{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:25:47Z","timestamp":1759537547694,"version":"build-2065373602"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In breast oncologic surgery, 75% of patients receive a postoperative opioid prescription at discharge, and 10%\u201320% will develop persistent opioid use. To inform future institutional guidelines, the objective of this study was to determine baseline opioid prescribing patterns in a single high\u2010volume, referral\u2010based breast center. We hypothesized that opioid prescribing practices varied between procedures and operating surgeons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis of all women undergoing breast cancer surgery between January and December 2019. Opioid prescriptions at discharge were converted to morphine milligram equivalents (MME). The primary outcome of interest was MME prescribed at discharge. Multiple linear regression was used to identify factors independently associated with MME prescribed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>392 patients met inclusion criteria; 68.3% underwent partial mastectomy. Median age was 61 (interquartile range [IQR] 51\u201370). Median MME prescribed at discharge was 112.5 (IQR 75\u2013150); 83.9% of patients were prescribed co\u2010analgesia. The prescriber was a trainee in 37.7% of cases. 15 patients (3.8%) required opioid renewal. On multivariate analysis, axillary procedure was associated with increased MME (<jats:italic>\u00df<\/jats:italic>\u00a0=\u00a017, 95% CI 5.5\u201328 and <jats:italic>\u00df<\/jats:italic>\u00a0=\u00a032, 95% CI 17\u201347, for sentinel node and axillary dissection, respectively). However, the factor with the greatest impact on MME was operating surgeon (<jats:italic>\u00df<\/jats:italic>\u00a0=\u00a072, 95% CI 58\u201387). Residents prescribed less MME compared to attending surgeons (<jats:italic>\u00df<\/jats:italic>\u00a0=\u00a011, 95% CI \u221222; \u22120.06).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In a tertiary care center, the operating surgeon had the greatest influence on opioid prescribing practices, and trainees tended to prescribe less MME. These findings support the need for a standardized approach to optimize prescribing and reduce opioid\u2010related harms after oncologic breast surgery.<\/jats:p><\/jats:sec>","DOI":"10.1002\/wjs.12079","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T03:45:21Z","timestamp":1707277521000},"page":"642-649","source":"Crossref","is-referenced-by-count":2,"title":["Opioid prescribing practices in breast oncologic surgery\u2014A retrospective cohort study"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2339-3778","authenticated-orcid":false,"given":"\u00c9lise","family":"Di Lena","sequence":"first","affiliation":[{"name":"Division of General Surgery Department of Surgery McGill University  Montreal Quebec Canada"},{"name":"Division of Experimental Surgery Department of Surgery McGill University  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha","family":"Barone","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences McGill University  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brent","family":"Hopkins","sequence":"additional","affiliation":[{"name":"Division of General Surgery Department of Surgery McGill University  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uyen","family":"Do","sequence":"additional","affiliation":[{"name":"Centre de recherche de l\u2019Universit\u00e9 de Montr\u00e9al  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pepa","family":"Kaneva","sequence":"additional","affiliation":[{"name":"The Steinberg\u2010Bernstein Center for Minimally Invasive Surgery McGill University  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Julio F.","family":"Fiore","sequence":"additional","affiliation":[{"name":"Division of General Surgery Department of Surgery McGill University  Montreal Quebec Canada"},{"name":"Division of Experimental Surgery Department of Surgery McGill University  Montreal Quebec Canada"},{"name":"The Steinberg\u2010Bernstein Center for Minimally Invasive Surgery McGill University  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarkis","family":"Meterissian","sequence":"additional","affiliation":[{"name":"Division of General Surgery Department of Surgery McGill University  Montreal Quebec Canada"},{"name":"Breast Center McGill University Health Center  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,2,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2020.07.006"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(21)02252\u20102"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.10734"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6610a1"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000001993"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000002623"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000003462"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsurg.2017.06.020"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434\u2010020\u201008197\u2010z"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(19)30352\u20106"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2017.74.1363"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2019\u20100868"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2021.10.033"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.21430"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2019.2518"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmsa1610524"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsurg.2021.03.005"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2020.10.045"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjq.2020.04.004"}],"container-title":["World 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