Can anesthetic technique for primary breast cancer surgery affect recurrence or metastasis?
Exadaktylos AK, Buggy DJ, Moriarty DC, Mascha E, Sessler DI.University Department of Anaesthesia and Intensive Care Medicine, Mater Misericordiae University Hospital, National Breast Screening Program-Eccles Unit, Dublin 7, Ireland. Comment in: • Anesthesiology. 2006 Oct;105(4):643-4. • Anesthesiology. 2007 Aug;107(2):354; author reply 354-5.
GROUND: Regional anesthesia is known to prevent or attenuate the surgical stress response; therefore, inhibiting surgical stress by paravertebral anesthesia might attenuate perioperative factors that enhance tumor growth and spread. The authors hypothesized that breast cancer patients undergoing surgery with paravertebral anesthesia and analgesia combined with general anesthesia have a lower incidence of cancer recurrence or metastases than patients undergoing surgery with general anesthesia and patient-controlled morphine analgesia. METHODS: In this retrospective study, the authors examined the medical records of 129 consecutive patients undergoing mastectomy and axillary clearance for breast cancer between September 2001 and December 2002. RESULTS: Fifty patients had surgery with paravertebral anesthesia and analgesia combined with general anesthesia, and 79 patients had general anesthesia combined with postoperative morphine analgesia. The follow-up time was 32 +/- 5 months (mean +/
