Impact of the Intraoperative Use of Amines in Breast Cancer Surgery on Tumor Recurrence

Adrenergic receptors (alpha and beta) are expressed on breast cancer cells, and their stimulation has been shown in experimental studies to promote tumor proliferation and metastasis. Conversely, observational data suggest that beta-blockers may have a protective effect on cancer recurrence. During mastectomy, adrenergic agonists such as catecholamines (e.g., ephedrine, phenylephrine, norepinephrine) and other agents (e.g., clonidine) are frequently used intraoperatively to maintain hemodynamic stability, potentially activating these receptors. While some data suggest that perioperative adrenergic stimulation may influence tumor biology, the clinical impact on cancer recurrence remains unclear. This retrospective exploratory study aims to evaluate whether the use of adrenergic agents during anesthesia for mastectomy influences tumor recurrence in breast cancer patients. Approximately 250 patients undergoing mastectomy over a 5-year period will be included. The study will assess the association between intraoperative exposure to adrenergic drugs and oncological outcomes, with the goal of better understanding the potential role of perioperative factors in cancer progression.