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參考答案:FDA Ends Ban on Silicone Implants
Safety Concerns Led to '92 Moratorium
By David Brown and Christopher Lee
Washington Post Staff Writers
Saturday, November 18, 2006; Page A01
The Food and Drug Administration ended its 14-year ban on the cosmetic use of silicone breast implants yesterday, despite lingering safety concerns from some health advocates.
The FDA is requiring that manufacturers tell women that the implants "are not lifetime devices" and that most recipients will need at least one additional surgery to remove or replace their implants. The agency is requiring the makers, Mentor Corp. and Allergan Inc., to conduct an extensive study of at least 40,000 implant recipients over the next decade and provide their findings to the government.
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More than 264,000 women had breast implant surgery last year with saltwater-filled devices, whose availability was never limited. Medical experts predict that yesterday's approval will increase that number because silicone-gel implants, which are considered more natural and appealing, will prove popular. The FDA is allowing the devices for breast augmentation for women who are least 22 years old and for all breast-reconstruction patients.
Silicone implants were first marketed more than 30 years ago, but a moratorium was placed on them in 1992 after many women who had received them reported pain, deformity and serious illness caused when the implants ruptured or leaked. At the time, the FDA concluded there was "inadequate information to demonstrate that breast implants were safe and effective." A major implant manufacturer, Dow Corning Corp., was pushed into bankruptcy because of lawsuits stemming from the problematic devices.
Michael Ball, president of Allergan, said that "science has prevailed here" and added: "The FDA set an extremely high bar for approval. . . . There's a huge body of scientific data there."
He said the worldwide market for breast implants is $540 million annually and has grown less than 10 percent a year, but he expects double-digit growth now.
Critics were disappointed by the FDA's decision, which had been expected for months.
Diana Zuckerman, president of the National Research Center for Women and Families, said the approval was the product of corporate lobbying rather than good science.
Zuckerman, a former Capitol Hill staffer who has worked on breast implant safety issues for more than 15 years, said too little is known about the long-term health risks of the implants. She said what is known indicates that some women will experience joint pain, chronic fatigue and leakage.
In recent years, the FDA has allowed silicone implants only for women whose breasts were reconstructed after cancer or trauma. At the same time, the FDA, the manufacturers and many academic researchers gathered data on the devices.
"The extensive body of scientific evidence provides reasonable assurance of the benefits and risks of these devices," said Daniel G. Schultz, director of the FDA's center for devices and radiological health.
The National Academy of Sciences' Institute of Medicine reviewed many studies and concluded that there was no convincing evidence that leaking silicone led to autoimmune diseases or cancer, as some researchers had feared. But less severe complications were common.
