Breast-Conserving Surgery Under Local Anesthesia in Elderly Patients with Severe Cardiorespiratory Comorbidities: A Hospital-Based Case-Control Study

• Published in: Breast care (Basel, Switzerland) Vol. 12; no. 1; pp. 28 - 32
• Main Authors: Karanlik, Hasan, Kılıç, Berkay, Yıldırım, Ilknur, Bademler, Süleyman, Ozgur, Ilker, Ilhan, Burak, Onder, Semen
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger GmbH 01.03.2017
• Subjects: Original; Original Article; Surgery; Local anesthesia; General anesthesia; Breast cancer; Safety; Lymph nodes; Breast-conserving surgery
• ISSN: 1661-3791; 1661-3805
• DOI: 10.1159/000455003

Introduction: We report the feasibility and safety of local anesthesia (LA) in patients having breast-conserving surgery (BCS). Methods: 37 patients with American Society of Anesthesiologists (ASA) score of 4 having BCS under LA and 54 age-matched subjects with ASA score of 3-4 having BCS under general anesthesia (GA) were included. Patients were retrospectively evaluated for the follow-up duration, duration of surgery, postoperative satisfaction scores (1-10), complication and survival time for locoregional recurrence and overall survival rates. Results: The mean follow-up duration was 55.09 ± 13.49 months (range 38-104) in GA group, and 58.7 ± 15.5 months (range 20-99) in LA group. There was a significant difference in the duration of surgery (p < 0.001). In the LA group, 5 patients (13.5%) had minor complications including seroma, wound infection or hematoma, whereas 6 patients (11.1%) had minor complications in the GA group (p > 0.05). The re-excision rate due to positive tumor margins was 5.4% (2 patients) in the LA group and 5.5% in the GA group, respectively. The locoregional recurrence-free survival and overall survival rate was not different between 2 groups (p = 0.192, p = 0.93). Conclusion: BCS under LA seemed to be effective and safe in selected high-risk elderly patients.