A new study adds to evidence that while women with breast implants are not at greater risk of breast cancer, they do seem to have an elevated rate of suicide.

The reason for the suicide risk is unclear, but several studies have now come to similar conclusions. Some researchers believe the link is explained by higher rates of depression, anxiety and low self-esteem among women who undergo breast augmentation.

Supporting that theory, one recent study found that women who received cosmetic breast implants were more likely to have a history of psychiatric hospitalization than those who underwent other types of plastic surgery.

Based on such findings, some experts have recommended that women be screened for past and present psychiatric disorders before they receive breast implants.

The current study, published in the journal Epidemiology, included 12,144 U.S. women who’d received breast implants between 1960 and 1988, and 3,614 women who’d undergone other types of cosmetic surgery during the same period.

Researchers compared the two groups’ rates of death from various causes over an average of 20 years; the rates in each group were also compared with statistics for women in the general population.

Overall, the study found, women who’d received implants had a lower risk of death from most causes when compared with the general population.

That included a lower risk of dying from breast cancer, a disease that has been a concern among breast implant recipients. Though research has failed to show that the implants contribute to breast cancer development, there is evidence that implants can interfere with mammography screening for breast tumors.

In this study, however, women with implants were only half as likely as those in the general population to die of breast cancer, according to the researchers, led by Dr. Louise A. Brinton of the National Cancer Institute in Bethesda, Maryland.

Women who’d received implants did, however, have a higher-than-average risk of suicide. And they were more than twice as likely as women who’d had other cosmetic procedures to take their own lives.

Between the two surgery groups, implant recipients were also more likely to die of respiratory cancer or brain cancer. However, few women in either group died of a brain tumor, and it’s not clear that there’s a cause-and-effect relationship between breast implants and either form of cancer, according to Brinton and her colleagues.

The elevated suicide risk, however, “remains of concern,” the researchers conclude.

In an unexpected finding, they note, women with implants were also more likely than those who’d had other cosmetic procedures to die in a car accident. Coupled with the suicide findings, Brinton and her colleagues write, this suggests that some of those traffic deaths were not accidental.

SOURCE: Epidemiology, March 2006.