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Are Younger Women More At Risk Of Phantom Breast Syndrome? A Systematic Review Of Prevalence And Neural Pathophysiology Of PBS
Cindy Gombaut, M.S. Medical Sciences, B.S. Psychology, Mira Johnson, B.A. Political Science and International Studies, Elizabeth Matison, B.S. Biological Anthropology, Waleed R. Rashid, B.S., Bharat Ranganath, M.D., Jerry Chao, M.D..
George Washington School of Medicine and Health Sciences, Washington, DC, USA.

PURPOSE: The prevalence of phantom breast syndrome (PBS) post-mastectomy is a poorly reported and understudied postoperative condition that can lead to debilitating chronic pain and lower quality of life. The pathophysiology of PBS may reveal nuanced information of related chronic pain conditions such as phantom breast pain (PBP) and intercostobrachial neuralgia. The purpose of this analysis was to examine the prevalence, risk factors, and pathophysiology of phantom breast syndrome in breast post-mastectomy.
METHODS: A comprehensive literature search was conducted in October, 2021 using publications extracted from Pubmed, Scopus, and Cochrane Library. Eligible studies reported postoperative complications related to PBS and its pathophysiology. Two independent reviewers screened articles and conflicts were resolved by a third reviewer. The criteria used were those described in the PRISMA Declaration for performing systematic reviews.
RESULTS: Initial screening yielded 233 studies and after 3 rounds of screening, 14 studies were included for final extraction. The predominant risk factors reported for PBS were younger age, preoperative sensory disturbances, depressive symptomatology, and tranquilizer use. A positive association between frequency of PBS and the appearance of a pain condition was also found.
CONCLUSION: Phantom breast syndrome (PBS) is a significant post-mastectomy condition that may reveal a susceptibility to maladaptive neuroplastic cortical changes. Further neuroimaging studies of PBS are needed to attain a better understanding of underlying peripheral and central neural mechanisms. Further analysis of the risk factors of PBS are needed to formulate specific disease criteria for post-mastectomy patients.


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