BMI

Radiation and body mass index, are your overweight patients more at risk? astudy looking at radiation doses during intervention for renal tract calculi (2020)

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Type of publication:
Conference abstract

Author(s):
Lefroy R.; Johnson A.; McCrea J.; *Dunk S.; *Elves A.

Citation:
British Journal of Surgery; Jun 2020; vol. 107 ; p. 226-227

Abstract:
Aim: Renal tract stones are more common in overweight individuals as part of metabolic syndrome. Modern fluoroscopic devices used during ureteroscopy adjust exposure, providing high imaging quality. Consequently, total radiation doses in this group is increased compared to patients with lower BMIs. Patients with obesity and stone disease will potentially be exposed to more radiation, increasing the risk of developing malignancy. We assessed the radiation doses that our stone population received during fluoroscopic ureteroscopic procedures and how this varied with BMI.
Method(s): 62 consecutive patients undergoing fluoroscopic ureteroscopic laser procedures were identified between March and August 2018, ten of these were uretorenoscopies and were therefore excluded from analysis. Radiation exposure was corrected for dose/unit time and BMI was defined by criteria set by NHS Choices.
Result(s): There was significant association between BMI and radiation exposure as measured does/unit time. The exposure for those with the highest BMI was up to four times that of the lowest BMI.
Conclusion(s): Fluoroscopy in patients with high BMI should seek to limit radiation exposure. This could be achieved by use of snap imaging and ureteroscopy under direct vision where appropriate. Consideration of radiation exposure should be given within the consent process especially when compared to alternative therapies.

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Elevated BMI Significantly increases recurrence rate of Breast Cancer; a district general hospital experience (2019)

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Type of publication:
Poster presentation

Author(s):
*Blossom Lake, *Albert Mansoor, *Donna Appleton

Citation:
British Journal Surgery; September 2019; Vol 106(S5), p.20 (Poster presentation at Association of Surgeons of Great Britain May 2019)

Abstract:
Aims: Excess body weight has been shown to be a risk factor for breast cancer recurrence. The aim of this study was to evaluate the effect of BMI on recurrence rate of Breast cancer in Shropshire.
Methods: Retrospective analysis of Somerset Database of all new breast cancers diagnosed from January 2012 to December 2012 at the Shrewsbury & Telford NHS Trust. Clinical portal and pre-op database were used to obtain patient demographics including BMI and recurrence rate. Excluded patients from analysis: no surgery performed, or operated at another hospital. Overall recurrence rate, local recurrence, distant metastasis rate and 5 year disease free survival (DFS) were compared for 3 groups: BMI< 25, overweight; 25.1-29.9,and obese; >30.
Results: 498 new breast cancers were diagnosed in 2012, of these 132 were excluded as per criteria. 366 records were analysed; 40 patients had recurrent breast cancer 10.9%. 97.5% of recurrent patients had one or more prognostic factor, size> 3cm, node positive or Grade 3, with no significant difference between BMI groups for adverse prognostic factors. Overall Recurrence rate for BMI <25 was 5.9%, this was significantly higher in BMI> 25, 13.3% p<0.05.BMI Overall Recurrence rate Local recurrence Distant Metastasis rate 5 year DFS<25 5.9% 0.8% 5.9% 94.1% Overweight 14.4% 4.2% 10.2% 85.6% Obese 12.3% 2.3% 11.5% 87.7%
Conclusion: Our experience suggests a significant increase in Breast Cancer recurrence with increasing BMI. Further studies are needed to clarify this and whether methods of reducing BMI may improve disease free survival

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