Dr. Borgen on Eliminating Opioid Use in Breast Cancer

Patrick I. Borgen, MD, chair and surgery director of the Breast Cancer Program at Maimonides Medical Center, discusses eliminating the use of opioids in patients with breast cancer.

Seven years ago, the challenge of opioid addiction and related mortalities in Brooklyn, New York, became apparent, Borgen says. Approximately 77% of all opioid users had their addiction begin with a prescription for pain killers, 80% of which were prescribed by surgeons. In response, Borgen’s institution began a hospital-wide campaign to minimize the use of opioids. 

For patients with breast cancer, a standard mastectomy has the third highest rate of opioid addiction of any operation performed in the United States, Borgen explains. The utilization of advanced recovery after surgery protocols, preoperative oral medications, and liposomal bupivacaine (Exparel) intraoperatively has successfully eliminated the use of opioids in breast surgery at Maimonides Medical Center, according to Borgen. Additionally, in just 6 years, the institution has greatly reduced their oral morphine equivalency by 100,000, Borgen adds.