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is clear that adversarial legal proceedings do not generate the kind of scientific inquiry and discussion that the IOM committee process does. On the other hand, information from legal discovery and arguments can identify directions for inquiry, useful literature, and data. This information has contributed to the completeness and accuracy of this report. The statements of women with breast implants and of scientists, physicians, and others who appeared before the committee (see Appendix A and B), although often anecdotal and not peer reviewed, were helpful too. A number of important issues emerged from the committee's reviews of available information. These issues are the ones that make up the committee's charge and they are the scientific and medical questions that are suggested or explicit in the reports concerning associations between silicone breast implants and human health conditions that have appeared in increasing numbers in the world's medical and scientific literature. In Chapters 2 through 12 the committee addresses the issues as closely and conclusively as possible under the headings of silicone chemistry, implant catalogue, silicone toxicology, reoperations and local and perioperative complications, silicone immunology, antinuclear antibodies, connective tissue or rheumatic disease, cancer, neurological disease, effects on breast feeding and on children, and screening and diagnostic mammography. Descriptions of the IOM scientific workshop and public meeting and comments on other recent policy-relevant reports appear in the appendix materials.