Prevalence and psychological repercussion of phantom breast syndrome in women undergoing mastectomy: a systematic review
DOI:
https://doi.org/10.29289/2594539420220025Palavras-chave:
breast neoplasms, mastectomy, pain, phantom limbResumo
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.
Downloads
Referências
Instituto Nacional de Câncer José Alencar Gomes da Silva. Estimativa 2020: incidência de câncer no Brasil. Rio de Janeiro: INCA; 2019.
Sledge GW, Mamounas EP, Hortobagyi GN, Burstein HJ, Goodwin PJ, et al. Past, present, and future challenges in breast cancer treatment. J Clin Oncol. 2014;32(19):1979-86. https://doi.org/10.1200/JCO.2014.55.4139
Staps T, Hoogenhout J, Wobbes T. Phantom breast sensations following mastectomy. Cancer. 1985;56(12):2898-901. https://doi.org/10.1002/1097-0142(19851215)56:12<2898::aid-cncr2820561229>3.0.co;2-j
Rothemund YV, Grüsser SM, Liebeskind U, Schlag PM, Flor H. Phantom phenomena in mastectomized patients and their relation to chronic and acute pre-mastectomy pain. Pain. 2004;107(1-2):140-6. https://doi.org/10.1016/j.pain.2003.10.007
Macdonald L, Bruce J, Scott NW, Smith WC, Chambers WA. Long-term follow-up of breast cancer survivors with post-mastectomy pain syndrome. Br J Cancer. 2005;92(2):225-30. https://doi.org/10.1038/sj.bjc.6602304
Silva BBD, Mendes LCM, Costa NKB, Holanda LGM, Lima GP, Teles JBM, et al. Síndrome da mama fantasma: características clínicas e epidemiológicas. Rev Bras Ginecol Obstet. 2007;29(9):446-51. https://doi.org/10.1590/S0100-72032007000900002
Demidoff AO, Pacheco FG, Sholl-Franco A. Membro-fantasma: o que os olhos não vêem, o cérebro sente. Cien Cogn. 2007;12:234-9.
Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1. https://doi.org/10.1186/2046-4053-4-1
Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603-5. https://doi.org/10.1007/s10654-010-9491-z
Brasil. Diretrizes Metodológicas. Sistema GRADE – manual de graduação da qualidade da evidência e força da recomendação para tomada de decisão em saúde. Brasília: Ministério da Saúde; 2014.
Faria SS, Freitas-Junior RD. Síndrome da mama fantasma em mulheres submetidas à mastectomia radical modificada. Rev Bras Mastologia. 2016;26(3):113-7. https://doi.org/10.5327/Z201600030006RBM
Dijkstra PU, Rietman JS, Geertzen JH. Phantom breast sensations and phantom breast pain: a 2-year prospective study and a methodological analysis of literature. Eur J Pain. 2007;11(1):99-108. https://doi.org/10.1016/j.ejpain.2006.01.002
Björkman B, Arnér S, Hydén LC. Phantom breast and other syndromes after mastectomy: eight breast cancer patients describe their experiences over time: a 2-year follow-up study. J Pain. 2008;9(11):1018-25. https://doi.org/10.1016/j.jpain.2008.06.003
Ahmed A, Bhatnagar S, Rana SPS, Ahmad SM, Joshi S, Mishra S. Prevalence of phantom breast pain and sensation among postmastectomy patients suffering from breast cancer: a prospective study. Pain Pract. 2014;14(2):E17-28. https://doi.org/10.1111/papr.12089
Spyropoulou AC, Papageorgiou C, Markopoulos C, Christodoulou GN, Soldatos KR. Depressive symptomatology correlates with phantom breast syndrome in mastectomized women. Eur Arch Psychiatry Clin Neurosci. 2008;258(3):165-70. https://doi.org/10.1007/s00406-007-0770-y
Markopoulos CJ, Spyropoulou AC, Zervas IM, Christodoulou GN, Papageorgiou C. Phantom breast syndrome: The effect of in situ breast carcinoma. Psychiatry Res. 2010;179(3):333-7. https://doi.org/10.1016/j.psychres.2009.08.016
Lena PT, Rempel C, Coltro D, Frigeri CDL, Grave MTQ. Perfil epidemiológico de mulheres mastectomizadas em um serviço de referência localizado no Vale do Taquari/RS. Rev Epidemiol Controle Infec. 2019;9(2):2238-3360. http://doi.org/10.17058/reci.v9i2.12102
Peuckmann V, Ekholm O, Rasmussen NK, Groenvold M, Christiansen P, Møller S, et al. Chronic pain and other sequelae in long-term breast cancer survivors: nationwide survey in Denmark. Eur J Pain. 2009;13(5):478-85. https://doi.org/10.1016/j.ejpain.2008.05.015
Medina JDMR, Fabro EAN, Silva BDA, Thuler LCS, Bergmann A. Frequência e fatores associados à síndrome da mama fantasma em mulheres submetidas à mastectomia por câncer de mama. Rev Bras Ginecol Obstet. 2015;37(9):397-401. https://doi.org/10.1590/SO100-720320150005353
Yurek D, Farrar W, Andersen BL. Breast cancer surgery comparing surgical groups and determining individual differences in postoperative sexuality and body change stress. J Consult Clin Psychol. 2000;68(4):697-709. https://doi.org/10.1037/0022-006X.68.4.69
Fakhari S, Pourfathi H, Farzin H, Bilehjani E. Post-Mastectomy Phantom Breast Syndrome. J Obstet Gynecol Cancer Res. 2018;3(4):137-42. http://doi.org/10.30699/jogcr.3.4.1
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2026 João Vitor Lima Silva Nascimento, Manuela Mattos Santana, Katia de Miranda Avena, Claudia Costa Pinto Furtado Machado
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
