This is in chart form what I had suggested previously It can be changed to a paragraph 1996 US Review US Institute of Medicine IOM 23 This review of existing studies concluded there was not sufficient evidence for an association of silicone gel or saline filled breast implants with defined connective tissue disease 2000 US Review request of a United States District Court 24 This review found no evidence of an association between silicone gel filled breast implants specifically and any of the individual CTDs all definite CTDs combined or other autoimmune or rheumatic conditions However there was discordance among studies in reports of arthralgias lymphadenopathy myalgias sicca symptoms skin changes and stiffness 2001 Great Britain UK Independent Review Group Another review of previous studies also found no evidence of an association with an abnormal immune response or connective tissue diseases However the report also stated that the question of whether siloxane polymers cause inflammatory reactions that directly provoke immune responses to the recipient s own tissues is unresolved 2 The study was funded by Dow Corning 2001 Australia Retrospective cohort 458 vs other plastic surgery 25 For diseases that occurred after surgery there was no difference between the two groups in the incidence in reporting of systemic sclerosis SLE or rheumatoid arthritis However axillary adenopathy and low titre positive antinuclear antibody ANA occurred with a significantly greater frequency in the exposed cohort 2001 Sweden Retrospective cohort 2376 vs 3470 breast reduction 26 The study reported that there was no identifiable increase in well defined connective tissue diseases However women with cosmetic breast implants continue to report specific as well as nonspecific physical and psychological symptoms after receiving their implants This study was funded in part by Dow Corning 2003 update Spain STOA Report to the European Parliament Petitions Committee 2000 This review of existing literature stated that there does not appear to be clear evidence of increased mortality or specific major diseases from silicone breast implants but there is still a need for further research particularly regarding some findings that indicate an apparent increased risk for brain and respiratory cancer as well as suicide 3 2004 Denmark Followup 2761 vs breast reduction general population 27 Found no differences between the implant and breast reduction surgery cohorts in the incidence of any CTD This study was funded by Dow Corning and the Danish Cancer Registry