Chan Shen, Ph.D., Associate Professor, Department of Surgery Chief, Division of Outcomes, Research and Quality, The Pennsylvania State University speaks about Prolonged Opioid Use After Surgery for Earlyâ€Stage Breast Cancer.
Link to Abstract:
https://theoncologist.onlinelibrary.wiley.com/doi/10.1634/theoncologist.2019-0868
Abstract:
Introduction:
This study looked at the patterns of long-term opioid usage and the variables that were linked to a greater risk of long-term opioid usage in patients with early-stage breast cancer who were opioid-naive.
Methods:
The study identified 23,440 opioid-naive individuals who had breast cancer surgery between January 2000 and December 2014 and filled at least one opioid prescription as a result of the operation using MarketScan data. Extra-prolonged opioid usage was defined as one or more opioid prescriptions between 181 and 365 days following surgery, while prolonged opioid usage was defined as one or more opioid prescriptions between 90 and 180 days following surgery. To find variables linked to long-term and extra-long-term opioid usage, researchers used multivariable logistic regressions.
Findings:
4,233 (18%) of the 23,440 patients had long-term opioid usage, and 2,052 (9%) had extra-long-term opioid usage. Patients who underwent a mastectomy with reconstruction had the greatest prevalence of long-term opioid usage (38%) followed by those who had a mastectomy alone (15 percent ). Patients who had mastectomy and reconstruction had the greatest chances ratio of extended opioid usage when compared to lumpectomy and whole breast irradiation (adjusted odds ratio, 5.6; 95 percent confidence range, 5.1–6.1), according to a multivariable logistic regression. The mean daily opioid dose was continuously high in individuals who used opioids, with no apparent dosage decrease.
Interpretation:
This large observational research demonstrated a high prevalence of long-term opioid usage among patients who had surgery for early-stage breast cancer, as well as a substantial variation in long-term opioid use by treatment type.
Consequences for Practice:
Working-age women with early-stage breast cancer who underwent curative surgery, particularly mastectomy, had a significant prevalence of persistent opioid usage, according to this large observational research. The mean daily opioid dose was continuously high among individuals who used opioids, with no clear dosage reduction. This study emphasizes the need of emphasizing proper opioid treatment, as well as the possibility of dose reduction or cessation, among patients with early-stage breast cancer who have undergone surgical procedures.