Background: Surgery is the treatment of choice in breast cancer and the current moto is towards less extension of removal of tissue with axillary dissection for removal of lymph nodes to guide further treatment. Aim: The present study compare thoracic epidural with general anesthesia in cancer surgeries of the breasts. Materials and Methods: It is a comparative study in 60 patients divided into two groups, epidural group (n = 30) underwent epidural thoracic block and other group(n = 30) underwent conventional general anesthesia. Following variables were noted as duration of the surgery, the need of anesthesia or sedation, and intraoperative hemodynamic parameters. In the postoperative period, length of time until discharge from the recovery room and from the hospital, severity of pain, adverse effects, and satisfaction with the anesthetic techniques were noted. Results: Both groups have no significance in the duration of the surgery was observed. The rate of hypertension was more in the group of patients who underwent general anesthesia, while hypotension was more in the epidural group. Postoperatively, pruritis (40%) has more incidences in the epidural block group. Nausea (20%) and vomiting (33%) was more in general anesthesia group. The length of stay in the recovery room and hospitalization were lower in the epidural group; Satisfaction with the anesthesia is more with epidural block. Conclusions: Epidural block is advantages when compared with general anesthesia and can be used as anesthesia option in oncologic mastectomies with axillary lymph node dissection.