{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T08:25:55Z","timestamp":1768897555379,"version":"3.49.0"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T00:00:00Z","timestamp":1686268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005831","name":"Foundation for Anesthesia Education and Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005831","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>We investigated whether age, body mass index (BMI), and tissue expander placement were related to postoperative opioid requirement for patients undergoing therapeutic versus prophylactic breast surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Postoperative opioid consumption was evaluated for patients who underwent bilateral mastectomy with immediate implant\u2010based reconstruction at a freestanding ambulatory cancer surgery center between 2016 and 2021. Ordinal regression tested whether surgical indication was associated with increased postoperative opioid requirements after adjusting for age, BMI, and tissue expander placement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 2447 patients, 6% underwent prophylactic surgeries. Therapeutic mastectomy patients had lower postoperative opioid requirement (OR\u2009=\u20090.67; 95% CI: 0.50\u22120.91; <jats:italic>p<\/jats:italic>\u2009=\u20090.030), but this was not significant after adjusting for covariates (OR\u2009=\u20090.75; 95% CI: 0.53\u22121.07; <jats:italic>p<\/jats:italic>\u2009=\u20090.2). Opioid use increased with higher BMI (OR\u2009=\u20091.06; 95% CI: 1.05\u22121.08;\u00a0<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and decreased with age (OR\u2009=\u20090.97; 95% CI: 0.96\u22120.98; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) with therapeutic mastectomy patients being older (median 46 vs. 39). The subpectoral tissue expander group had nearly double the postoperative opioid requirement compared to prepectoral placement (OR\u2009=\u20091.86; 95% CI: 1.55\u22122.23; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Increased postoperative opioid requirement in women undergoing prophylactic procedures is best explained by age. Mastectomy patients should be counseled similarly about postoperative pain irrespective of indication. A larger prophylactic mastectomy sample is required to provide more precise estimates.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.27372","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T07:48:15Z","timestamp":1686296895000},"page":"719-725","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Patient and procedure characteristics associated with postoperative pain after prophylactic versus therapeutic ambulatory bilateral breast surgery"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1268-2216","authenticated-orcid":false,"given":"Natalie B.","family":"Simon","sequence":"first","affiliation":[{"name":"Eastern Virginia Medical School Norfolk Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Assel","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna","family":"Serafin","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taylor M.","family":"McCready","sequence":"additional","affiliation":[{"name":"New York University Grossman School of Medicine New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0329-4422","authenticated-orcid":false,"given":"Jonas A.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew J.","family":"Vickers","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy\u2010Ann","family":"Moo","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanae K.","family":"Tokita","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,6,9]]},"reference":[{"issue":"4","key":"e_1_2_9_2_1","article-title":"Risk\u2010reducing mastectomy for the prevention of primary breast cancer","volume":"4","author":"Carbine NE","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/93.21.1633"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/tbj.12521"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2022.2065"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpra.2016.08.005"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.annonc.a059215"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2006.02.007"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000298"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.151276"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000019834"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6604534"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-022-11976-5"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2017.08.008"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.6111"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10434-000-0150-6"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2016.03.018"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.5152\/ejbh.2020.5730"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-020-09479-2"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-018-6644-x"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2021.1798"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2012.08.003"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X1103900102"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68700-X"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000002190"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000001731"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clbc.2017.11.015"},{"issue":"24","key":"e_1_2_9_28_1","first-page":"5058","article-title":"One\u2010stage breast reconstruction techniques in elderly patients to preserve quality of life","volume":"20","author":"Maruccia M","year":"2016","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004270"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31825f05b4"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000008892"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2005.09.008"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.27372","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T14:17:33Z","timestamp":1695824253000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.27372"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,9]]},"references-count":31,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1002\/jso.27372"],"URL":"https:\/\/doi.org\/10.1002\/jso.27372","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,9]]},"assertion":[{"value":"2023-04-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-01","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}