- effects are rare, but critics cit many possible hazards:
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- -- Scarring and hardening of breast tissue
- -- Leakage
- -- Reduced effectiveness of mammograms
- -- Autoimmune reactions
- -- Infections
- -- Cancer
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