유방판탐현상의 출현율과 정신의학적 양상

The Incidence and Psychiatric Manifestations of Phantom Breast Phenomenon

Objects ： Phantom breast phenomenon(PBP) is characterized by a, sensation of persistence of the breast after its removal by mastectomy. The etiology and pathophysiological mechanisms underlying PBP are still unknown, despite great efforts to explain them by neurologic and psychologic aspects. The aims of this study were firstly, estimating the incidence o f PBP after mastectomy because of breast cancer, secondly, comparing the sociodemographic characteristics, clinical characteristics of the breast cancer and psychopathological states between patient groups with and without PBP(Abscence of PBP, APBP) to investigate the psychiatric characteristics o f the patient with PBP. Methods : This was a prospective study of 37 women patients who, after having undergone mastectomy because of breast cancer, embarked consecutively on the day before operation, 3 days, 1 month after operation at the Department of General Surgery at the Chonnam University Hospital. The sociodemographic characteristics, clinical characteristics o f breast cancer and psychopathological states such as anxiety, depression and pain and distress have been obtained by self reporting scales and semistructured interview. Results ： The indicence of PBP was 37.8% till the time of 1 month after operation. In terms of the sociodemographic characteristics there was no significant difference between PBP group and APBP group. Among the clinical characteristics of breast cancer, only the severity of stump pain at the time of 3 days after mastectomy was significantly higher in PBP group than in APBP group. The scores for rating scales for anxiety, depression and pain and distress were significantly higher in PBP group than in APBP group at all the times of follow up study. Conclusion ： The present incidence of PBP is close to the incidence reported by others. The psychopathological states were more severe in PBP group than in APBP group. These results suggest the need of psychiatric intervention before and after the mastectomy for the prevention and management of PBP.