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Last month I stumbled across a twitter post shared by The American Academy of Orthopaedic Surgeons rightfully highlighting the importance of breast cancer education and research in support of Breast Cancer Awareness Month.
The post itself proved the importance of education, as I was ignorant to the fact that Breast Cancer Awareness Month even existed. The post also included a journal article titled “Increased Prevalence of Breast and All-cause Cancer in Female Orthopaedic Surgeons”¹, which surprised me to say the least.
It had never occurred to me that a surgical environment may have such sinister links to occupational health diseases, let alone cancer. The research article stated, “The prevalence of cancer was 189% higher among female orthopaedic surgeons compared with that of the age-adjusted and race-adjusted general US female population”¹. The study also found the same surgeons are almost four times more likely to have breast cancer compared with that of the general population.
After conducting my own research it’s quite clear that occupational exposure to ionizing radiation is one of the leading causes of breast cancer amongst women in orthopaedics. The issue is well documented and has become somewhat of a public health warning within the field. There are many other studies reporting similar results such as Stanford University, who conducted their own study which found “the prevalence of cancer was 85% higher in female orthopaedic surgeons than in the general U.S. population”. Stanford University also compared their results with female surgeons in urology, and plastic surgery and found that the “increased breast cancer risk was unique to orthopaedics”⁵.
What is so different about orthopaedics to have such a dramatic increase in risk of cancer? Unfortunately, there’s yet to be a confirmed definitive answer to my question.
Orthopaedic surgeries typically involve the higher use of fluoroscopy, which can expose surgeons to radiations for several hours. In many instances, lead protection wear is often the incorrect size exposing the armpit and upper outer quadrant of the breast which is the most common area for breast cancer. As we know, the risk of radiation isn’t a bespoke issue for orthopaedics. When compared with other medical fields that also use the technology, the risks of cancer are nowhere near the figures for female orthopaedic surgeons.
Dr Loretta Chou stated “With an increasing percentage of women in orthopaedic surgery, it is imperative that we study and understand the occupational risks for this population to mitigate risks². At present just six percent of orthopaedic surgeons are women³, with orthopaedics being noted as one of the least gender diverse medical specialities in the world⁴. With so few females specialising in the field, it makes me wonder if the pool of women in the studies are large enough to generate reliable results, and potentially cause a sampling bias.
As we see an increase of women joining the field, I’m sure researchers will get to the bottom of this apparent phenomenon “unique to orthopaedics”.
References:
1. Chou, Loretta B. MD; Johnson, Brianna MD; Shapiro, Lauren M. MD, MS; Pun, Stephanie MD; Cannada, Lisa K. MD; Chen, Antonia F. MD, MBA; Valone, Lindsey C. MD; Van Nortwick, Sara S. MD; Ladd, Amy L. MD; Finlay, Andrea K. PhD. Increased Prevalence of Breast and All-cause Cancer in Female Orthopaedic Surgeons. JAAOS: Global Research and Reviews: May 2022 - Volume 6 - Issue 5 - e22.00031 doi: 10.5435/JAAOSGlobal-D-22-00031
2. https://ortho.stanford.edu/news/cancer-in-female-orthopaedic-surgeons.html
3. https://www.motherjones.com/politics/2022/08/why-do-orthopedic-surgeons-have-such-high-breast-cancer-rates/