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Grant Details

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


Abstract

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.



Publications

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
Related Citations

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
Related Citations

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
Related Citations

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
Related Citations

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
Related Citations

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
Related Citations

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
Related Citations

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
Related Citations

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
Related Citations

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
Related Citations

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
Related Citations

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.
PMID: 31136472
Related Citations

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
Related Citations

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
Related Citations

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
Related Citations

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
Related Citations

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.
PMID: 29102781
Related Citations

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.
PMID: 27906762
Related Citations

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.
PMID: 29208440
Related Citations

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.
EPub date: 2017-11-13 00:00:00.0.
PMID: 29145033
Related Citations

Direct-to-Implant versus Two-Stage Tissue Expander/Implant Reconstruction: 2-Year Risks and Patient-Reported Outcomes from a Prospective, Multicenter Study.
Authors: Srinivasa D.R. , Garvey P.B. , Qi J. , Hamill J.B. , Kim H.M. , Pusic A.L. , Kronowitz S.J. , Wilkins E.G. , Butler C.E. , Clemens M.W. .
Source: Plastic And Reconstructive Surgery, 2017 Nov; 140(5), p. 869-877.
PMID: 29068918
Related Citations

Complications and Patient-Reported Outcomes after Abdominal-Based Breast Reconstruction: Results of the Mastectomy Reconstruction Outcomes Consortium (MROC) Study.
Authors: Erdmann-Sager J. , Wilkins E.G. , Pusic A.L. , Qi J. , Hamill J.B. , Kim H.M. , Guldbrandsen G.E. , Chun Y.S. .
Source: Plastic And Reconstructive Surgery, 2017-10-10 00:00:00.0; , .
EPub date: 2017-10-10 00:00:00.0.
PMID: 29019862
Related Citations

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.
EPub date: 2017-06-13 00:00:00.0.
PMID: 28612125
Related Citations

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; , .
EPub date: 2017-08-03 00:00:00.0.
PMID: 28806288
Related Citations

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.
PMID: 28346808
Related Citations

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; , .
EPub date: 2017-06-28 00:00:00.0.
PMID: 28658472
Related Citations

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.
PMID: 28445350
Related Citations

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.
PMID: 28713853
Related Citations

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; , .
EPub date: 2017-02-13 00:00:00.0.
PMID: 28198770
Related Citations

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; , .
PMID: 28215963
Related Citations

Late Surgical-Site Infection in Immediate Implant-Based Breast Reconstruction.
Authors: Sinha I. , Pusic A.L. , Wilkins E.G. , Hamill J.B. , Chen X. , Kim H.M. , Guldbrandsen G. , Chun Y.S. .
Source: Plastic And Reconstructive Surgery, 2017 Jan; 139(1), p. 20-28.
PMID: 28027221
Related Citations

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
Related Citations

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; , .
PMID: 27806906
Related Citations

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.
PMID: 27673513
Related Citations

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.
PMID: 26101986
Related Citations

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; , .
PMID: 27355266
Related Citations

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.
PMID: 26165633
Related Citations

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.
PMID: 26397595
Related Citations

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.
PMID: 26397634
Related Citations

Sociodemographic Predictors of Breast Reconstruction Procedure Choice: Analysis of the Mastectomy Reconstruction Outcomes Consortium Study Cohort.
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 Surgery International, 2015; 2015, p. 150856.
PMID: 26605082
Related Citations

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.
PMID: 25942233
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