{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T13:21:20Z","timestamp":1788182480446,"version":"build-2803163510"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Breast cancer is a prevalent malignancy in women. General anesthesia (GA) is commonly employed during breast cancer surgery. However, GA is not immunologically inert. Cell-mediated immunity plays a role in antitumor immunity. The primary objective of this study was to compare levels of tumor necrosis factor alpha (TNF \u03b1), interleukin (IL) 1, IL6, IL 10, interferon gamma (IFN-\u03b3), leukocytes, lymphocytes, neutrophils, monocytes, eosinophils, and basophils before and after GA for breast cancer surgeries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology:<\/jats:title>\n                    <jats:p>This prospective observational study was conducted on thirty patients undergoing breast cancer surgery under GA. The anesthesia was achieved using IV glycopyrrolate, midazolam, fentanyl, propofol, and laryngeal mask airway. Anesthesia was maintained using a mixture of oxygen, nitrous oxide, and isoflurane. At the end of the procedure, IV paracetamol 1 g and ondansetron 4 mg were administered. Blood samples for immunemodulators were collected before and 2 h after the induction of anaesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results and Conclusion:<\/jats:title>\n                    <jats:p>\n                      The total leukocyte count showed a nonsignificant increase with a\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.148. Lymphocyte count significantly decreased from 30.59 \u00b1 9.19 to 25.69 \u00b1 8.74 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003). Neutrophil count increased significantly from 61.22 \u00b1 8.97 to 66.15 \u00b1 9.79 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.014). Monocyte, eosinophil, and basophil counts did not show any significant difference. TNF-\u03b1 levels increased significantly from 49.54 \u00b1 16.04 to 54.95 \u00b1 19.03 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.037). IL-1, IL-2, IL-6, IL-10, and IFN-\u03b3 did not show any statistically significant difference. To conclude, GA in patients undergoing breast cancer surgery induces measurable immunomodulatory effects, characterized by a significant decrease in lymphocyte and an increase in neutrophil counts with stable total leukocyte counts. The significant increase in TNF-\u03b1 with nonsignificant changes in other inflammatory markers, such as IL-1, IL-2, IL-6, IL-10, and IFN-\u03b3, was also noted. These findings suggest that anesthesia may influence the immune response in this vulnerable patient population, and perioperative immune perturbations could modulate short-term metastatic risk, though long-term studies are needed to confirm clinical relevance.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aam.aam_187_25","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T15:02:53Z","timestamp":1760022173000},"page":"1227-1231","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Immunomodulatory Effects of General Anesthesia in Patients with Breast Cancer - An Observational Study"],"prefix":"10.4103","volume":"25","author":[{"given":"Nitu","family":"Puthenveettil","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Critical Care, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, 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