Many Breast Cancer Patients Don't Adhere to Therapy
Half aren't fully adherent to hormonal therapy; younger women at high risk of non-adherence
WEDNESDAY, June 30 (HealthDay News) -- Only half of hormone-sensitive stage I to III breast cancer patients prescribed adjuvant hormonal therapy adhere to that therapy for the full duration at the optimal schedule, and younger women in particular are at high risk of non-adherence, according to a study published online June 28 in the Journal of Clinical Oncology.
Dawn L. Hershman, M.D., of the Columbia University Medical Center in New York City, and colleagues evaluated 8,769 women diagnosed with hormone-sensitive stage I to III breast cancer from 1996 to 2007 who filled at least one prescription for tamoxifen (43 percent), aromatase inhibitors (26 percent), or both (30 percent) within one year of diagnosis.
The researchers found that earlier discontinuation of hormone therapy was linked to younger or older age, presence of comorbidities, and lumpectomy. However, completion of 4.5 years of therapy was associated with Asian race, being married, earlier year at diagnosis, receipt of chemotherapy or radiotherapy, and longer prescription refill interval. Women under 40 years of age demonstrated the highest risk of discontinuation (hazard ratio, 1.51). After 4.5 years, 32 percent of women had discontinued therapy. Of women who continued therapy, 72 percent were fully adherent. In total, just 49 percent of the patients continued therapy and took medications in the prescribed fashion through 4.5 years.
"Further investigation is warranted to determine the association between non-adherence to hormonal therapy and breast cancer-specific mortality. Ultimately, interventions need to be defined to help such patients comply with the full course of adjuvant hormonal therapy," the authors conclude.