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I am a 3rd year medical student, struggling to get through the physically rigorous clinical clerkships (I am a good student-- scored in top 5 % on national boards) because of chronic fatigue syndrome (CHANGE THE NAME!) and fibromyalgia. These illnesses began in 1993, 4 years after I had Mentor silicone breast implants put in. For years, I pooh-poohed and exercised denial regarding the risks of silicone. But once I opened my eyes and saw that the complaints of women with SBI were the SAME as MINE, I began to frantically dig through the scientific literature. I was and am deeply disturbed that proper studies of the risks have yet to be done. The Mayo clinic has just perpetrated an unforgivable crime on the medical and scientific world by publishing their most recent study on "local complications" of SBI, in which they FORGET to say that their prior (much quoted by implant manufacturers) study of "classical" connective tissue disease and SBI DID NOT EXAMINE THE RISK of "non-classical" diseases, eg CFS and FM (the very illnesses most often claimed to be related to SBI, and the FORGOT to tell the reader than their sample size was too small to find even a doubling of risk of the rare disease scleroderma. Maybe their selective memory was related to the support they received from implant manufactur- ers? (This support is acknowledged on the first page of the article). Worse, to me, is that the NEW ENGLAND JOURNAL OF MEDICINE would publish this article with its clear corporate bias in place. I have seen sufficient evidence in the scientific and medical literature to convince me that there is a real and likely possibility that silicone can cause immune related disorders. That proper epidemiological studies have not yet been done is NOT PROOF that there is no problem. Opponents of silicone disease theory cite the "monetary motivations" of the sick women.This ignores the fact that a lot of these sick women have lost their livelihood and have to fight tooth and nail just to get meager disability benefits. For the vast majority, significant compen- sation from implant manufacturers remains a distant dream (Dow bankruptcy) or impossibility (Mentor settlement allowed a maximum of $1500 compensation per patient--doesn't even pay the cost of explantation). As an "implant victim" I don't expect to reap millions. But I would like knowledge about silicone related disease to be viewed objectively, so that thousands of people can get appropriate medical care, support and disability benefits, and so that research can begin on TREATMENT for these illnesses.

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