Lumpectomy Patients are at Highest Risk for Opioid Overprescription: A Comparison Between Practice Patterns and OPEN National Guidelines

• Published in: Annals of surgical oncology 2025-01
• Main Authors: Swafford, Emily P, Anantha, Sadhana, Davis, Jenna, Heath, Rainya, Draper, Allison, Tevis, Sarah, Goel, Neha, Kesmodel, Susan B, Rojas, Kristin E
• Format: Article
• Language: English
• ISSN: 1068-9265; 1534-4681; 1534-4681
• DOI: 10.1245/s10434-024-16823-3

Nearly 25% of opioid-related deaths are from prescribed opioids, and the exacerbation of the opioid epidemic by the coronavirus disease 2019 (COVID-19) pandemic underscores the urgent need to address superfluous prescribing. Therefore, we sought to align local opioid prescribing practices with national guidelines in postoperative non-metastatic breast cancer patients. A single-institution analysis included non-metastatic breast surgery patients treated between April 2020 and July 2021. 'Overprescription' was defined as a discharge prescription quantity of oral morphine equivalents (OMEs) greater than the upper limit of the procedure-specific Michigan Opioid Prescribing Engagement Network (OPEN) recommendations. Univariable and multivariate analyses identified risk factors associated with opioid prescribing. Overall, 464 patients met the inclusion criteria: 280 patients underwent lumpectomy, and 184 patients underwent mastectomy. 52% of patients were overprescribed opioids, including 74% of lumpectomy patients (p