Our Summary

This research paper discusses the use of a different type of anesthesia, thoracic epidural anesthesia (TEA), during breast cancer surgery, specifically modified radical mastectomy (MRM). Normally, this procedure is done under general anesthesia (GA), which involves the patient being fully unconscious. However, for some patients with multiple health problems or difficult breathing pathways, GA is not an ideal choice. TEA could be a safer and more beneficial alternative to GA for these patients as it does not require handling of airways and also dampens the body’s stress response. The study shows that the use of TEA can stabilize patient’s blood flow, reduce the need for painkillers, lessen post-surgery nausea and vomiting, allow for quicker return to eating, and reduce hospital stay time. The study reports the successful use of TEA in a 57-year-old female patient with advanced breast cancer and other health issues. The paper also includes a thorough review of other literature on the use of TEA for MRM.

FAQs

  1. What is a modified radical mastectomy (MRM) and how is it typically performed?
  2. Why might thoracic epidural anesthesia (TEA) be a safer choice than general anesthesia for certain patients undergoing MRM?
  3. What are the potential benefits of using thoracic epidural anesthesia in MRM procedures?

Doctor’s Tip

One helpful tip a doctor might tell a patient about radical mastectomy is to discuss the possibility of using thoracic epidural anesthesia as an alternative to general anesthesia. This can help minimize stress response, reduce postoperative complications, and lead to a faster recovery. It may be particularly beneficial for patients with multiple comorbidities or difficult airways.

Suitable For

Patients who are typically recommended radical mastectomy include those with advanced breast cancer, large tumors, tumors that involve the chest wall or skin, multiple tumors in different areas of the breast, or tumors that are close to the chest wall or under the arm. Additionally, patients who have a strong family history of breast cancer or genetic mutations such as BRCA1 or BRCA2 may also be recommended for radical mastectomy.

Timeline

  • Patient is diagnosed with advanced breast cancer
  • Patient undergoes preoperative evaluation and preparation for surgery
  • Surgery date is scheduled for radical mastectomy
  • Patient is brought to the operating room and given anesthesia
  • Modified radical mastectomy is performed under general anesthesia or thoracic epidural anesthesia
  • Postoperatively, patient is monitored closely for any complications
  • Patient receives postoperative care, including pain management and wound care
  • Patient is discharged from the hospital and continues with follow-up appointments and treatment as necessary.

What to Ask Your Doctor

  1. What are the benefits of undergoing a radical mastectomy compared to other treatment options?
  2. What are the potential risks and complications associated with a radical mastectomy?
  3. How long is the recovery period after a radical mastectomy?
  4. Will I need additional treatments such as chemotherapy or radiation therapy after the surgery?
  5. Are there any alternative surgical options to a radical mastectomy that may be suitable for my case?
  6. How will a radical mastectomy affect my physical appearance and self-esteem?
  7. What are the chances of the cancer returning after a radical mastectomy?
  8. Will I need any additional support or resources during my recovery period?
  9. How often will I need follow-up appointments after the surgery?
  10. Are there any lifestyle changes I should make to improve my overall health and reduce the risk of cancer recurrence after the surgery?

Reference

Authors: Srivastava A, Jamil S, Khandelwal A, Raj M, Singh S. Journal: Cureus. 2021 Jun 22;13(6):e15822. doi: 10.7759/cureus.15822. eCollection 2021 Jun. PMID: 34306886