J Breast Dis.  2019 Jun;7(1):9-15. 10.14449/jbd.2019.7.1.9.

Oncologic Results of Breast Conserving Surgery under Procedural Sedation in Elderly Patients

• Lee J
• Jung JH
• Kim WW
• Lim YS
• Lee RK
• Kwak KH
• Park HY

• KMID: 2451794
• DOI: http://doi.org/10.14449/jbd.2019.7.1.9

Abstract

PURPOSE
Although surgery is the most frequently implemented treatment modality for breast cancer, many older patients with breast cancer are under- or untreated because of their high incidence of postoperative complications. We assessed the efficacy and safety of breast surgery under procedural sedation in older patients (aged >70 years) by comparing selected clinical and oncologic factors after surgery for breast cancer under general anesthesia versus procedural sedation.
METHODS
Of 79 older patients with breast cancer, 49 underwent breast-conserving surgery, 30 under general anesthesia and 19 under procedural sedation, and relevant clinical and oncologic variables were compared and analyzed between groups.
RESULTS
The mean age was younger in the general anesthesia group and the mean operation time, hospital stay, and fasting time shorter in the procedural sedation group. There were no statistically significant differences in oncologic results between the two groups during follow-up.
CONCLUSION
Breast surgery under procedural sedation is a safe and effective means of reducing tumor burden in older patients with breast cancer when their American Society of Anesthesiologists (ASA) physical status indicates a high risk of life-threatening perioperative complications associated with general anesthesia. And we also found that the oncologic results may be not inferior to same procedure under general anesthesia.

Keyword

Aged; Breast neoplasms; Sedation; Surgery

MeSH Terms

Aged*
Anesthesia, General
Breast Neoplasms
Breast*
Fasting
Follow-Up Studies
Humans
Incidence
Length of Stay
Mastectomy, Segmental*
Postoperative Complications
Tumor Burden