The health risks of breast implants are not without debate. For example, it is well documented that women with breast implants can face local complications, such as pain, rupture and deflation, but some people have also suggested that breast implants can be a source of illnesses like autoimmune disease. Together, this has prompted extensive research to better understand their safety and toxicity.

One of the components of interest in safety and toxicity tests of breast implants is platinum (Pt). This is because a platinum salt, hexachloroplatinate, is sometimes used to cross-link the silicone gel (poly(dimethysiloxane) or PDMS) used in both silicone breast implants and the envelope of saline breast implants. Its presence raises the possibility that platinum may leech out, and since certain forms of platinum are associated with health risks, potentially be of concern. Nevertheless, the fate of this platinum, and in particular its chemical state, is not yet clear.

E. D. Lykissa and S. V. M. Maharaj, from the Center for Research on Environmental Medicine, Maryland, recently took aim at this question. They used ion chromatography coupled to inductively coupled plasma mass spectrometry (IC-ICP/MS) to determine the total platinum concentration in samples from women exposed to silicone and saline breast implants. Their results reveal higher levels of platinum in exposed women and their method may help future studies designed to assess the risk associated with such levels. The results are published in Analytical Chemistry.

Lykissa and Maharaj's study involved 23 subjects, 18 of which had or once had breast implants and 5 of which did not. For those exposed to breast implants, the time of this exposure ranged from 3 to 25 years. The authors collected whole blood, urine, hair, nails, sweat, brain tissue, breast milk, and explants to test for platinum concentrations.

All of the analysis for platinum was performed using IC-ICP/MS. Lykissa and Maharaj began with a quality control check of their IC-ICP/MS method using platinum-spiked samples, which gave them a good recovery (93-100.8%) and detection limit (10-75 pg/g Pt). Moving on to samples from women, the authors found that women exposed to silicone breast implants had platinum levels 60-1,700x for urine, 14x for hair, 3x for nails, and 100x for breast milk compared to non-platinum exposed individuals.

However, platinum is not necessarily harmful to human health. Indeed, only platinum in oxidation states other than zero (e.g. +2, +4, +6) are suggested to perhaps be a health risk. But "no previous study ever actually analyzed a breast implant or explant for various forms of Pt," write the authors.

Lykissa and Maharaj therefore went on to separate and analyze the oxidation states of the platinum in some of their samples. They found that platinum in explanted silicone breast implant gel occurred mostly in the +2, +4 and +6 oxidation states. Furthermore, tests of whole blood samples found platinum in the [0] oxidation state in control women, but mainly in the +2 and +4 states in women exposed to silicone breast implants.

"Silicone breast implants are the most likely source of the elevated total Pt levels and the reactive forms of Pt in women exposed to these devices," conclude the authors. Nevertheless, they point out that their report is "limited by the number of cases studies" and independent research "is needed to corroborate and extend the results."

Related Links:

• Analytical Chemistry 2006, 78, 2925-33: "Total Platinum Concentration and Platinum Oxidation States in Body Fluids, Tissue, and Explants from Women Exposed to Silicone and Saline Breast Implants by IC-ICPMS"
• FDA Breast Implant Consumer Handbook, 2004
• Epidemiology 2002, 13, S34-9: "Epidemiology of silicone-gel breast implants"

Article by David Secko