Pathologic findings in nerve and muscle biopsies from 47 women with silicone breast implants

Objective: To describe the pathologic findings in 47 consecutively received nerve and muscle biopsies from patients with silicone breast implants (SBI). Background: The controversial proposal that systemic illness may result from SBI includes diseases of the central and peripheral nervous system. Methods: All of the biopsies were processed in full according to current standard methodologies in nerve and muscle pathology. Myelinated fiber histograms were prepared in 40 of the 47 cases. Results: Eight of the 47 nerves showed pathologic changes likely to be symptomatic: 7 with an axonal neuropathy, including 1 with a granulomatous neuritis and myositis and 1 with diabetic neuropathy, and the eighth with a hypertrophic onion bulb neuropathy, Eleven showed minor morphologic or morphometric alterations of uncertain clinical significance. The remaining 28 nerve biopsies were normal, including 1 in which the accompanying muscle showed an inflammatory myopathy typical of polymyositis. Conclusions: These findings represent the largest set of reported pathologic data derived from women with SBI. Within this highly selected cohort of women with SBI, the majority of the biopsies were normal, and in 9 of 47 diverse abnormalities were detected including axonal and demyelinating neuropathies and inflammatory myopathies. These findings do not support a consistent association between SBI and any neuropathologic entity.