The effect of anesthesia technique on tumor reccurrence rate after mastectomy


  • Melis Dulgeroglu Department of Anesthesiology, Ankara Education and Research Hospital, Ankara, Turkey
  • Aynur Camkiran Firat Department of Anesthesiology, Baskent University Hospital, Ankara, Turkey
  • Coskun Araz Department of Anesthesiology, Baskent University Hospital, Ankara, Turkey
  • Selim Candan Department of Anesthesiology, Okan University Hospital, Ankara, Turkey



Breast canser, Regional anesthesia, Tumor recurrence


Background: Breast cancer is most common cancer in women. Although surgical and chemotherapy methods have improved survival, mortality is seen secondary to metastasis and recurrence. Neuroaxial anesthesia has been shown to suppress neuroendocrine stress response due to surgery with sympathetic blockade and has a positive effect on tumor recurrence. In this study, the hypothesis was regional anesthesia may have a positive effect on patient comfort, surgical success rate and complications in the short term, tumor recurrence and metastasis in the long term.

Methods: Patients who underwent mastectomy for breast cancer were divided into two groups as thoracic epidural or general anesthesia retrospectively. Preoperative patient characteristics, intraoperative hemodynamic data and postoperative complications were recorded. Static and dynamic pain was evaluated at 12, 24 and 48 hours, at 1 week, 3 and 6 months, and at the end of 1 and 3 years. The presence of metastasis and recurrence was evaluated.

Results: In this study, no relationship between recurrence and anesthesia type (p=1.0) could be found. Intraoperative hemodynamic data and pain scores were lower in patients who underwent thoracic epidural anesthesia.

Conclusions: As a result, thoracic epidural anesthesia had hemodynamic effects and lower pain scores in postoperative pain control, but had no effect on tumor recurrence in breast cancer patients.


Colleoni M, Sun Z, Price KN, Karlsson P, Forbes JF, Thürlimann B, et al. Annual hazard rates of recurrence for breast cancer during 24 years of follow-up: results from the international breast cancer study group trials I to V. J Clini Oncol. 2016 Mar 20;34(9):927.

European Network of Cancer Registries. Fact sheet: Breast Cancer in Europe, 2014. Available at: Accessed 12 September 2014.

American Cancer Society. Breast Cancer Facts&Figures, 2019-2020. Available at: Accessed 14 August 2020.

Brewster AM, Hortobagyi GN, Broglio KR, Kau SW, Santa-Maria CA, Arun B, et al. Residual risk of breast cancer recurrence 5 years after adjuvant therapy. J Nat Cancer Instit. 2008 Aug 20;100(16):1179-83.

O’Riain SC, Buggy DJ, Kerin MJ, Watson RW, Moriarty DC. Inhibition of the stress response to breast cancer surgery by regional anesthesia and analgesia does not affect vascular endothelial growth factor and prostaglandin E2. Anes Analg. 2005 Jan 1;100(1):244-9.

Deegan CA, Murray D, Doran P, Ecimovic P, Moriarty DC, Buggy DJ. Effect of anaesthetic technique on oestrogen receptor-negative breast cancer cell function in vitro. Br J Anesth. 2009 Nov 1;103(5):685-90.

Sessler DI, Ben-Eliyahu S, Mascha EJ, Parat MO, Buggy DJ. Can regional analgesia reduce the risk of recurrence after breast cancer?: Methodology of a multicenter randomized trial. Contem Clini Trials. 2008 Jul 1;29(4):517-26.

Exadaktylos AK, Buggy DJ, Moriarty DC, Mascha E, Sessler DI. Can anesthetic technique for primary breast cancer surgery affect recurrence or metastasis?. Anesthesiol: J Am Soc Anesthesiolog. 2006 Oct 1;105(4):660-4.

Bar-Yosef S, Melamed R, Page GG, Shakhar G, Shakhar K, Ben-Eliyahu S. Attenuation of the tumor-promoting effect of surgery by spinal blockade in rats. Anesthesiol: J Am Soc Anesthesiolog. 2001 Jun 1;94(6):1066-73.

Grandhi RK, Lee S, Abd-Elsayed A. The relationship between regional anesthesia and cancer: a metaanalysis. Ochsner J. 2017 Dec 21;17(4):345-61.

Wink J, Veering BT, Aarts LP, Wouters PF. Effects of Thoracic Epidural Anesthesia on Neuronal Cardiac Regulation and Cardiac Function. Anesthesiology: Anesthesiol: J Am Soc Anesthesiolog. 2019 Mar 1;130(3):472-91.

Schnabel A, Reichl SU, Kranke P, Pogatzki-Zahn EM, Zahn PK. Efficacy and safety of paravertebral blocks in breast surgery: a meta-analysis of randomized controlled trials. Br J Anesth. 2010 Dec 1;105(6):842-52.




How to Cite

Dulgeroglu, M., Firat, A. C., Araz, C., & Candan, S. (2020). The effect of anesthesia technique on tumor reccurrence rate after mastectomy. International Journal of Research in Medical Sciences, 8(5), 1692–1695.



Original Research Articles