A new retrospective study has reported that use of a powerful nonsteroidal anti-inflammatory drug (NSAID) during mastectomy surgery might reduce the risk of breast cancer recurrence compared with other analgesícs. Some reports have suggested that opioids such as morphine could promote relapse and that regional analgesia and NSAIDs could improve cancer prognosis.
The study included 327 consecutive female patients who underwent mastectomy with axillary dissection for breast cancer. The primary objective was to compare cancer recurrence rates at one to four years after surgery based on the different analgesics received during surgery. Perioperative characteristics, cancer prognostic factors, and length of surgery were comparable between the different types of analgesic used.
The overall rate of recurrence in the study group was 11%. A lower rate of cancer recurrence was found among women who had been given the NSAID ketorolac (Toradol, Acular) before surgery. Women who received ketorolac had a recurrence rate of 6% compared to 17% among those who did not. The results held after adjustment for other factors such as age and stage of the cancer. Other analgesics (sufentanil, ketamine, and clonidine) were not associated with a significant reduction in cancer recurrence rates (the study was not designed to assess whether other types of analgesics promoted recurrence). The authors conclude that intraoperative administration of ketorolac might reduce the risk of breast cancer relapse compared with other analgesícs.