How Surgery Affects the Immune System

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Any type of major surgery can stress the body and suppress the immune system. The reasons for this aren’t fully understood, but we do know that surgery and the anesthesia medications given to help make you sleep can be hard on the body. It can take a couple of weeks to many months for the immune system to recover fully. During this time, you’re more prone to infections that can affect any area of the body, such as the sinuses, throat, mouth, lungs, skin, and urinary tract. The more extensive your surgery is and the more surgeries you have, the greater the impact is likely to be. This includes surgery to treat breast cancer, such as lumpectomy and mastectomy, as well as reconstructive surgeries.

Breast cancer surgery also can challenge your immune system for a couple of other reasons:

  • Surgery breaks the skin and underlying tissues, which can allow bacteria and germs to enter the body. If an infection happens, it can occur right away or during the healing process. Once the incision heals, the risk of local infection goes away.
  • During surgery to treat the cancer, your doctor usually removes a few or more of the underarm lymph nodes so they can be checked for the presence of breast cancer cells. If cancer cells are found, more lymph nodes may need to be removed. (For more information, see the Lymph Node Removal section.) Lymph nodes play a key role in filtering out bacteria and other harmful substances while also exposing them to infection-fighting white blood cells and triggering an immune response. The more lymph nodes you have removed, the greater the disruption to your immune system. Any cut, bug bite, burn, or other injury that breaks the skin on the arm, hand, or trunk on that side of your body can challenge the immune system and possibly lead to infection. This risk never really goes away.

What you and your doctor can do about surgery’s effects on the immune system

Before and after breast cancer surgery, it’s a good idea to follow the common-sense ways to take care of your immune system, such as getting enough rest, eating a healthy diet, exercising, and reducing stress as much as you can. Having surgery for breast cancer can be quite stressful, so you may want to try complementary strategies such as meditation or acupuncture.

You and your doctor also should discuss any factors that could increase your risk of infection, such as:

  • the extent of your surgery (number and size of incisions)
  • any complications during surgery, such as excessive bleeding
  • other medical problems you may have, such as diabetes or heart or lung problems
  • previous cancer treatments, such as chemotherapy or radiation

You may need to take antibiotics after surgery to reduce infection risk. While you’re in the hospital, make sure that any doctor or nurse who comes to examine your incision(s) washes his or her hands first — a key strategy for fighting infection. Before you’re discharged, if you haven’t been told yet, ask for instructions about how to care for your incision(s) and whom to call if you have any symptoms of infection. These could appear near the incision or they may involve your entire body (such as fever and chills).

Since it can take weeks or months for your immune system to bounce back completely after major surgery, you also can follow some specific steps for protecting yourself against infection.

If you had lymph nodes removed, your immune system may not work as well on that side of your body. The more lymph nodes and vessels you had taken out, the greater the potential impact. If any bacteria, fungi, or other germs enter the hand, arm, or trunk, it’s possible for your immune system to get overwhelmed, leading to infection. Infection can increase your risk of developing a condition known as lymphedema, in which lymph fluid “backs up” in the arm, hand, and/or trunk and causes swelling and discomfort. For more information on reducing lymphedema risk and lymphedema and infection, visit our Lymphedema section.



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