Breast Implants and Connective-Tissue Diseases

To the Editor: As rheumatologists who have examined and evaluated a combined total of more than 3000 symptomatic women with silicone breast implants, we feel compelled to point out the shortcomings of the study by Gabriel et al. (June 16 issue). 1 This study addresses only classic connective-tissue diseases, such as systemic lupus erythematosus, rheumatoid arthritis, Sjogren's syndrome, and scleroderma, and appropriately concludes that it is unlikely that common rheumatic diseases, such as rheumatoid arthritis, are associated with implants. The sample size is inadequate to assess the frequency of uncommon rheumatic diseases, such as systemic lupus erythematosus or scleroderma, and the . . .