Thoracic Segmental Spinal Anaesthesia for Emergency Palliative Mastectomy with Moderate Pericardial Effusion: A Case Report

Breast cancer may rarely present as Locally Advanced Breast Cancer (LABC) with acute severe bleeding. In some cases, breast haemorrhage can be a life-threatening condition for patients, and its treatment includes compressive dressing, the use of topical or intravascular haemostatic agents, radiotherapy, and surgery. Additionally, breast cancer patients in the geriatric population are commonly associated with coexisting major medical illnesses, which makes anaesthetic management challenging. In such cases, regional anaesthesia is a preferable option over General Anaesthesia (GA). Hereby, the authors present a case report in which Thoracic Segmental Spinal Anaesthesia (TSSA) is used as the sole anaesthetic plan for a palliative simple mastectomy in an elderly female patient (74-year-old) with a bleeding carcinoma of the breast, poor cardiopulmonary reserve, and moderate pericardial effusion. The present findings support that TSSA can be effectively utilised as the sole anaesthetic technique in a breast cancer patient with moderate pericardial effusion when breast haemorrhage is life-threatening.