Munchausen's syndrome and prophylactic mastectomy

Area of Science:

• Plastic Surgery
• Oncology
• Psychiatry

Background:

• Bilateral prophylactic mastectomy is a significant ablative procedure.
• Family history is a key factor in assessing breast cancer risk.
• Munchausen's syndrome involves fabricating medical conditions for attention.

Observation:

• A patient presented for bilateral prophylactic mastectomies citing a strong family history of breast cancer.
• The reported family history was subsequently revealed to be fabricated by the patient.
• This highlights the potential for psychological factors to influence surgical decisions.

Findings:

• Relying solely on patient-reported family history for prophylactic mastectomy can be misleading.
• Fabricated family history may be a manifestation of Munchausen's syndrome.
• Objective criteria are crucial for justifying ablative plastic surgery.

Implications:

• Plastic surgeons must maintain a high index of suspicion for Munchausen's syndrome in similar cases.
• Thorough verification of family history is essential to avoid unwarranted surgical interventions.
• Recognizing potential underlying psychological conditions prevents iatrogenic harm and unnecessary procedures.