title: Excisional breast biopsy under local anesthesia: stress-related neuroendocrine, metabolic and immune reactions during the procedure.
abstract: OBJECTIVE
  The aim of this study was to evaluate three axes: the sympathetic system (adrenaline and noradrenaline), surgical stress-related endocrine factors (prolactin, cortisol, insulin, glucose and growth hormone) and inflammatory cytokines (IL-1alpha, IL-1beta and IL-6) during excisional breast biopsy under local anesthesia (EBBLA).
  
  
  METHODS
  On 14 women undergoing EBBLA, all the aforementioned molecules were measured in peripheral venous blood samples prior (baseline), during (at 10 and 30 minutes), at the end of EBBLA (46+/-9 minutes) and one hour after its end.
  
  
  RESULTS
  Serum growth hormone glucose and cortisol were found elevated at the 10th and 30th minute and at the end of EBBLA. Serum prolactin increased only at the 30th minute. Of notice, none of the measured parameters was found elevated one hour after the end of biopsy. Concerning adrenaline, noradrenaline and interleukins, no significant changes were documented.
  
  
  CONCLUSIONS
  During EBBLA, significant stress-related endocrine events arise. However, no significant sympathetic / cytokine triggering was noted.
authors: Breast Unit, First Department of Propaedeutic Surgery, Hippokratio Hospital, School of Medicine, Associate Professor of Surgery, University of Athens, 101, Vas Sofias Ave, Ampelokipi, Athens 11521, Greece. gzografo@med.uoa.gr
authors: George C
authors: GC
authors: Zografos
authors: Flora
authors: F
authors: Zagouri
authors: Theodoros N
authors: TN
authors: Sergentanis
authors: Georgia
authors: G
authors: Giannakopoulou
authors: Xeni
authors: X
authors: Provatopoulou
authors: Eleni
authors: E
authors: Kalogera
authors: Christos
authors: C
authors: Papadimitriou
authors: George
authors: G
authors: Filippakis
authors: Alexandros
authors: A
authors: Sagkriotis
authors: John
authors: J
authors: Bramis
authors: Antonia
authors: A
authors: Gounaris
mesh_terms: D000328:Adult; D000772:Anesthesia, Local; D001706:Biopsy / Q000523:psychology*; D001941:Breast Diseases / Q000473:pathology* / Q000523:psychology; D005260:Female; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007107:Immune System / Q000276:immunology / Q000378:metabolism*; D007328:Insulin / Q000097:blood; D053582:Interleukin-1alpha / Q000097:blood; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008875:Middle Aged; D009490:Neurosecretory Systems / Q000276:immunology / Q000378:metabolism*; D011388:Prolactin / Q000097:blood; D013315:Stress, Psychological / Q000276:immunology / Q000378:metabolism*
chemical_list: D007328:Insulin; D053582:Interleukin-1alpha; D053583:Interleukin-1beta; D015850:Interleukin-6; D019382:Human Growth Hormone; D011388:Prolactin; D006854:Hydrocortisone