Analysis of functional significance using Ingenuity Pathway Analysis software demonstrated that surgery activated a number of pathways that may mediate adverse neural and cognitive development, the top 10 canonical pathways in order of significance are; thrombin signalling, aldosterone signalling in epithelial cells, axonal guidance signalling, B-cell receptor signalling, ERK-5 (or big MAP-kinase 1) signalling, glioma signalling, breast cancer regulation by stathmin 1, eNOS signalling, iCOS-iCOSL signalling in helper T-cells and growth hormone signalling. This evidence concerns the gene ICOS and breast cancer.