ERAS Protocol versus No ERAS Protocol for the Reduction of Prescribed Opioids among Patients with Breast Cancer Undergoing Breast Conserving Surgery with Lumpectomy and Sentinel Lymph Node Biopsy

Inclusion Criteria

• Males or females age ≥ 19 years old at time of study entry.
• Patient must be able to provide study-specific informed consent prior to study enrollment.
• Histologic confirmation of breast cancer diagnosis on core needle biopsy. Pathology will be confirmed by internal University of Nebraska Medical Center (UNMC) review if biopsy was completed at outside institution.
• Clinical or radiographic cT1-T3 N0 disease.
• Patients must undergo breast conserving surgery with lumpectomy and sentinel lymph node biopsy.
• No prior definitive treatment or intervention received.
• Patients must be able to swallow and retain oral carbohydrate drinks and medication.

Exclusion Criteria

• Patients who are pregnant.
• Patients who have contraindications to receipt of ERAS protocol components.
• Patients undergoing the following procedures: lumpectomy without sentinel lymph node biopsy, mastectomy, bilateral surgery, combination oncoplastic surgery with the Plastic and Reconstructive Surgery team, or axillary lymph node dissection.
• Patients diagnosed with cT4 or N1-3 disease at presentation.
• Patients with metastatic disease at presentation.
• Patients taking opioid pain medications for other indications.
• Patients with a history of substance use disorder. For the purposes of the trial, substance use disorder will be defined as a diagnosis in their past medical history at any time. As substance use disorder and recovery times vary widely for each individual it is impossible to determine if a remote very recent history would confound our results. As such, we have elected to exclude all patients with any history of substance use disorder at any time.
• Any patient, in the treating physician's opinion, in whom ERAS protocol could compromise patient safety.