Major health and labor market outcomes among women with breast implants (BRISK)

Research problem and specific questions: Approximately 4% of middle-aged women in Sweden have breast implants, the large majority (~80%) for cosmetic reasons.

At the same time there are rising concerns for adverse health effects, including reports of multiple adverse symptoms (‘breast implant illness’) as well as some psychiatric- and autoimmune conditions among women with breast implants.

Yet, comprehensive research efforts are still needed to determine if these risks are preexisting or caused by the procedure itself.

Therefore, the aim of the BRISK study is to leverage unique Swedish population-based data sources to determine pre- and post- implant procedure risks of: 1) mental disorders and psychotropic drug use; 2) autoimmune and chronic fatigue conditions; 3) sick-leave and disability pension among women with cosmetic breast implants.

Data and method: We will identify 28 835 women with cosmetic breast implants through the Breast Implant Register (BRIMP; N=20 779 operated 2014-22) and ongoing mammography studies (N=8 056 with breast implants, identified 2008-21).

By record linkage to the population-based Patient, Primary Care- and Prescription Medicines Registers, and Databases for Health Insurance and Labor Market, we will compare the rates of psychiatric- and autoimmune conditions as well as sick leave and disability pension among women with breast implants to that of their full sisters and an age- and region matched cohort of women (1:10 unexposed women).

We will assess pre-surgery rates of these conditions and take them into account when assessing the post-surgery rates of the studied health outcomes.Societal relevance and utilization: Solid evidence on major health outcomes associated with breast implant surgery is currently lacking, leaving women considering this surgery option largely uninformed on long-term health effects.

This comprehensive investigation will provide valuable information for health care policy and the growing population of women with breast implants.

Plan for project realization:  We seek three years of funding for a post-doc, record linkages, database management and presentation of the results to stakeholders and the scientific community.

Implementation of record linkages and preliminary analyses will be completed during the first year (2025), statistical analyses during the second year (2026), and publication of three scientific papers in leading international scientific journals by the end of the third year (2027).