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Adjuvant endocrine therapy non-initiation and non-persistence in young women with early-stage breast cancer.
- Source :
-
Breast cancer research and treatment [Breast Cancer Res Treat] 2023 Feb; Vol. 197 (3), pp. 547-558. Date of Electronic Publication: 2022 Nov 27. - Publication Year :
- 2023
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Abstract
- Purpose: Characterizing oral adjuvant endocrine therapy (ET) non-initiation and non-persistence in young women with breast cancer can inform strategies to improve overall adherence in this population.<br />Methods: We identified 693 women with hormone receptor-positive, stage I-III breast cancer enrolled in a cohort of women diagnosed with breast cancer at age ≤ 40 years. Women were classified as non-initiators if they did not report taking ET in the 18 months after diagnosis. Women who initiated but did not report taking ET subsequently (through 5-year post-diagnosis) were categorized as non-persistent. We assessed ET decision-making and used logistic regression to identify factors associated with non-initiation/non-persistence and to evaluate the association between non-persistence and recurrence.<br />Results: By 18 months, 9% had not initiated ET. Black women had higher odds and women with a college degree had lower odds of non-initiation. Among 607 women who initiated, 20% were non-persistent. Younger age, being married/partnered, and reporting more weight problems were associated with higher odds of non-persistence; receipt of chemotherapy and greater hot flash and vaginal symptom burden were associated with lower odds of non-persistence. Adjusting for age and clinical characteristics, non-persistence was associated with lower odds of recurrence. Women who initiated were more likely to report shared decision-making than non-initiators (57% vs. 38%, p = 0.049), while women who were non-persistent were less likely to indicate high confidence with the decision than women who were persistent (40% vs. 63%, p < 0.001).<br />Conclusion: Interventions to improve ET decision-making may facilitate initiation and address barriers to adherence in young breast cancer survivors.<br />Trial Registration: www.<br />Clinicaltrials: gov , NCT01468246.<br /> (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Details
- Language :
- English
- ISSN :
- 1573-7217
- Volume :
- 197
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Breast cancer research and treatment
- Publication Type :
- Academic Journal
- Accession number :
- 36436128
- Full Text :
- https://doi.org/10.1007/s10549-022-06810-1