{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:06:34Z","timestamp":1792785994862,"version":"4.5.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"National Institute for Public Health and the Environment","id":[{"id":"https:\/\/ror.org\/01cesdt21","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Over the past decade, various large observational studies have suggested an association between silicone breast implants and autoimmune and rheumatic diseases, rekindling long-standing breast implant safety concerns among breast cancer survivors with breast reconstructions and newly diagnosed breast cancer patients.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We investigated the association between silicone breast implants and autoimmune and rheumatic diseases in a large multicenter cohort of women treated for breast cancer, part of whom received silicone breast implants for reconstructive purposes. Clinical data and events of interest were identified through linkages with prospectively maintained nationwide and institutional registries. Hazard ratios (HRs) for autoimmune and rheumatic diseases were calculated using Cox proportional hazards regression models adjusted for potential confounders.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 12\u2009262 women in the cohort, 3082 (25%) had received silicone breast implant\u2013based breast reconstructions. Median follow-up time was 12.0 years (IQR = 7.0 years). The event rate of autoimmune and rheumatic disease diagnoses was 62.5 per 10\u2009000 person-years. Compared with women without silicone breast implant exposure, women with an implant-based breast reconstruction did not have an increased risk of autoimmune and rheumatic diseases (multivariably adjusted HR = 1.06, 95% CI = 0.89 to 1.27). In addition, no statistically significant association was found between silicone breast implant exposure and inflammatory arthritis, systemic rheumatic disease, inflammatory dermatosis, inflammatory bowel disease, or any specific condition. Sensitivity analyses in which silicone breast implant exposure was analyzed as a time-dependent variable confirmed the results of the main analysis.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The findings of this study indicate that silicone breast implant exposure is not associated with an increased risk of autoimmune and rheumatic diseases in women with breast cancer and challenge the results of earlier studies in women with cosmetic implants.<\/jats:p>\n <\/jats:sec>\n \n Registration<\/jats:title>\n This study is registered at ClinicalTrials.gov on June 2, 2022 (NCT05400954)<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/jnci\/djag115","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T11:43:55Z","timestamp":1775821435000},"page":"1846-1856","source":"Crossref","is-referenced-by-count":2,"title":["Risk of autoimmune and rheumatic diseases in breast cancer patients with silicone breast implants"],"prefix":"10.1093","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6553-3452","authenticated-orcid":false,"given":"Jonathan","family":"Spoor","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Netherlands Cancer Institute Antoni van Leeuwenhoek , Amsterdam,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6941-7734","authenticated-orcid":false,"given":"Marc A M","family":"Mureau","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam , Rotterdam,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9725-4060","authenticated-orcid":false,"given":"Daphne","family":"de Jong","sequence":"additional","affiliation":[{"name":"Department of Pathology, Netherlands Cancer Institute Antoni van Leeuwenhoek , Amsterdam,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9665-883X","authenticated-orcid":false,"given":"Renaud L M","family":"Tissier","sequence":"additional","affiliation":[{"name":"Biostatistics Unit, Netherlands Cancer Institute Antoni van Leeuwenhoek , Amsterdam,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marijn","family":"Vis","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, University Medical Center Rotterdam , Rotterdam,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1663-6092","authenticated-orcid":false,"given":"Hinne","family":"Rakhorst","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Hand Surgery, Medisch Spectrum Twente , Enschede,","place":["the Netherlands"]},{"name":"Department of Plastic, Reconstructive and Hand Surgery, Ziekenhuisgroep Twente , Almelo,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9122-2869","authenticated-orcid":false,"given":"Juli\u00ebtte","family":"Hommes","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Zuyderland Medical Centre , Heerlen,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7214-0713","authenticated-orcid":false,"given":"Mintsje","family":"de Boer","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Maastricht University Medical Centre , Maastricht,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8626-1401","authenticated-orcid":false,"given":"Hester S 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Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9973-0618","authenticated-orcid":false,"given":"Daniel J","family":"Evers","sequence":"additional","affiliation":[{"name":"Department of Surgery, Ziekenhuisgroep Twente , Almelo,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1944-6777","authenticated-orcid":false,"given":"Linetta B","family":"Koppert","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam , Rotterdam,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura H","family":"Zaal","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Velthuis Kliniek , Hilversum,","place":["the 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