Wells K E, Roberts C, Daniels S M, Hann D, Clement V, Reintgen D, Cox C E
Division of Plastic Surgery, Department of Surgery, University of South Florida College of Medicine, Tampa, Fla., USA.
Plast Reconstr Surg. 1997 Mar;99(3):680-5. doi: 10.1097/00006534-199703000-00012.
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.
对硅胶乳房植入物安全性的担忧，导致许多出现多种生理和心理症状的女性寻求取出乳房植入物。这项回顾性组间比较研究描述了要求取出乳房植入物的女性与两个对照组相比的心理状况。使用简明症状量表来比较三组女性的心理症状：一组是要求取出植入物的术前乳房植入组（n = 78），一组是无乳房植入物的术后乳腺癌组（n = 64），还有一组是无已知乳房疾病且乳房植入物状况不明的对照组（n = 68）。比较了简明症状量表的总体严重程度指数以及九个分量表的得分：躯体化、强迫观念与行为、人际敏感、抑郁、焦虑、敌对、恐惧焦虑、偏执观念和精神病性。与其他组相比，乳房植入组的总体严重程度指数得分以及躯体化、强迫观念与行为、抑郁、敌对和焦虑分量表得分显著升高。事后数据分析显示，因预防乳腺癌在皮下乳房切除术后植入乳房植入物的女性（n = 18）与进行美容隆乳的女性（n = 53）相比，症状表现明显不同，总体严重程度指数得分更高。此外，进行皮下乳房切除术并植入乳房植入物的女性在人际敏感、恐惧焦虑、偏执观念和精神病性分量表上的得分显著高于美容植入组的女性。要求取出硅胶乳房植入物的女性比最近被诊断出患有乳腺癌的女性或无已知乳房疾病且乳房植入物状况不明的对照组女性有更大的心理困扰。然而，在植入组中，进行皮下乳房切除术的女性比进行隆乳术的女性表现出更大的心理障碍。
