Breast Cancer and Anaesthesia: Genetic Influence

Ponferrada, Aída Raigón; Orriach, José Luis Guerrero; Ruiz, J.C.; Molina, Salvador Romero; Luque, Aurelio Gómez; Mañas, José Cruz

doi:10.3390/ijms22147653

Cited by 9 publications

(5 citation statements)

References 205 publications

(226 reference statements)

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“…Since the inception of this review, several trials studying the effects of opioids on cancer recurrence are underway. While outside the scope of the present review, these studies analyze incorporate additional patient and tumor covariates that may influence the association between opioids and breast cancer recurrence and include mu-opioid receptor polymorphisms, other genetic biomarkers ( 36 , 37 ), immunological processes ( 38 ). and hormone receptor-specific responses to opioids ( 39 ).…”

Section: Discussionmentioning

confidence: 99%

The association between perioperative opioids and breast cancer recurrence: a narrative review of the literature

Thomas¹,

Bowers²,

Gómez³

et al. 2023

Transl Breast Cancer Res

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Background and Objective Opioid use disorder is an evolving crisis, and 17.2% of postsurgical patients continue to fill an opioid prescription one year after surgery. Preclinical studies suggest perioperative opioid use, defined here as opioids used in the setting of operative pain, may be linked to inferior oncologic outcomes. If this were true, opioid minimization strategies for surgical patients may reduce opioid-related deaths in more than one way. This review aims to describe the association between perioperative opioid use and breast cancer recurrence. Methods On November 1, 2021, we searched the Ovid and EMBASE databases for the terms “breast neoplasm”, “opioid analgesics”, “neoplasm recurrence”, and “neoplasm metastasis”. Of the 350 articles retrieved, 11 met our inclusion criteria. The review was undertaken using the enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) checklist for quality. Key Content and Findings Clinical studies report no clear association between perioperative opioid use and local or distant breast cancer recurrence. Mixed results were found when assessing perioperative opioid use and overall survival. Multiple studies paradoxically found opioid use to be associated with lower recurrence rates, despite higher mortality rates. Most studies showed no difference in recurrence or survival in breast cancer surgery patients who did or did not receive opioid-containing analgesia, although most findings were limited by study design and low event rates in patients with breast cancer. Conclusions The lack of a clear connection between perioperative opioid use and breast cancer recurrence contradicts some preclinical data, which describes mechanisms through which opioids upregulate tumor proliferation which might worsen oncologic outcomes. Existing clinical literature is limited to mostly retrospective studies in patients with predominantly early-stage breast cancers, with low event rates. Given the worsening opioid epidemic and preclinical study findings, opioid minimization strategies should still be explored. Future work should be prospective and examine cancer recurrence in high-risk patients with more advanced tumor pathologies.

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Section: Discussionmentioning

confidence: 99%

The association between perioperative opioids and breast cancer recurrence: a narrative review of the literature

Thomas¹,

Bowers²,

Gómez³

et al. 2023

Transl Breast Cancer Res

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“…However, the efficacy of the combined drugs cannot be accurately predicted because the combination may have synergistic and additive effects as well as antagonistic effects, leading to pharmacodynamic changes. Therefore, the compound effects of different drugs need to be analyzed one by one to clarify the drug efficacy of their combination [15][16][17]. This study combined two drugs (fentanyl and sufentanil) with propofol.…”

Section: Discussionmentioning

confidence: 99%

Clinical Value of Total Intravenous Anesthesia with Sufentanil and Propofol in Radical Mastectomy

2022

Disease Markers

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Objective. To investigate the clinical value of sufentanil combined with propofol for total intravenous anesthesia (TIVA) in radical mastectomy. Methods. The data of 120 patients undergoing radical mastectomy of breast cancer in our hospital from February 2020 to February 2021 were retrospectively analyzed, and they were randomly assigned to the experimental group (EXG) ( n = 60 ) and the control group (COG) ( n = 60 ). The anesthesia maintenance scheme was 0.01–0.03 μg/(kg·min) of sufentanil + 80 –100 μg/(kg·min) of propofol in EXG and 3 μg/(kg·h) of fentanyl + 80 –100 μg/(kg·min) of propofol in COG. The hemodynamic indices, stress indexes, postoperative pain scores, and incidence of adverse reactions were compared between EXG and COG. Results. The heart rates (HR) and mean arterial pressure (MAP) after tracheal intubation (T2) and at separation of deep tissues (T3), tracheal extubation (T4), and the end of surgery (T5) were markedly lower in EXG than in COG ( P < 0.001 ). The stress indexes and postoperative pain scores at 1 h (T6), 6 h (T7), and 12 h (T8) after surgery were lower in EXG than in COG ( P < 0.001 ). The incidence of dizziness, headache, pruritus, and emergence agitation in EXG was lower compared with that in COG ( P < 0.05 ). Conclusion. Sufentanil combined with propofol for TIVA can stabilize intraoperative hemodynamic indices of patients undergoing radical mastectomy, alleviate perioperative stress response, and reduce pain perception. Therefore, this anesthesia method is safe and merits clinical promotion.

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“…The aggressiveness of cancer cells is effectively inhibited at the concentration of lidocaine used in surgical procedures [ 31 , 32 ]. This invasive effect is not related to its anesthetic activity (sodium channel blocking) [ 33 ]. However, the impact of lidocaine on anion channels is not fully understood.…”

Section: Discussionmentioning

confidence: 99%

Lidocaine promotes apoptosis in breast cancer cells by affecting VDAC1 expression

et al. 2022

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Objective To investigate the effect of lidocaine on the expression of voltage-dependent anion channel 1 (VDAC1) in breast invasive carcinoma (BRCA) and its impact on the apoptosis of breast cancer cells. Methods We collected clinical data from patients with invasive breast cancer from 2010 to 2020 in the First affiliated hospital of Nanchang University, evaluated the prognostic value of VDAC1 gene expression in breast cancer, and detected the expression of VDAC1 protein in breast cancer tissues and paracancerous tissues by immunohistochemical staining of paraffin sections. Also, we cultured breast cancer cells (MCF-7) to observe the effect of lidocaine on the apoptosis of MCF-7 cells. Results Analysis of clinical data and gene expression data of BRCA patients showed VDAC1 was a differentially expressed gene in BRCA, VDAC1 may be of great significance for the diagnosis and prognosis of BRCA patients. Administration of lidocaine 3 mM significantly decreased VDAC1 expression, the expression of protein Bcl-2 was significantly decreased (p < 0.05), and the expression of p53 increased significantly (p < 0.05). Lidocaine inhibited the proliferation of MCF-7 breast cancer cells, increased the percentage of G2 / M phase cells and apoptosis. Conclusion Lidocaine may inhibit the activity of breast cancer cells by inhibiting the expression of VDAC1, increasing the apoptosis in breast cancer cells.

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Breast Cancer and Anaesthesia: Genetic Influence

Cited by 9 publications

References 205 publications

The association between perioperative opioids and breast cancer recurrence: a narrative review of the literature

The association between perioperative opioids and breast cancer recurrence: a narrative review of the literature

Clinical Value of Total Intravenous Anesthesia with Sufentanil and Propofol in Radical Mastectomy

Lidocaine promotes apoptosis in breast cancer cells by affecting VDAC1 expression

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