Killer boobs: what has changed in the last year?

05-15-2022

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The documentary killer boobs showed the problems that can arise after breast implants. Much has changed since then, but much remains to be clarified.

“The documentary has contributed a lot. I was inundated with messages from women who recognized themselves in my story,” says Dionne Slagter, filmmaker of the documentary. killer boobs† The silicone clinic line at the UMC in Amsterdam is also red hot after the broadcast. Women have doubts about the safety of their implants, identify with the disease or want to have their implants removed (preventively). “At a certain point, the waiting time increased to 18 months,” according to internist Prabath Nanayakkara. This has now been reduced to one year, through collaborations with peripheral clinics and the appointment of an additional PhD student.

consumption
Nine years ago, Dionne believes she was not properly briefed during her intake interview. “I was told that the implants could stay in my body for life and that they were the safest implants.” Parliamentary questions on this will be asked in the summer of 2021. In response to questions, the then Health Care Minister, Tamara van Ark, emphasized the importance of good information for women to “make a good decision in consultation with their doctor about whether or not they should have breast implants. Fortunately, this information is getting better and better, Nanayakkara knows. “The information folder has become more extensive and the entire Internet is full of information.”

Both Van Ark and Nanayakkara don’t know how things really work in the treatment room. That is why Van Ark emphasizes once again that women want to “help ask the three good questions” to their treating doctor, drawn up by the patient federation. decide together† By doing so, you put the responsibility back on the patient. Ridiculous, according to Dionne. ‘Even if you choose it yourself, I think you have the right to know what you choose. The risks simply have to be presented clearly. You need someone to give you honest advice and tell you what’s going on. Of course you have to investigate, I did too.

Sometimes the urge for prosthetics is so strong that someone takes the risk for granted, Nanayakkara knows. “Some women hear what they want to hear.” Doctors should be aware of that, but ‘it remains to be decided together – shared decision making

CE mark
also the tv show Radar dives into the world of breast implants; they compare it to the world of medicine. “While a drug has to be tested for almost ten years before it can be marketed, a pelvic floor mat, pacemaker or breast implant can already be approved if there is nothing ‘technically’ wrong,” he writes. Radar in September 2021. The tests do not guarantee long-term safe use in the body, according to Nanayakkara. ‘Complaints related to breast implant disease develop after eight to ten years. Studies are not carried out over a longer period of time for CE markings. So you don’t know what the risks will be ten or fifteen years from now.

A long-term study comparable to that of drugs would be nice, but it’s not feasible yet, according to Nanayakkara. ‘It is not easy to find ten thousand women who have implants for aesthetic reasons and who are followed for ten years.’ The Breast Implant Registry has been recording data on breast implants in the Netherlands since 2015; this study also monitors long-term quality and safety.

Recognition
Everything is based on a missing factor: recognition. “That’s the first step,” according to Nanayakkara. because although breast implant disease by the FDA (Food and Drug Administration) is recognized, there are still aesthetic doctors who do not believe it exists. “There is now enough information to find that silicone breast implants cause complaints in at least some of the women,” but there are no standards for the disease. Therefore, what we do is exclude alternative explanations and see if the pattern of complaints corresponds to the known pattern of complaints appropriate for breast implant disease† We do not have laboratory measurements for that. We cannot show with a test, like the PCR test for covid, if someone suffers from this”, says Nanayakkara. “We give women the benefit of the doubt.”

Unreliable platinum hair test
For some time now, there seems to be an easy way to prove the presence of silicone, and with it an increased risk of complications, in the body: the platinum hair test, a test Dionne has also done in the documentary. However, after research by Amsterdam UMC, this does not appear to be reliable. “The test does not provide information about a possible leak,” the hospital writes. The values ​​of women with implants do not differ significantly from the values ​​of people without silicone implants, according to the researchers. “Also, some women with broken prostheses did not have elevated platinum levels.” There is no new (simple) test yet. Nanayakkara: ‘That’s not easy. We’re working on it, but we don’t have one right now.”

Large-scale research is needed to remove doubt about the disease. ‘I don’t know how many thousands or millions of women in the world walk around with silicone prostheses without complaining. But we have seen more than 1,300 women with complaints. We do not know what percentage of women develop complaints. It would be great if women who have had breast implants for ten or fifteen years without complaint also come forward, so that we can use these women as the so-called control population for comparison.’

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