Lea Evans devans@compusmart.ab.ca

Dearest Caroline:

I have been going through my old mail and I found this. Have you seen this, because I can't remember ever seeing this before? I must have brain damage.

Happy moving.

Much love...Lea

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Subject: Hellth Canada Study

Canadian Medical Association Journal 1996; 155: 1592

The Laboratory Centre for Disease Control, in collaboration with the Epidemiology Research Group of Laval University and the Ontario Cancer Treatment and Research Foundation, has designed a large cohort study to determine the risk of cancer, connective-tissue disorders and other negative outcomes in women with cosmetic breast implants. Phase I, which will focus on cancer risk, involves identifying 40 000 Ontario and Quebec women who received breast implants from 1974 to 1989. First they will be compared with a control group of 20 000 women who received other elective cosmetic surgery at the same practices, and then to the general female population, identified from cancer and death-registry data. The study will estimate the subsequent cancer incidence, mortality and survival rate among women with breast implants. Risk estimates will be compared both for specific types of implants and for time since surgery.

The study, after passing a rigorous scientific and ethical review, has been authorized to collect patient information from medical files. Physicians will not be breaching physician­patient confidentiality by participating, and all information will remain strictly confidential. Women will be notified collectively; those who do not want their file to be part of the research can inform the study group by calling 888 377-0477 (toll free).

Although the study will focus on the risk of breast cancer, the risks for all cancers will be investigated, since other cancer sites have been associated with breast implants in other studies. Data collection, follow-up, analysis and preparation of reports is expected to take 3 years. Connective-tissue disorders and local complications will be investigated in subsequent phases. Up to 200 000 Canadian women have received breast implants since the early 1960s. Physicians seeking further information can call the toll-free number or visit the study's website,