Is anesthesia used in surgery linked to breast cancer recurrence?

June 25, 2019

A retrospective study reviewed in Anesthesiology News reported no correlation between the type of anesthesia used in breast cancer surgery and the rate of recurrence. The study retrospectively analyzed 5,331 patients who were split into two groups; the IV group was anesthetized with propofol and remifentanil and the volatile group received enflurance, isoflurance, sevoflurance or desflurance. The results showed no significant difference in the five-year survival rates between the two groups. Dr. Jin-Tae Kim, MD, PHD, senior study author, noted the primary cause of death after cancer surgery was the recurrence of cancer and stated that both anesthetic techniques can be used to treat breast cancer, the choice should be dependent on the patients’ needs.  

Physiologically, anesthesia agents have properties which would appear to either lead to reduced recurrence of the disease (ex. Propofol has antioxidant and anti-inflammatory qualities) or increased risk of recurrence (volatile anesthetics are harmful to the immune system). Several studies have been conducted in an attempt to determine the link, if any, between anesthesia and cancer recurrence. While the results of these studies have been variable, it is possible that the level of trauma of a major operation might be the significant influencer of cancer recurrence. The study of this relationship is still in the early stages, but any influence anesthesia may have to reduce cancer recurrence is important to analyze and continue to monitor. Dr. Kim noted that additional large randomized trials comparing cancer recurrence are presently underway.