Nipple-sparing mastectomy in normal breast
consequence of simulation and disease anxiety
Keywords:
breast neoplasms, patient simulation, factitious disordersAbstract
Diagnosis in psychiatry is a thorough and potentially artificial process. In this letter, we discuss this diagnostic process in the context of a young patient who underwent nipple-sparing mastectomy after falsifying a breast biopsy report revealing invasive ductal carcinoma. The secondary pathology revision was also forged by the patient and confirmed the diagnosis. The patient was summoned by the Service’s board and admitted the falsification of breast cancer reports. After evaluation at the Psychiatric Service, changes in vital mood, psychosis, delusional activity and obsessive-compulsive symptoms were ruled out. In view of the growing demand for prophylactic mastectomy observed worldwide, similar cases may become more frequent.
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References
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorder (DSM-5). 5ª ed. American Psychiatric Association; 2013.
Feldman MD. Prophylactic bilateral radical mastectomy resulting from factitious disorder. Psychosomatics. 2001;42(6):519-21. https://doi.org/10.1176/appi.psy.42.6.519
Yates GP, Feldman MD. Factitious disorder: a systematic review of 455 cases in the professional literature. Gen Hosp Psychiatry. 2016;41:20-8. https://doi.org/10.1016/j.genhosppsych.2016.05.002
Grenga TE, Dowden RV. Munchausen’s syndrome and prophylactic mastectomy. Plast Reconstr Surg. 1987;80(1):119-20.
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Copyright (c) 2021 Leonardo Ribeiro Soares, Savio Augusto Teixeira-Silva, Murilo Ferreira Caetano, Gustavo Amaral Modesto, Marise Amaral Rebouças Moreira, Ruffo Freitas-Junior
This work is licensed under a Creative Commons Attribution 4.0 International License.
