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4. Increasing use of post-mastectomy hypofractionated radiation therapy for breast cancer in Victoria

Author

Kim, S, Pitson, G, Koh, TL, Chao, M, Byrne, K, Hornby, C, Foroudi, F, Millar, J, Ong, WL, Kim, S, Pitson, G, Koh, TL, Chao, M, Byrne, K, Hornby, C, Foroudi, F, Millar, J, and Ong, WL

Abstract

INTRODUCTION: The aim of this study was to evaluate the use of post-mastectomy hypofractionationed radiation therapy (HFRT) for breast cancer in Victoria, Australia. METHODS: This is a population-based cohort of women with breast cancer who received post-mastectomy RT to the chest wall with or without nodal irradiation between 2012 and 2017. HFRT was defined as <25 fractions of RT. Data were captured in the Victorian Radiotherapy Minimum Dataset (VRMDS). The changing pattern of HFRT use was evaluated using the Cochran-Armitage test. Patient-, treatment- and institutional-related factors associated with HFRT use were evaluated using multivariable logistic regression. RESULTS: Two thousand and twenty-one women were included in this study, of which 238 (12%) received HFRT. This increased from 8% in 2012 to 18% in 2017 (P-trend < 0.001). Older women were more likely to have HFRT (26% in women above 70 years vs 6% in women under 50 years; P < 0.001). Women who did not have nodal irradiation were more likely to have HFRT than those who did (18% vs 9% respectively; P < 0.001). In multivariate analyses, the progressive increase in HFRT use over time remained statistically significant - women treated in 2017 were four times more likely to receive HFRT than those treated in 2012 (95% CI = 2.1-7.7; P < 0.001). Other factors independently associated with increased likelihood of HFRT use included increasing age at RT, and lack of nodal irradiation. CONCLUSION: In this first Australian study evaluating the use of post-mastectomy HFRT, we observed increasing HFRT use in Victoria over time. We anticipate this rising trend will continue in the coming years.

Published
2022

5. Circulating free testosterone and risk of aggressive prostate cancer: Prospective and Mendelian randomisation analyses in international consortia

Author

Watts, EL, Perez-Cornago, A, Fensom, GK, Smith-Byrne, K, Noor, U, Andrews, CD, Gunter, MJ, Holmes, M, Martin, RM, Tsilidis, KK, Albanes, D, Barricarte, A, Bueno-de-Mesquita, B, Chen, C, Cohn, BA, Dimou, NL, Ferrucci, L, Flicker, L, Freedman, ND, Giles, GG, Giovannucci, EL, Goodman, GE, Haiman, CA, Hankey, GJ, Huang, J, Huang, W-Y, Hurwitz, LM, Kaaks, R, Knekt, P, Kubo, T, Langseth, H, Laughlin, G, Le Marchand, L, Luostarinen, T, MacInnis, RJ, Maenpaa, HO, Mannisto, S, Metter, JE, Mikami, K, Mucci, LA, Olsen, AW, Ozasa, K, Palli, D, Penney, KL, Platz, EA, Rissanen, H, Sawada, N, Schenk, JM, Stattin, P, Tamakoshi, A, Thysell, E, Tsai, CJ, Tsugane, S, Vatten, L, Weiderpass, E, Weinstein, SJ, Wilkens, LR, Yeap, BB, Allen, NE, Key, TJ, Travis, RC, Watts, EL, Perez-Cornago, A, Fensom, GK, Smith-Byrne, K, Noor, U, Andrews, CD, Gunter, MJ, Holmes, M, Martin, RM, Tsilidis, KK, Albanes, D, Barricarte, A, Bueno-de-Mesquita, B, Chen, C, Cohn, BA, Dimou, NL, Ferrucci, L, Flicker, L, Freedman, ND, Giles, GG, Giovannucci, EL, Goodman, GE, Haiman, CA, Hankey, GJ, Huang, J, Huang, W-Y, Hurwitz, LM, Kaaks, R, Knekt, P, Kubo, T, Langseth, H, Laughlin, G, Le Marchand, L, Luostarinen, T, MacInnis, RJ, Maenpaa, HO, Mannisto, S, Metter, JE, Mikami, K, Mucci, LA, Olsen, AW, Ozasa, K, Palli, D, Penney, KL, Platz, EA, Rissanen, H, Sawada, N, Schenk, JM, Stattin, P, Tamakoshi, A, Thysell, E, Tsai, CJ, Tsugane, S, Vatten, L, Weiderpass, E, Weinstein, SJ, Wilkens, LR, Yeap, BB, Allen, NE, Key, TJ, and Travis, RC

Abstract

Previous studies had limited power to assess the associations of testosterone with aggressive disease as a primary endpoint. Further, the association of genetically predicted testosterone with aggressive disease is not known. We investigated the associations of calculated free and measured total testosterone and sex hormone-binding globulin (SHBG) with aggressive, overall and early-onset prostate cancer. In blood-based analyses, odds ratios (OR) and 95% confidence intervals (CI) for prostate cancer were estimated using conditional logistic regression from prospective analysis of biomarker concentrations in the Endogenous Hormones, Nutritional Biomarkers and Prostate Cancer Collaborative Group (up to 25 studies, 14 944 cases and 36 752 controls, including 1870 aggressive prostate cancers). In Mendelian randomisation (MR) analyses, using instruments identified using UK Biobank (up to 194 453 men) and outcome data from PRACTICAL (up to 79 148 cases and 61 106 controls, including 15 167 aggressive cancers), ORs were estimated using the inverse-variance weighted method. Free testosterone was associated with aggressive disease in MR analyses (OR per 1 SD = 1.23, 95% CI = 1.08-1.40). In blood-based analyses there was no association with aggressive disease overall, but there was heterogeneity by age at blood collection (OR for men aged <60 years 1.14, CI = 1.02-1.28; Phet = .0003: inverse association for older ages). Associations for free testosterone were positive for overall prostate cancer (MR: 1.20, 1.08-1.34; blood-based: 1.03, 1.01-1.05) and early-onset prostate cancer (MR: 1.37, 1.09-1.73; blood-based: 1.08, 0.98-1.19). SHBG and total testosterone were inversely associated with overall prostate cancer in blood-based analyses, with null associations in MR analysis. Our results support free testosterone, rather than total testosterone, in the development of prostate cancer, including aggressive subgroups.

Published
2022

7. Increased non‐melanoma skin cancer risk in young patients with inflammatory bowel disease on immunomodulatory therapy: a retrospective single‐centre cohort study

Author

Clowry, Julianne, Sheridan, Juliette, Healy, R., Deady, S., Keegan, Denise, Byrne, K., Cullen, Garret, Mulcahy, H., Comber, Harry, Parnell, Andrew, Doherty, Glen, Lally, Aoife, Clowry, Julianne, Sheridan, Juliette, Healy, R., Deady, S., Keegan, Denise, Byrne, K., Cullen, Garret, Mulcahy, H., Comber, Harry, Parnell, Andrew, Doherty, Glen, and Lally, Aoife

Published
2017

8. Increased non‐melanoma skin cancer risk in young patients with inflammatory bowel disease on immunomodulatory therapy: a retrospective single‐centre cohort study

Author

Clowry, J., primary, Sheridan, J., additional, Healy, R., additional, Deady, S., additional, Keegan, D., additional, Byrne, K., additional, Cullen, G., additional, Mulcahy, H., additional, Comber, H., additional, Parnell, A.C., additional, Doherty, G., additional, and Lally, A., additional

Published
2017
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22. Reply

Author

McFarlane, S. I., primary, Shin, J., additional, Byrne, K., additional, and Williams, R., additional

Published
2003
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40. CAROTID ARTERY ATHEROMA: ULTRASOUND APPEARANCE IN SYMPTOMATIC AND ASYMPTOMATIC VESSELS

Author

C M Steffen, Robert J. Lusby, Byrne K, and A. C. Gray-Weale

Subjects
Carotid Artery Diseases, Male, medicine.medical_specialty, Arteriosclerosis, medicine.medical_treatment, Endarterectomy, Asymptomatic, Duplex scanning, Carotid artery disease, Carotid atheroma, Carotid bifurcation, medicine, Humans, Prospective Studies, Prospective cohort study, Aged, Ultrasonography, business.industry, Ultrasound, General Medicine, Middle Aged, medicine.disease, Surgery, Carotid Arteries, cardiovascular system, Female, Radiology, medicine.symptom, business
Abstract

The distribution of carotid plaque ultrasound appearance has been evaluated using duplex ultrasound in symptomatic and asymptomatic patients. There were 134 patients with unilateral carotid territory symptoms who subsequently underwent endarterectomy of the symptomatic carotid bifurcation, and 92 asymptomatic patients. Both carotid bifurcations in all patients were examined, thus providing three groups of vessels for study: (i) asymptomatic vessels in asymptomatic patients (n = 184); (ii) asymptomatic vessels in symptomatic patients (n = 134); and (iii) asymptomatic contralateral vessels in symptomatic patients (n = 134). Ultrasound appearances were classified as types 1-4. This classification has previously been compared prospectively with endarterectomy specimen pathology where the more echolucent type 1 and 2 lesions correlated well with the presence of intraplaque haemorrhage or ulceration. In the symptomatic arteries, type 1 and 2 lesions were predominant, whereas in the asymptomatic patients the most common lesions were types 3 and 4. This difference was statistically significant (P less than 0.01). Evaluation of the asymptomatic contralateral vessel in the symptomatic patients showed a pattern of plaque type distribution between the other two groups.

Published
1989
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50. Alcohol intake and endogenous sex hormones in women: Meta-analysis of cohort studies and Mendelian randomization.

Author

Tin Tin S, Smith-Byrne K, Ferrari P, Rinaldi S, McCullough ML, Teras LR, Manjer J, Giles G, Le Marchand L, Haiman CA, Wilkens LR, Chen Y, Hankinson S, Tworoger S, Eliassen AH, Willett WC, Ziegler RG, Fuhrman BJ, Sieri S, Agnoli C, Cauley J, Menon U, Fourkala EO, Rohan TE, Kaaks R, Reeves GK, and Key TJ

Subjects
Adult, Female, Humans, Middle Aged, Alcohol Dehydrogenase genetics, Breast Neoplasms blood, Breast Neoplasms genetics, Breast Neoplasms metabolism, Cohort Studies, Cross-Sectional Studies, Estradiol blood, Estradiol metabolism, Postmenopause blood, Progesterone blood, Progesterone metabolism, Testosterone blood, Testosterone metabolism, Alcohol Drinking adverse effects, Alcohol Drinking blood, Alcohol Drinking metabolism, Gonadal Steroid Hormones blood, Gonadal Steroid Hormones metabolism, Mendelian Randomization Analysis, Premenopause blood, Sex Hormone-Binding Globulin metabolism, Sex Hormone-Binding Globulin analysis
Abstract

Background: The mechanisms underlying alcohol-induced breast carcinogenesis are not fully understood but may involve hormonal changes., Methods: Cross-sectional associations were investigated between self-reported alcohol intake and serum or plasma concentrations of estradiol, estrone, progesterone (in premenopausal women only), testosterone, androstenedione, dehydroepiandrosterone sulfate, and sex hormone binding globulin (SHBG) in 45 431 premenopausal and 173 476 postmenopausal women. Multivariable linear regression was performed separately for UK Biobank, European Prospective Investigation into Cancer and Nutrition, and Endogenous Hormones and Breast Cancer Collaborative Group, and meta-analyzed the results. For testosterone and SHBG, we also conducted Mendelian randomization and colocalization using the ADH1B (alcohol dehydrogenase 1B) variant (rs1229984)., Results: Alcohol intake was positively, though weakly, associated with all hormones (except progesterone in premenopausal women), with increments in concentrations per 10 g/day increment in alcohol intake ranging from 1.7% for luteal estradiol to 6.6% for postmenopausal dehydroepiandrosterone sulfate. There was an inverse association of alcohol with SHBG in postmenopausal women but a small positive association in premenopausal women. Two-sample randomization identified positive associations of alcohol intake with total testosterone (difference per 10 g/day increment: 4.1%; 95% CI, 0.6-7.6) and free testosterone (7.8%; 4.1-11.5), and an inverse association with SHBG (-8.1%; -11.3% to -4.9%). Colocalization suggested a shared causal locus at ADH1B between alcohol intake and higher free testosterone and lower SHBG (posterior probability for H4, 0.81 and 0.97, respectively)., Conclusions: Alcohol intake was associated with small increases in sex hormone concentrations, including bioavailable fractions, which may contribute to its effect on breast cancer risk., (© 2024 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.)

Published
2024
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