Opioid Use After Surgical Resection of Breast Cancer
Posted: Friday, September 18, 2020
There is a high rate of prolonged opioid use among women who underwent surgery for early-stage breast cancer, particularly those who had a mastectomy. Sharon H. Giordano, MD, MPH, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues published this work in The Oncologist.
“This study highlights the need to emphasize appropriate opioid therapy and potential dosage reduction or discontinuation among patients with early‐stage breast cancer who received surgical interventions,” concluded the authors.
The authors utilized MarketScan data to identify 23,440 opioid-naive patients who had undergone surgery for breast cancer between January 2000 and December 2014 and filled at least one opioid prescription related to the surgery. Women included had either undergone mastectomy with or without reconstruction or lumpectomy with or without radiation therapy. Prolonged opioid use was defined as the use of opioids 90 to 180 days after surgery. Extra-prolonged use was defined as filling an opioid prescription 181 to 365 days after surgery.
Among the entire cohort, 18% met the criteria for prolonged opioid use, and 9% met the criteria for extra-prolonged opioid use. Women who had undergone mastectomy plus reconstruction or mastectomy alone had the highest rates of prolonged opioid use, with 38% and 15% of each cohort using opioids beyond 90 days. Women who underwent mastectomy seemed to be more likely to have prolonged opioid use as compared with women who underwent lumpectomy (odds ratio = 1.66), especially if they had reconstruction (odds ratio = 5.56).
Extra-prolonged opioid use was also more likely to occur in patients after mastectomy with (odds ratio = 4.51) or without reconstruction (odds ratio = 1.35) when compared with women after lumpectomy. Factors including a later diagnosis time frame, presence of comorbidity, depression, anxiety, substance use disorder, chemotherapy, and the presence of a positive node were all associated with increased odds of extra-prolonged opioid use.
Disclosure: The authors reported no conflicts of interest.