Is it possible to surgically remove a breast tumor using only local anesthesia, and is this a viable alternative to general anesthesia?

Breast cancer (mammary carcinoma) is a malignant disease of the mammary gland tissue characterized by the uncontrolled proliferation of mammary gland cells. Treatment of the disease depends on numerous factors. In many cases, locally confined tumors can be surgically removed. This may involve breast-conserving surgery or a mastectomy (complete removal of the affected breast). General anesthesia is typically used for the surgery. This puts patients into a sleep-like state. Potential side effects and aftereffects—such as nausea, a longer recovery time, or complications related to intubation and anesthetics—are drawbacks. An alternative method is local anesthesia of the surgical site. A specific technique here is tumescent local anesthesia (TLA). In this procedure, the surgical site is infiltrated with a large volume of local anesthetic solution. The advantage is that the patient remains awake, thereby eliminating the general risks associated with general anesthesia. In addition, this procedure may offer benefits regarding postoperative pain.

The aim of this study is to investigate pain following surgery under tumescent local anesthesia and general anesthesia. For the study, patients are divided into two groups. Group 1 will receive general anesthesia for the surgery, and Group 2 will receive tumescent local anesthesia. The study is open-label, meaning that both the medical staff and the patient know which treatment is being administered. The primary endpoint is postoperative pain over a five-week observation period. Patients will rate their perceived pain on a visual analog scale during the first three days after surgery and two to five weeks after surgery.

Women aged 18 and older with newly diagnosed breast cancer or a precancerous condition (carcinoma in situ, e.g., DCIS, LCIS) who are scheduled for breast-conserving surgery or mastectomy are eligible to participate in this study. Bilateral surgery or breast reconstruction using implants must not be planned.