Statement: Scheduled flap reconstruction within 10 days prior to beginning is acceptable for patients entering the primary trial.
Primary_evidence: Inclusion Criteria:   Primary breast cancer without known extension beyond the breast and axillary nodes (i.e. believed to be Tumor Stage 1-3, Nodes 0-2)   Scheduled for unilateral or bilateral mastectomy with or without implant (isolated "lumpectomy" will not qualify)   Isolated "lumpectomy" with axillary node dissection (anticipated removal of at least five nodes)   Written informed consent, including willingness to be randomized to morphine or regional analgesia Exclusion Criteria:   Previous surgery for breast cancer (except diagnostic biopsies)   Inflammatory breast cancer   Age < 18 or > 85 years old   Scheduled free flap reconstruction   ASA Physical Status  4   Any contraindication to epidural or paravertebral anesthesia and analgesia (including coagulopathy, abnormal anatomy)   Any contraindication to midazolam, propofol, sevoflurane, fentanyl, or morphine   Other cancer not believed by the attending surgeon to be in long-term remission   Systemic disease believed by the attending surgeon to present  25% two-year mortality