Prevalence and psychological repercussion of phantom breast syndrome in women undergoing mastectomy: a systematic review

Abstract

Breast cancer is the most common cancer among women in the world and the leading cause of death among Brazilian women. The presence of phantom breast syndrome (PBS) is one of the possible postoperative complications and may reach prevalences of up to 53% among mastectomized women. This study assessed the scientific evidence regarding the presence of PBS and its psychological repercussions in women undergoing mastectomy. This is a systematic review of observational studies based on the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. The methodological quality of the studies and the level of scientific evidence were assessed using the Newcastle-Ottawa Scale and the Grading of Recommendations Assessment, Development and Evaluation. A total of 95 articles were identified, but only 11 met the eligibility criteria. The outcomes of the presence of PBS and psychological repercussion were evaluated in 2,160 and 1,996 patients, respectively. It was found that the prevalence of PBS varies according to age, being on average 28% and reaching up to 50% in women under 80 years of age. This phenomenon can occur from three months to six years after amputation, tending to regress over time. Anxiety, depression, and sleep disorders are the most prevalent psychological effects (35.8%, 31.5%, and 29.2%, respectively). The studies presented strong scientific evidence of PBS and moderate evidence of psychological repercussions associated with this context.