title: Breast cancer surgery-induced immunomodulation.
abstract: OBJECTIVE
  Surgical procedures can cause tumor cells to disseminate into the circulatory system. Although this spread of metastatic cells will be limited by immune activity, immunosuppression tends to be the main effect resulting from surgery. The objective of this study is to assess hormonal and immunological changes induced by breast cancer surgery.
  
  
  METHODS
  Endocrine and immune responses to surgery were determined in 27 breast cancer patients. Blood samples were taken at 6 days and 1 day before surgery and 2 hr, 1 day, and 5 days after surgery. Changes in endocrine function, number of leucocytes and their subpopulations, enumerative immune expression, functional activity, and cytokine levels were determined.
  
  
  RESULTS
  Breast cancer surgery induces a pro-inflammatory response and leucocytosis. Immunosuppression is indicated by decreased HLA-DR expression, decreased NKCA, and a Th2 response. A delayed Th1 response was also found 5 days after surgery. As no cortisol level change was observed, this hormone can be excluded as the mediator of surgery-related immunomodulation in breast cancer.
  
  
  CONCLUSIONS
  Although breast cancer surgery is classified as minor surgery the surgical procedure produces substantial immunomodulation.
authors.affiliation: Helen Dowling Institute, Centre for Psycho-Oncology, Utrecht, The Netherlands.
authors.forename: Martijn F
authors.initials: MF
authors.lastname: Boomsma
authors.forename: Bert
authors.initials: B
authors.lastname: Garssen
authors.forename: Edith
authors.initials: E
authors.lastname: Slot
authors.forename: Monique
authors.initials: M
authors.lastname: Berbee
authors.forename: Johannes
authors.initials: J
authors.lastname: Berkhof
authors.forename: Eltica de Jager
authors.initials: Ede J
authors.lastname: Meezenbroek
authors.forename: Walentina
authors.initials: W
authors.lastname: Slieker
authors.forename: Adriaan
authors.initials: A
authors.lastname: Visser
authors.forename: Sybren
authors.initials: S
authors.lastname: Meijer
authors.forename: Robert H J
authors.initials: RH
authors.lastname: Beelen
mesh_terms: D001943:Breast Neoplasms / Q000276:immunology* / Q000601:surgery*; D002097:C-Reactive Protein / Q000032:analysis; D016207:Cytokines / Q000378:metabolism; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis; D007108:Immune Tolerance; D007111:Immunity, Cellular; D056747:Immunomodulation
chemical_list: D016207:Cytokines; D002097:C-Reactive Protein; D006854:Hydrocortisone