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Officials ignoring call for breast-implant registry

Don Harrison
The Province

Sunday, January 11, 2004

Surgeon Lloyd Carlsen displays a breast implant filled with soybean oil at Scarborough, Ont., hospital.

Ottawa and Victoria are continuing to ignore calls for a breast-implant registry despite the operation's possible impact on women's health, self-esteem and the public purse.

Unlike the U.S. ,U.K. and Germany, Canada does not have a registry, leaving experts to guess there are between 100,000 and 200,000 Canadians who've undergone breast-implant surgery. And it is estimated that 80 per cent of that work is medically unnecessary breast enlargement, all done in for-profit clinics.

But a small-sample study by the B.C. Centre of Excellence for Women's Health found women with augmentation implants had an over 400-per-cent higher hospital admission rate than those without implants. This follows research by the Mayo Clinic that showed 25 per cent of U.S. breast-implant women had breast/chest complications severe enough to warrant surgery within five years.

While other studies in the past decade have disputed safety concerns over implants, the U.S. and Canada had a moratorium on enlargements with silicone since 1992 after questions of cancer and connective tissue damage arose.

However, late last year the U.S. Food and Drug Administration voted to lift the moratorium and one of B.C.'s top cosmetic and reconstructive surgeons and the head of surgery at the Providence Health Care hospital group in Vancouver, Nancy Van Laeken, has publicly questioned Canada's ban.

And noted Vancouver plastic surgeon Benjamin Gelfant raised another registry issue -- privacy.

"People don't want personal data stored by agencies which may be vulnerable," he claimed.

But B.C. Centre of Excellence report co-author Ann Pederson said women are harmed by the duelling studies and privacy debates, as right now science has insufficient data to verify the health outcomes in those who choose breast enlargement.

"The issue is how can we know the nature and scale of the situation," Pederson insisted, "since the initial procedures occur in the private sector and they don't have to keep records.'"

Pederson said the U.K. registry helped in that country's recall of soybean implants two years ago, yet she said five years of registry talks have produced "nothing formal" from Victoria or Ottawa.

B.C., although it would have to contribute to a national registry, said last week it is a federal matter. But new Prime Minister Paul Martin has all ministries looking to cut, not add, programs, while Health Canada's major Ontario-Quebec implant survey won't be finished until later this year.

"We are looking at the issue" of a registry, was all Health Canada's Catherine Saunders could say.

Besides the registry, there's also a possible connection between implants and health problems and its impact on public health funds.

Implants for enlargement are paid for and performed privately, but if complications arise and hospitalization is required, the taxpayer, not the woman who chose implants, is left paying.

Finally, a prominent women's group questions the physician's role in what medicare defines as medically unnecessary surgery.

Karen Duncan, Vancouver Women's Health Collective executive director, said she was "disgusted" to see a private clinic's ad in a popular Vancouver entertainment/news weekly encouraging men to give their girlfriends bigger breasts for Christmas.

"It's about [exploiting] insecurities women have about their self-image," Duncan charged.
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