The Plastic Surgery Foundation
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Grants We Funded

In 2019, The Plastic Surgery Foundation (The PSF) awarded 33 investigator-initiated projects and allocated $891,274 to support the newest, clinically relevant research in plastic surgery.

The American Society of Plastic Surgeons/PSF leadership is committed to continuing to provide high levels of investigator-initiated research support to ensure that plastic surgeons have the needed research resources to be pioneers and innovators in advancing the practice of medicine.

Research Abstracts

Search The PSF database to have easy access to full-text grant abstracts from past PSF-funded research projects 2003 to present. All abstracts are the work of the Principal Investigators and were retrieved from their PSF grant applications. Several different filters may be applied to locate abstracts specific to a particular focus area, or PSF funding mechanism.

The Impact of Preoperative Mammography on Reduction Mammoplasty Episode of Care

Principal Investigator
Erika Sears MD

Year
2017

Institution
The Regents of the University of Michigan

Funding Mechanism
AAPS/PSF Academic Scholar Award

Focus Area
Breast (Cosmetic / Reconstructive)

Abstract
Reduction mammoplasty ranks as one of the most commonly performed plastic surgery procedures in the U.S. Given the potential for breast reduction surgery to cause postoperative mammography changes, classic teaching has advocated performing a baseline mammogram before surgery in patients older than 30 years of age. However, screening guidelines have recommend against screening average risk women younger than 40 for breast cancer. Given the risks of over-screening, the American Society of Plastic Surgeons have recommended that surgeons avoid performing routine mammograms before elective breast surgery beyond what is recommended for the general population of patients of specific age groups. Despite these recommendations, recent survey research suggests that surgeons continue to order unnecessary pre-operative mammograms in patients undergoing reduction mammoplasty.
The goal of this proposal is to evaluate the national practice patterns of mammography utilization in patients evaluated for symptomatic macromastia and downstream healthcare utilization. Specifically, the aims of this study are (1) to evaluate national practice patterns of pre-operative mammography in reduction mammoplasty patients and (2) to assess the impact of pre-operative mammography on treatment efficiency and resource utilization, including the number of additional procedures and outpatient physician visits, in addition to costs of care for the patient and the health system. To accomplish these goals, we intend to conduct a secondary data analysis of the Marketscan dataset maintained by Truven Health Analytics, which contains the largest collection of employer-based patient data in the United States. We will include a cohort of female patients ages 18 and 70 with a new diagnosis of macromastia between January 1, 2010 and December 31, 2013 in our analysis.
We hypothesize that patients undergoing reduction mammoplasty will undergo screening mammography at a higher rate compared to women of similar age in the general population. Additionally, we anticipate that the use of preoperative mammography will be associated with a greater risk of additional procedures, attending more outpatient visits, prolonged time to surgery, and incurring higher treatment charges and out-of-pocket expenditures.


Biography
Erika D. Sears, MD, MS, serves as an Assistant Professor in the Section of Plastic Surgery at the University of Michigan Health System. At VA Ann Arbor Health Care System, she is a Staff Physician in Plastic Surgery and a research investigator in the VA Center for Clinical Management Research. Dr. Sears received her Bachelors of Science in Biomedical Engineering from Northwestern University and Doctor of Medicine from the University of Michigan Medical School. She completed the Integrated Plastic Surgery Residency and Hand Surgery Fellowship at the University of Michigan. She also received additional research training in health services research as a fellow of the Robert Wood Johnson Clinical Scholars Program where she earned a Master of Science degree in health services research from the University of Michigan Rackham Graduate School. Dr. Sears has published 32 peer-reviewed manuscripts and 15 book chapters. Her research interests include the study of practice variation in hand and plastic surgery and its influence on patient outcomes and resource utilization. Her research is dedicated to finding strategies to improve the efficiency and value of surgical care. With grant support from the PSF, Dr. Sears will conduct a national study of the impact of pre-operative mammography use on the efficiency and value of breast reduction surgery.