Abstract
BACKGROUND: Research at the intersection of breast cancer and general anesthesia has advanced rapidly, yet its thematic structure and evolving hotspots remain unclear. This study provides the first comprehensive bibliometric analysis of the global research landscape from 1985 to 2024. Its objective is to systematically map the field, identify evolving research hotspots, and analyze thematic trajectories to reveal shifting research priorities. METHODS: A bibliometric analysis was conducted using the Web of Science Core Collection. VOSviewer, CiteSpace, and the R package “bibliometrix” were used to construct co-occurrence networks and perform cluster and burst keyword analyses. RESULTS: A total of 428 studies were included. Cluster analysis of high-frequency keywords identified four major research clusters: (1) the impact of anesthetic technique on cancer recurrence and metastasis, (2) diagnostic and management strategies in breast cancer, (3) surgical approaches and pain outcomes, and (4) analgesic techniques and perioperative management. Keyword burst analysis revealed an early focus on diagnosis and surgical technique, with a clear transition in the past decade toward patient-centered outcomes such as recurrence prevention, persistent pain, survivorship, and quality of life. CONCLUSION: This cluster analysis-based bibliometric study reveals four primary research hotspots in breast cancer and general anesthesia, highlighting a thematic evolution from technical and procedural concerns to patient-centered outcomes and survivorship. These findings suggest future research will focus increasingly on optimizing anesthetic strategies to improve long-term outcomes and quality of life for breast cancer patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12672-026-04778-8.