Grant Number:	1R01CA152192-01A1 Interpret this number
Primary Investigator:	Wilkins, Edwin
Organization:	University Of Michigan At Ann Arbor
Project Title:	Mastectomy Reconstruction Outcome Consortium (Mroc Study)
Fiscal Year:	2011

DESCRIPTION (provided by applicant): Despite the growing use of breast conservation as primary therapy for breast cancer, mastectomy remains a common treatment option. Many patients choose to undergo breast reconstruction as an effective means of lessening the adverse impact of mastectomy on psychosocial functioning. Despite these benefits, well-designed studies comparing the current choices from the patient's point of view are difficult (if not impossible) to come by. Previous research on breast reconstruction outcomes has also failed to include race as an important variable. In order to actively participate in the reconstruction decision making process, breast cancer survivors need objective, up-to- date information on breast reconstruction outcomes from the patient's perspective. The proposed Mastectomy Reconstruction Outcomes Consortium (MROC) Study will use a prospective cohort design to compare outcomes for the five commonly used options for breast reconstruction: expander/implant, latissimus dorsi/implant, pedicle transverse rectus abdominis musculocutaneous (TRAM), free TRAM, and deep inferior epigastric perforator techniques. Outcomes assessed will include complications, postoperative pain, psychosocial well-being, physical functioning, patient satisfaction and costs. The project will also evaluate the effects of race and ethnicity on reconstruction outcomes. Nine leading centers in the United States will participate. Together, these institutions perform over 2700 breast reconstructions annually. The five year study will evaluate patients preoperatively and at one week, three months, one year and two years following reconstruction. For data sources, the project will rely on medical and billing records, as well as a panel of generic and condition-specific patient-report outcome measures. The MROC Study will benefit a variety of stakeholders in the healthcare marketplace: The project will provide consumers, providers, payers, and policy-makers with reliable, up-to-date information on the effectiveness and relative costs of surgical options for breast reconstruction, thereby promoting a more evidence-based approach to treatment and policy decision-making. Study findings will also assist health care organizations in designing systems of care tailored to the specific needs and preferences of diverse patient populations. PUBLIC HEALTH RELEVANCE: The Mastectomy Reconstruction Outcomes Consortium (MROC) Study will bring together nine leading centers in the United States to compare the outcomes of common techniques for breast reconstruction. Implant and natural tissue techniques will be compared using a variety of measures, including complication rates and costs. Most importantly, these options will be assessed using data from patient surveys that ask about post-operative pain, quality of life, body image, sexuality, physical functioning, and patient satisfaction, the outcomes that matter most to women. To track the long-term results of these operations, this five year study will follow patients for two years after their reconstructions. The effects of race and ethnicity on breast reconstruction outcomes will also be studied. Findings from the MROC study will assist patients, surgeons, payers and policy makers in identifying the most effective surgical options for women seeking reconstruction after mastectomy. Study results will also help design reconstruction services which better meet the needs and preferences of diverse patient populations.




Outcomes of breast reconstruction in patients with stage IV breast cancer.
Authors: Hespe G.E. , Matusko N. , Hamill J.B. , Kozlow J.H. , Pusic A.L. , Wilkins E.G. .
Source: Journal Of Plastic, Reconstructive & Aesthetic Surgery : Jpras, 2023 Aug; 83, p. 51-56.
EPub date: 2023-04-19 00:00:00.0.
PMID: 37270995
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ASO Author Reflections: Enhancing Surgical Decision-Making for Breast Reconstruction-Machine Learning-Driven Prediction of Postoperative Quality of Life.
Authors: Xu C. , Pfob A. , Sidey-Gibbons C. .
Source: Annals Of Surgical Oncology, 2023-07-30 00:00:00.0; , .
EPub date: 2023-07-30 00:00:00.0.
PMID: 37516722
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Enhanced Surgical Decision-Making Tools in Breast Cancer: Predicting 2-Year Postoperative Physical, Sexual, and Psychosocial Well-Being following Mastectomy and Breast Reconstruction (INSPiRED 004).
Authors: Xu C. , Pfob A. , Mehrara B.J. , Yin P. , Nelson J.A. , Pusic A.L. , Sidey-Gibbons C. .
Source: Annals Of Surgical Oncology, 2023-07-30 00:00:00.0; , .
EPub date: 2023-07-30 00:00:00.0.
PMID: 37516723
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Machine learning to predict individual patient-reported outcomes at 2-year follow-up for women undergoing cancer-related mastectomy and breast reconstruction (INSPiRED-001).
Authors: Pfob A. , Mehrara B.J. , Nelson J.A. , Wilkins E.G. , Pusic A.L. , Sidey-Gibbons C. .
Source: Breast (edinburgh, Scotland), 2021-09-29 00:00:00.0; 60, p. 111-122.
EPub date: 2021-09-29 00:00:00.0.
PMID: 34619573
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Association of Clinical Complications of Chemotherapy and Patient-Reported Outcomes After Immediate Breast Reconstruction.
Authors: Hart S.E. , Brown D.L. , Kim H.M. , Qi J. , Hamill J.B. , Wilkins E.G. .
Source: Jama Surgery, 2021-09-01 00:00:00.0; 156(9), p. 847-855.
PMID: 34160601
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Comparing Nipple-sparing Mastectomy to Secondary Nipple Reconstruction: A Multi-institutional Study.
Authors: Santosa K.B. , Qi J. , Kim H.M. , Hamill J.B. , Pusic A.L. , Chun Y.S. , Wilkins E.G. , Kozlow J.H. .
Source: Annals Of Surgery, 2021-08-01 00:00:00.0; 274(2), p. 390-395.
PMID: 31469747
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Towards Patient-Centered Decision-Making in Breast Cancer Surgery: Machine Learning to Predict Individual Patient-Reported Outcomes at 1-Year Follow-up.
Authors: Pfob A. , Mehrara B.J. , Nelson J.A. , Wilkins E.G. , Pusic A.L. , Sidey-Gibbons C. .
Source: Annals Of Surgery, 2021-03-18 00:00:00.0; 277(1), p. e144-52.
EPub date: 2021-03-18 00:00:00.0.
PMID: 33914464
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Development of an evidence-based approach to the use of acellular dermal matrix in immediate expander-implant-based breast reconstruction.
Authors: Ganesh Kumar N. , Berlin N.L. , Kim H.M. , Hamill J.B. , Kozlow J.H. , Wilkins E.G. .
Source: Journal Of Plastic, Reconstructive & Aesthetic Surgery : Jpras, 2021 01; 74(1), p. 30-40.
EPub date: 2020-10-21 00:00:00.0.
PMID: 33172826
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Patient-Reported Outcomes after Irradiation of Tissue Expander versus Permanent Implant in Breast Reconstruction: A Multicenter Prospective Study.
Authors: Yoon A.P. , Qi J. , Kim H.M. , Hamill J.B. , Jagsi R. , Pusic A.L. , Wilkins E.G. , Kozlow J.H. .
Source: Plastic And Reconstructive Surgery, 2020 May; 145(5), p. 917e-926e.
PMID: 32332528
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Obesity and Breast Reconstruction: Complications and Patient-Reported Outcomes in a Multicenter, Prospective Study.
Authors: Srinivasa D.R. , Clemens M.W. , Qi J. , Hamill J.B. , Kim H.M. , Pusic A.L. , Wilkins E.G. , Butler C.E. , Garvey P.B. .
Source: Plastic And Reconstructive Surgery, 2020 03; 145(3), p. 481e-490e.
PMID: 32097295
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Elective Revisions after Breast Reconstruction: Results from the Mastectomy Reconstruction Outcomes Consortium.
Authors: Nelson J.A. , Voineskos S.H. , Qi J. , Kim H.M. , Hamill J.B. , Wilkins E.G. , Pusic A.L. .
Source: Plastic And Reconstructive Surgery, 2019 12; 144(6), p. 1280-1290.
PMID: 31764633
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Impact of Unilateral versus Bilateral Breast Reconstruction on Procedure Choices and Outcomes.
Authors: Taylor E.M. , Wilkins E.G. , Pusic A.L. , Qi J. , Kim H.M. , Hamill J.B. , Guldbrandsen G.E. , Chun Y.S. .
Source: Plastic And Reconstructive Surgery, 2019 Jun; 143(6), p. 1159e-1168e.
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Comparison of 2-Year Complication Rates Among Common Techniques for Postmastectomy Breast Reconstruction.
Authors: Bennett K.G. , Qi J. , Kim H.M. , Hamill J.B. , Pusic A.L. , Wilkins E.G. .
Source: Jama Surgery, 2018-10-01 00:00:00.0; 153(10), p. 901-908.
PMID: 29926077
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Long-term Patient-Reported Outcomes in Postmastectomy Breast Reconstruction.
Authors: Santosa K.B. , Qi J. , Kim H.M. , Hamill J.B. , Wilkins E.G. , Pusic A.L. .
Source: Jama Surgery, 2018-10-01 00:00:00.0; 153(10), p. 891-899.
PMID: 29926096
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Nonresponse bias in survey research: lessons from a prospective study of breast reconstruction.
Authors: Berlin N.L. , Hamill J.B. , Qi J. , Kim H.M. , Pusic A.L. , Wilkins E.G. .
Source: The Journal Of Surgical Research, 2018 Apr; 224, p. 112-120.
EPub date: 2017-12-22 00:00:00.0.
PMID: 29506826
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Impact of Radiotherapy on Complications and Patient-Reported Outcomes After Breast Reconstruction.
Authors: Jagsi R. , Momoh A.O. , Qi J. , Hamill J.B. , Billig J. , Kim H.M. , Pusic A.L. , Wilkins E.G. .
Source: Journal Of The National Cancer Institute, 2018-02-01 00:00:00.0; 110(2), .
PMID: 28954300
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Outcomes of immediate versus delayed breast reconstruction: Results of a multicenter prospective study.
Authors: Yoon A.P. , Qi J. , Brown D.L. , Kim H.M. , Hamill J.B. , Erdmann-Sager J. , Pusic A.L. , Wilkins E.G. .
Source: Breast (edinburgh, Scotland), 2018 Feb; 37, p. 72-79.
EPub date: 2017-11-02 00:00:00.0.
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Complications in Postmastectomy Breast Reconstruction: One-year Outcomes of the Mastectomy Reconstruction Outcomes Consortium (MROC) Study.
Authors: Wilkins E.G. , Hamill J.B. , Kim H.M. , Kim J.Y. , Greco R.J. , Qi J. , Pusic A.L. .
Source: Annals Of Surgery, 2018 Jan; 267(1), p. 164-170.
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Radiotherapy in the setting of breast reconstruction: types, techniques, and timing.
Authors: Ho A.Y. , Hu Z.I. , Mehrara B.J. , Wilkins E.G. .
Source: The Lancet. Oncology, 2017 12; 18(12), p. e742-e753.
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Is chronic postsurgical pain surgery-induced? A study of persistent postoperative pain following breast reconstruction.
Authors: Roth R.S. , Qi J. , Hamill J.B. , Kim H.M. , Ballard T.N.S. , Pusic A.L. , Wilkins E.G. .
Source: Breast (edinburgh, Scotland), 2017-11-13 00:00:00.0; 37, p. 119-125.
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Direct-to-Implant versus Two-Stage Tissue Expander/Implant Reconstruction: 2-Year Risks and Patient-Reported Outcomes from a Prospective, Multicenter Study.
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Complications and Patient-Reported Outcomes after Abdominal-Based Breast Reconstruction: Results of the Mastectomy Reconstruction Outcomes Consortium (MROC) Study.
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Impact of Bilateral Prophylactic Mastectomy and Immediate Reconstruction on Health-Related Quality of Life in Women at High Risk for Breast Carcinoma: Results of the Mastectomy Reconstruction Outcomes Consortium Study.
Authors: McCarthy C.M. , Hamill J.B. , Kim H.M. , Qi J. , Wilkins E. , Pusic A.L. .
Source: Annals Of Surgical Oncology, 2017 Sep; 24(9), p. 2502-2508.
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Acellular Dermal Matrix in Immediate Expander/Implant Breast Reconstruction: A Multicenter Assessment of Risks and Benefits.
Authors: Sorkin M. , Qi J. , Kim H.M. , Hamill J.B. , Kozlow J.H. , Pusic A.L. , Wilkins E.G. .
Source: Plastic And Reconstructive Surgery, 2017-08-03 00:00:00.0; , .
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Patient-Reported Outcomes 1 Year After Immediate Breast Reconstruction: Results of the Mastectomy Reconstruction Outcomes Consortium Study.
Authors: Pusic A.L. , Matros E. , Fine N. , Buchel E. , Gordillo G.M. , Hamill J.B. , Kim H.M. , Qi J. , Albornoz C. , Klassen A.F. , et al. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2017-08-01 00:00:00.0; 35(22), p. 2499-2506.
EPub date: 2017-03-27 00:00:00.0.
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Association of Fat Grafting With Patient-Reported Outcomes in Postmastectomy Breast Reconstruction.
Authors: Bennett K.G. , Qi J. , Kim H.M. , Hamill J.B. , Wilkins E.G. , Mehrara B.J. , Kozlow J.H. .
Source: Jama Surgery, 2017-06-28 00:00:00.0; , .
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Shaped versus Round Implants in Breast Reconstruction: A Multi-Institutional Comparison of Surgical and Patient-Reported Outcomes.
Authors: Khavanin N. , Clemens M.W. , Pusic A.L. , Fine N.A. , Hamill J.B. , Kim H.M. , Qi J. , Wilkins E.G. , Kim J.Y.S. .
Source: Plastic And Reconstructive Surgery, 2017 May; 139(5), p. 1063-1070.
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Factors Associated with Acute Postoperative Pain Following Breast Reconstruction.
Authors: Kulkarni A.R. , Pusic A.L. , Hamill J.B. , Kim H.M. , Qi J. , Wilkins E.G. , Roth R.S. .
Source: Jpras Open, 2017 Mar; 11, p. 1-13.
EPub date: 2016-09-15 00:00:00.0.
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Should Immediate Autologous Breast Reconstruction be considered in Women who require Post-Mastectomy Radiation Therapy? A Prospective Analysis of Outcomes.
Authors: Billig J. , Jagsi R. , Qi J. , Hamill J.B. , Kim H.M. , Pusic A.L. , Buchel E. , Wilkins E.G. , Momoh A.O. .
Source: Plastic And Reconstructive Surgery, 2017-02-13 00:00:00.0; , .
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Racial And Ethnic Variations In One-year Clinical And Patient-reported Outcomes Following Breast Reconstruction
Authors: Berlin N.L. , Momoh A.O. , Qi J. , Hamill J.B. , Kim H.M. , Pusic A.L. , Wilkins E.G. .
Source: American Journal Of Surgery, 2017-02-09 00:00:00.0; , .
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Late Surgical-Site Infection in Immediate Implant-Based Breast Reconstruction.
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Source: Plastic And Reconstructive Surgery, 2017 Jan; 139(1), p. 20-28.
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Managing suicidal ideation in a breast cancer cohort seeking reconstructive surgery.
Authors: Ballard T.N. , Chen X. , Kim H.M. , Hamill J.B. , Pusic A.L. , Wilkins E.G. , Roth R.S. .
Source: Psycho-oncology, 2016 Dec; 25(12), p. 1515-1518.
PMID: 26489687
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Effect Of Patient Age On Outcomes In Breast Reconstruction: Results From A Multicenter Prospective Study
Authors: Santosa K.B. , Qi J. , Kim H.M. , Hamill J.B. , Pusic A.L. , Wilkins E.G. .
Source: Journal Of The American College Of Surgeons, 2016-10-24 00:00:00.0; , .
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Postmastectomy Radiation Therapy And Two-stage Implant-based Breast Reconstruction: Is There A Better Time To Irradiate?
Authors: Santosa K.B. , Chen X. , Qi J. , Ballard T.N. , Kim H.M. , Hamill J.B. , Bensenhaver J.M. , Pusic A.L. , Wilkins E.G. .
Source: Plastic And Reconstructive Surgery, 2016 Oct; 138(4), p. 761-9.
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Understanding and Optimizing the Patient Experience in Breast Reconstruction.
Authors: Cohen W.A. , Ballard T.N. , Hamill J.B. , Kim H.M. , Chen X. , Klassen A. , Wilkins E.G. , Pusic A.L. .
Source: Annals Of Plastic Surgery, 2016 Aug; 77(2), p. 237-41.
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Tradeoffs Associated With Contralateral Prophylactic Mastectomy In Women Choosing Breast Reconstruction: Results Of A Prospective Multicenter Cohort
Authors: Momoh A.O. , Cohen W.A. , Kidwell K.M. , Hamill J.B. , Qi J. , Pusic A.L. , Wilkins E.G. , Matros E. .
Source: Annals Of Surgery, 2016-06-28 00:00:00.0; , .
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Understanding the recovery phase of breast reconstructions: Patient-reported outcomes correlated to the type and timing of reconstruction.
Authors: Weichman K.E. , Hamill J.B. , Kim H.M. , Chen X. , Wilkins E.G. , Pusic A.L. .
Source: Journal Of Plastic, Reconstructive & Aesthetic Surgery : Jpras, 2015 Oct; 68(10), p. 1370-8.
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Sociodemographic and Clinical Variables Impacting Procedure Choice in Breast Reconstruction.
Authors: Ballard T.N. , Kim Y. , Cohen W.A. , Hamill J.B. , Momoh A.O. , Pusic A.L. , Kim H.M. , Wilkins E.G. .
Source: Plastic And Reconstructive Surgery, 2015 Oct; 136(4 Suppl), p. 85-6.
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Breast Reconstruction in Patients with Unilateral Breast Cancer Who Choose Contralateral Prophylactic Mastectomy - An Assessment of Postoperative Morbidity.
Authors: Momoh A.O. , Cohen W.A. , Kidwell K.M. , Hamill J.B. , Pusic A.L. , Wilkins E.G. , Matros E. .
Source: Plastic And Reconstructive Surgery, 2015 Oct; 136(4 Suppl), p. 116-7.
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Sociodemographic Predictors of Breast Reconstruction Procedure Choice: Analysis of the Mastectomy Reconstruction Outcomes Consortium Study Cohort.
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Source: Plastic Surgery International, 2015; 2015, p. 150856.
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Abstract 122: prevalence and management of preoperative depression and anxiety disorders in patients undergoing mastectomy reconstruction.
Authors: Ballard T.N. , Hamill J.B. , Roth R.S. , Pusic A.L. , Wilkins E.G. .
Source: Plastic And Reconstructive Surgery, 2014 Mar; 133(3 Suppl), p. 137-8.
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