Recently, our breast department and anesthesiology department successfully operated on an 80-year-old breast cancer patient with high-risk heart disease. The patient was an 80-year-old woman with the following diagnoses: 1) left breast cancer with ulceration; 2) hypertension grade 3, very high risk; 3) coronary artery disease with unstable angina; 4) arrhythmia, sinus bradycardia 49 beats/min; 5) third degree atrioventricular block. The risk of anesthesia for such a patient can be imagined. However, since the patient’s cancerous area had ulcerated, after repeated discussions and communication with the family, the family finally decided to operate on the patient considering that the cancer would endanger the patient’s life if not operated. Considering the patient’s age and poor tolerance, the risk of surgical anesthesia was extremely high. Director Zhuo Rui of the Department of Mammary Gland and Director Li Yanhua of the Department of Anesthesiology attached great importance to the patient and carefully arranged the perioperative work, firstly, the patient was fitted with a pacemaker before surgery, and at the same time, various preoperative resuscitation drugs and equipment were prepared, and intraoperative and postoperative monitoring and care were strengthened to ensure the safety of the patient’s life during the perioperative period. The patient was operated after the pacemaker was installed. Director Li Yanhua, considering the patient’s high blood pressure (180-205/70-78 mmHg), decided to administer a laryngeal mask anesthesia with less airway stimulation, and established invasive real-time blood pressure before anesthesia, and induced anesthesia under close observation of hemodynamic changes. The anesthesia was stable and the vital signs were stable during the whole operation. The patient woke up 15 minutes after the operation and was safely returned to the ward 30 minutes later. The patient and his family were very satisfied with the successful completion of the operation and anesthesia. This is the first case of very rare high-risk anesthesia in our hospital, which not only provides valuable experience for similar anesthesia cases in the future, but also reflects the high responsibility and challenging spirit of our medical staff for cancer patients.