Dr. James co-authors article in Journal of Bone & Joint Surgery

Dr. Michelle James is co-author of an article published in the November 2016 issue of The Journal of Bone and Joint Surgery that examines why female orthopaedic surgeons have higher rates of breast cancer than the general population.

Breast Radiation Exposure in Female Orthopaedic Surgeons is the title of the article that details the results of a study conducted at the University of California, San Francisco (UCSF). Dr. James, Chief of Orthopaedic Surgery at Shriners Hospitals for Children — Northern California, collaborated with UCSF surgeons Dr. Lindsey C. Valone and Dr. Lisa Lattanza on the study.

The study was conceived by Dr. Valone when she was a medical student and worked at Shriners Hospital with Dr. James through a grant administered through the UC Davis Clinical and Translational Sciences Center. The study began when Dr. Valone was an orthopaedic resident at UCSF and did a rotation at the Northern California Shriners Hospital.

“The research was motivated by the desire to find out why female orthopaedic surgeons are at a higher risk of developing breast cancer,” said Dr. James. “We know that exposure to radiation contributes to the risk of cancer, so we asked what could make a surgeon more vulnerable to exposure,” she added.

The study focused on three factors:

  • the size of the protective apron worn during surgery;
  • the position of the surgeon; and
  • the position of the C-arm during surgery.

A mannequin was used to simulate a surgeon using fluoroscopic radiation during a simulated surgery. Results showed the mannequin received more radiation to the part of the breast that is most susceptible to cancer, when the protective lead apron did not fit properly.

In their article, the three orthopaedic surgeons outline several steps that should be taken to reduce exposure to radiation during surgery. Recommendations include:

  • Wearing properly fitted lead aprons or vests;
  • Increasing the distance between the surgeon and the x-ray source;
  • Positioning the x-ray source beneath the operating table;
  • Educating surgeons about radiation safety.

Shriners Hospitals for Children is devoted to transforming the lives of children through excellence in treatment, teaching and research.  Located at 2425 Stockton Boulevard in Sacramento, Shriners Hospitals for Children – Northern California provides care to children with orthopaedic conditions, spinal cord injuries, burns, cleft lip, scars from any cause and other complex surgical needs. There are no barriers to care as admission is based on age and diagnosis.   Care is provided regardless of the family’s ability to pay. For further information call (916) 453-2000.


Media Contact:  Catherine Curran | Public Relations (916) 453-2218 | ccurran@shrinenet.org

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