title: [Seven Cases of Surgery for Breast Cancer under Tumescent Local Anesthesia].
abstract: BACKGROUND
  Surgical procedures for breast cancer are usually performed under general anesthesia. However, general anesthesia needs to be avoided in some cases due to patient-related factors such as the presence of comorbid diseases. In these cases, we perform surgery under tumescent local anesthesia(TLA)in our department.
  
  
  METHODS
  Seven patients who were diagnosed with breast cancer underwent surgery under TLA instead of general anesthesia due to their comorbidities.
  
  
  RESULTS
  The planned surgical procedures were successfully completed under TLA. A shift to general anesthesia could be avoided in all cases. The operative procedures for the breasts included modified radical mastectomy (Bt) in 3 cases and wide excision (Bp) in 4 cases. In addition, axillary lymph node dissection was performed in 2 cases; sampling, in 1 case; sentinel lymph node biopsy, in 2 cases; and no procedure for the axilla, in 2 cases. In terms of anesthesia, 2 cases were managed under TLA alone and 5 cases were managed under TLA combined with epidural anesthesia. Lidocaine was used for local anesthesia and did not reach the maximal permissive dose in all cases. No postoperative complication was observed. No local recurrence or new metastasis was observed during the observation period, which ranged from 1 to 67 months after the surgery.
  
  
  CONCLUSIONS
  These findings demonstrate that surgery for breast cancer under TLA is safe and offers high curability for patients at high risk for complications of general anesthesia.
authors.affiliation: Dept. of Breast Surgery, Tokyo Medical and Dental University.
authors.forename: Tokuko
authors.initials: T
authors.lastname: Hosoya
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Goshi
authors.initials: G
authors.lastname: Oda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Uetake
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012008:Recurrence