Date of this Version
Background: Surgical intervention for breast malignancy is the treatment of choice for the breast cancer patient population. Extensive research has established the correlation between the mode of anesthetic delivery and breast cancer recurrence and metastasis in patients undergoing surgical intervention for breast cancer. Researchers have identified the implications of volatile anesthetic agents (VAA), or inhalational agents, on the suppression of the immune response throughout the perioperative period; thus, cultivating an environment that is ideal for cancer cell proliferation, migration, and eventual metastasis via systemic circulation. Although the standardization of the anesthetic management for this patient population has not been declared, total intravenous anesthesia (TIVA) has been identified as the optimal anesthetic method to reduce the risk of breast cancer recurrence and metastasis in patients undergoing breast surgery, due to the immunologic protectant effects proffered by the drugs utilized in TIVA anesthetic administration.
Methods: PubMed, Google Scholar, and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) search engines were accessed via the Florida International University (FIU) library database to compose a comprehensive search for peer-reviewed research studies within the last 10 years that examined the effects of VAA or TIVA anesthetic on breast cancer recurrence and metastasis in patients undergoing surgical intervention for breast cancer.
Results: Eight high-level research articles were selected for appraisal and inclusion of this review due to novelty and relevance. The articles included in this review evaluate the long-term effects of VAA or TIVA anesthetic delivery on breast cancer recurrence and metastasis in the breast cancer patient surgical population and identify the existing research-to-practice gap that must be addressed in the anesthesia community to yield the best possible outcomes for the aforementioned target population.
Conclusion: Current evidence-based research has illuminated the impactful role that anesthesia providers may have on the long-term outcomes of patients with breast malignancy presenting for surgical intervention via the selection of a TIVA-based anesthetic approach. It is anticipated that the implementation of a QI project will enhance the anesthesia providers’ capacity to improve the quality of life and reduce the risk of life-altering implications with the selection of their anesthetic approach in breast cancer patients.
de la Vega, Kiersten A. and Miller, Ann B., "Total Intravenous Anesthesia to Reduce Metastasis and Recurrence Rates in Patients Presenting for Breast Cancer Surgery: An Educational Intervention" (2022). Nicole Wertheim College of Nursing Student Projects. 129.