title: Comparison of psychological symptoms of women requesting removal of breast implants with those of breast cancer patients and healthy controls.
abstract: Concern about the safety of silicone breast implants has led many women with numerous physical and psychological symptoms to seek breast implant removal. This retrospective group comparison study describes the psychological profile of women requesting breast implant removal compared with two control groups. The Brief Symptom Inventory was used to compare psychological symptoms of three groups of women: a preoperative breast implant group requesting removal of implants (n = 78), a postoperative breast cancer group without breast implants (n = 64), and a control group with no known breast disease and unknown breast implant status (n = 68). Scores were compared on the Global Severity Index of the Brief Symptom Inventory as well as on nine subscales: somatization, obsessive-compulsiveness, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. The breast implant group had significantly elevated Global Severity Index scores, as well as somatization, obsessive-compulsiveness, depression, hostility, and anxiety subscale scores, when compared with the other groups. Post hoc data analysis revealed that women who had implants after subcutaneous mastectomy as prophylaxis for breast cancer (n = 18) had a significantly different symptom profile and higher Global Severity Index scores than women who had cosmetic augmentation (n = 53). Additionally, women who had subcutaneous mastectomy and implants had significantly higher subscales of interpersonal sensitivity, phobic anxiety, paranoid ideation, and psychoticism than the cosmetic implant subjects. Women requesting removal of silicone breast implants had greater psychological distress than women who were recently diagnosed with breast cancer or controls with no known breast disease and unknown implant status. Within the implant group, however, women who had subcutaneous mastectomy showed greater psychological disturbance than those who had augmentation mammaplasty.
authors.affiliation: Division of Plastic Surgery, Department of Surgery, University of South Florida College of Medicine, Tampa, Fla., USA.
authors.forename: K E
authors.initials: KE
authors.lastname: Wells
authors.forename: C
authors.initials: C
authors.lastname: Roberts
authors.forename: S M
authors.initials: SM
authors.lastname: Daniels
authors.forename: D
authors.initials: D
authors.lastname: Hann
authors.forename: V
authors.initials: V
authors.lastname: Clement
authors.forename: D
authors.initials: D
authors.lastname: Reintgen
authors.forename: C E
authors.initials: CE
authors.lastname: Cox
mesh_terms: D000328:Adult; D018427:Breast Implants / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000523:psychology*; D016022:Case-Control Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000523:psychology*; D017533:Marital Status; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D013315:Stress, Psychological