Silicone does not seem to raise the risk of cancer in women

THE QUESTION The safety of breast implants has sparked debate for years. Some people have argued that implants may make women more susceptible to various diseases. Might cancer be one of them?

THIS STUDY involved 3,486 Swedish women who had implants for cosmetic reasons; nearly all of them were made of silicone gel. After an average of 18 years, 180 cancers had been detected, equating to a slightly lower overall cancer rate than among women without implants. Fewer women with implants had developed breast cancer than would have been expected in the same-size group in the general population (53 vs. 72). Only lung cancer was more common than expected: 20 cases among those with implants vs. an expected nine.

WHO MAY BE AFFECTED BY THESE FINDINGS? Women with silicone implants. Since 1992, only women having breast reconstruction after cancer surgery have had access to silicone implants in the United States; the Food and Drug Administration restricted their use because of concerns that leaks could jeopardize a woman’s health. The agency now is deciding whether to allow them once again. About 3 million American women have implants, most made of either silicone or saline.

CAVEATS The authors theorized that the higher lung cancer rate may be related to the above-average number of smokers among women in the study.

FIND THIS STUDY April 19 issue of the Journal of the National Cancer Institute; abstract available online at www.jncicancerspectrum.oxfordjournals.org.

LEARN MORE ABOUT breast implants at www.fda.gov/cdrh/breastimplants and www.plasticsurgery.org.

A heart-healthy diet may also guard against cognitive decline

THE QUESTION Adhering to a so-called Mediterranean diet — lots of fruit, vegetables and fish, and little poultry, meat and dairy products — appears to reduce the risk of cardiovascular disease. Might what’s good for the heart also be good for the brain?

THIS STUDY followed 2,258 older people (average age, 77) with normal mental faculties, recording what they ate and periodically assessing their cognitive abilities. In a four-year period, 262 of them were diagnosed with Alzheimer’s disease. The more closely people followed a Mediterranean diet, the less likely they were to have Alzheimer’s. Compared with those who followed the diet the least, people in the mid-range of adherence had Alzheimer’s 15 percent less often, and those who followed the eating pattern the closest were 40 percent less likely to develop Alzheimer’s.

WHO MAY BE AFFECTED BY THESE FINDINGS? Older people. About 10 percent of those over 65 and about half of people older than 85 have Alzheimer’s. The number of Americans with the disease, currently about 4½ million, is expected to grow to as many as 16 million in the next 15 years.

CAVEATS The study did not address the effects of following a Mediterranean diet earlier in life.

FIND THIS STUDY April 18 online issue of Annals of Neurology; abstract available at www.interscience.wiley.com/journal/ana (click “Early View”).

LEARN MORE ABOUT Alzheimer’s disease at www.alz.org and www.alzinfo.org.

Drug combination seems to reduce severity of brain attack

THE QUESTION The arsenal of drugs available to prevent strokes includes aspirin, cholesterol-lowering statins and the blood pressure drugs known as ACE inhibitors. Each has been shown to work, when taken separately. Might combinations of these drugs ratchet up their effectiveness?

THIS STUDY analyzed data on 179 people hospitalized for a stroke caused by a blood clot or obstruction. Those who had been taking aspirin, a statin and an ACE inhibitor had less-severe strokes than did people who were taking aspirin alone, aspirin and a statin, aspirin and an ACE inhibitor or none of the drugs. About 65 percent of those taking the three drugs showed neurologic improvement by the time they were discharged, compared with 45 percent of those in the aspirin/ACE inhibitor group, 43 percent for the aspirin/statin group, 38 percent for aspirin alone and 33 percent of those taking none of the drugs. People on the triple treatment also were able to function better when discharged and spent somewhat less time in the hospital than the others.

WHO MAY BE AFFECTED BY THESE FINDINGS? People taking medication in hopes of preventing a stroke. High blood pressure, diabetes and heart disease are among the stroke risk factors that often are treated with medication. In the United States, someone has a stroke about every 45 seconds.

CAVEATS The findings have not been confirmed by a large-scale, randomized study. Information on how long the participants had been taking the various drugs was not available. The analysis did not consider other medical conditions that may have affected participants’ ability to function and length of hospitalization.

FIND THIS STUDY April 25 issue of Neurology; abstract available online at www.neurology.org.

LEARN MORE ABOUT stroke at www.strokeassociation.org and www.clevelandclinic.org/health.