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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 7 of 7 Research Studies DisplayedRosenberg SM, Dominici LS, Gelber S
Association of breast cancer surgery with quality of life and psychosocial well-being in young breast cancer survivors.
This study looked at the short-term and long-term effects of breast cancer surgery on young breast cancer survivors (aged 40 and younger). The researchers compared the effects of bilateral mastectomy (BM), unilateral mastectomy (UM), and breast conserving surgery (BCS) among women diagnosed with Stage 0-3 unilateral breast cancer between 2006 and 2016 who had surgery and completed QOL and psychosocial assessments. Out of 826 women, 45% had BM, 31% BCS, and 24% UM. Of the women who had BM/UM, 84% also underwent reconstructive surgery. Women who had BM vs BCS or UM had consistently worse sexuality and body image. Anxiety improved across all groups, but adjusted mean scores remained higher among women who had BM vs BCS/UM at 1 year. There were minimal between-group differences in depression levels.
AHRQ-funded; HS023680.
Citation: Rosenberg SM, Dominici LS, Gelber S .
Association of breast cancer surgery with quality of life and psychosocial well-being in young breast cancer survivors.
JAMA Surg 2020 Nov;155(11):1035-42. doi: 10.1001/jamasurg.2020.3325..
Keywords: Cancer: Breast Cancer, Cancer, Women, Quality of Life, Surgery
Gutnik L, Allen CM, Presson AP
Breast cancer surgery decision role perceptions and choice of surgery.
This study examined the finding that breast cancer patients who reported more personal responsibility for the surgery decision were more likely to undergo aggressive surgery. Retrospective cohort data was used from 100 newly diagnosed breast cancer patients. Surgery types compared were mastectomy, lumpectomy, and unilateral versus bilateral mastectomy. Patients’ decision-making role was identified using the Patient Preference Scale. Type of surgery and patient role concordance was compared as well as patient decision role performance, role perception, and provider role perception. Patient decision role and perceptions were not associated with type of surgery. Patient role preference depended on the stage of disease. Stage III patients preferred the most active roles with stage I and stage II patients preferring a more collaborative role. Providers perceived more passive patient roles in the mastectomy group.
AHRQ-funded; HS024784.
Citation: Gutnik L, Allen CM, Presson AP .
Breast cancer surgery decision role perceptions and choice of surgery.
Ann Surg Oncol 2020 Oct;27(10):3623-32. doi: 10.1245/s10434-020-08485-8.
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Keywords: Cancer: Breast Cancer, Cancer, Decision Making, Surgery, Women
Yu J, Olsen MA, Margenthaler JA
Indications for readmission following mastectomy for breast cancer: an assessment of patient and operative factors.
In this study, the investigators examined the impact of patient and operative factors on 30-day hospital readmission following mastectomy for breast cancer. Using the 2011 HCUP California State Inpatient Database, they evaluated readmissions in adult women undergoing mastectomy for invasive, in situ, or history of breast cancer. The investigators found that surgical site infection and wound complications were the most common diagnoses requiring readmission and resulted in over half of readmissions in their study population at 30 days.
AHRQ-funded; HS19455.
Citation: Yu J, Olsen MA, Margenthaler JA .
Indications for readmission following mastectomy for breast cancer: an assessment of patient and operative factors.
Breast J 2020 Oct;26(10):1966-72. doi: 10.1111/tbj.14029..
Keywords: Healthcare Cost and Utilization Project (HCUP), Hospital Readmissions, Surgery, Cancer: Breast Cancer, Cancer, Women
Azad AD, Bozkurt S, Wheeler AJ
Acute pain after breast surgery and reconstruction: a two-institution study of surgical factors influencing short-term pain outcomes.
This study analyzed the relationship between differing breast cancer excisional procedures, reconstruction, and short-term pain outcomes. Women who underwent breast cancer surgery with and without reconstruction were included from two institutions: an academic hospital (AH) and a Veterans Health Administration (VHS) facility. Average pain scores at time of discharge and at 30-day follow-up were analyzed. The study included 1402 patients at AH and 1435 at VHA. Of those, 425 AH and 165 VHA patients underwent breast reconstruction. Pain scores were highest at discharge and improved over time. Younger age, preoperative opioid use, and longer length of stay were all associated with worse pain scores.
AHRQ-funded; HS024096.
Citation: Azad AD, Bozkurt S, Wheeler AJ .
Acute pain after breast surgery and reconstruction: a two-institution study of surgical factors influencing short-term pain outcomes.
J Surg Oncol 2020 Sep 15;122(4):623-31. doi: 10.1002/jso.26070..
Keywords: Pain, Cancer: Breast Cancer, Cancer, Surgery, Outcomes, Women
Smith ME, Vitous CA, Hughes TM
Barriers and facilitators to de-implementation of the Choosing Wisely((R)) guidelines for low-value breast cancer surgery.
The objective of this study was to understand why surgeons stop performing certain unnecessary cancer operations but not others and how best to de-implement entrenched and emerging unnecessary procedures. The investigators concluded that with a growing focus on the elimination of ineffective, unproven or low value practices, it is imperative that the behavioral determinants are understood and targeted with specific interventions to decrease utilization rapidly.
AHRQ-funded; HS026030.
Citation: Smith ME, Vitous CA, Hughes TM .
Barriers and facilitators to de-implementation of the Choosing Wisely((R)) guidelines for low-value breast cancer surgery.
Ann Surg Oncol 2020 Aug;27(8):2653-63. doi: 10.1245/s10434-020-08285-0..
Keywords: Cancer: Breast Cancer, Cancer, Surgery, Decision Making, Guidelines, Women
Wang T, Baskin AS, Dossett LA
Deimplementation of the choosing wisely recommendations for low-value breast cancer surgery: a systematic review.
Overtreatment of early-stage breast cancer results in increased morbidity and cost without improving survival. Major surgical organizations participating in the Choosing Wisely campaign identified 4 breast cancer operations as low value. The purpose of this study was to evaluate the extent to which these procedures have been deimplemented, determine the implications of decreased use, and recognize possible barriers and facilitators to deimplementation.
AHRQ-funded; HS026030.
Citation: Wang T, Baskin AS, Dossett LA .
Deimplementation of the choosing wisely recommendations for low-value breast cancer surgery: a systematic review.
JAMA Surg 2020 Aug;155(8):759-70. doi: 10.1001/jamasurg.2020.0322..
Keywords: Cancer: Breast Cancer, Cancer, Surgery, Decision Making, Women, Evidence-Based Practice
Gibson DC, Chou LN, Raji MA
Opioid prescribing trends in women following mastectomy or breast-conserving surgery before and after the 2014 federal reclassification of hydrocodone.
This study compares changes in opioid prescribing among surgical breast cancer patients following the 2014 federal reclassification of hydrocodone. Data from 2009 to 2017 was used from a large nationally representative commercial insurance health program. Women aged 18 years and older who were diagnosed with carcinoma in-situ or malignant breast cancer and received breast-conserving surgery or a mastectomy from 2010 to 2016 were included. Patients in 2015 or 2016 who had surgery were less likely to receive a greater than 1-day supply of opioid prescriptions or 30 days or more supply than in 2013. However, only in 2016 were surgical breast cancer patients less likely to receive a 90-day supply than in 2013.
AHRQ-funded; HS026133.
Citation: Gibson DC, Chou LN, Raji MA .
Opioid prescribing trends in women following mastectomy or breast-conserving surgery before and after the 2014 federal reclassification of hydrocodone.
Oncologist 2020 Apr;25(4):281-89. doi: 10.1634/theoncologist.2019-0758..
Keywords: Opioids, Medication, Surgery, Cancer: Breast Cancer, Cancer, Women