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. 2012 Nov;8(6):e149-57.
doi: 10.1200/JOP.2012.000543. Epub 2012 Jul 17.

Patient-reported discontinuation of endocrine therapy and related adverse effects among women with early-stage breast cancer

Erin J Aiello Bowles  1 , Denise M Boudreau, Jessica Chubak, Onchee Yu, Monica Fujii, Janet Chestnut, Diana S M Buist
Affiliations

Patient-reported discontinuation of endocrine therapy and related adverse effects among women with early-stage breast cancer

Erin J Aiello Bowles et al. J Oncol Pract. 2012 Nov.

Abstract

Background: Approximately 20% to 50% of women diagnosed with hormone receptor-positive breast cancer discontinue endocrine therapy early; most reports come from automated pharmacy data or small self-report evaluations. We conducted a larger self-report evaluation of endocrine therapy discontinuation associated with patient characteristics and therapy-related adverse effects.

Methods: We surveyed 538 women from a single health plan who were diagnosed with early-stage breast cancer from 2002 to 2008 and received endocrine therapy. Women reported adverse effects and reasons for discontinuation via mailed survey; tumor characteristics were obtained via registry linkage. We classified women as discontinuers if they self-reported stopping therapy and their self-reported duration of tamoxifen plus aromatase inhibitor (AI) use was < 5 years, and nondiscontinuers if they self-reported ≥ 5 years use or current use. We estimated odds ratios (ORs) with 95% CIs for discontinuation versus continuation by using logistic regression adjusted for age and year of diagnosis.

Results: Among 538 women, 98 (18.2%) discontinued endocrine therapy early. Women with positive lymph nodes (v negative) were significantly less likely to discontinue therapy (odds ratio [OR] = 0.54; 95% CI, 0.31 to 0.93). Almost all women (94%) experienced adverse effects. Experiencing headaches was associated with discontinuation of AIs (OR = 4.16; 95% CI, 2.16 to 8.01) and tamoxifen (OR = 2.34; 95% CI, 1.24 to 4.41); few other individual adverse effects were related to discontinuation despite most discontinuers reporting they "did not like adverse effects" (AIs: 66.7%, tamoxifen: 59.1%).

Conclusion: Few individual adverse effects or patient characteristics were significantly associated with endocrine therapy discontinuation, yet adverse effects were prevalent and were the most common reason women reported for discontinuing therapy.

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References

    1. Carlson RW, Hudis CA, Pritchard KI, et al. Adjuvant endocrine therapy in hormone receptor-positive postmenopausal breast cancer: Evolution of NCCN, ASCO, and St Gallen recommendations. J Natl Compr Canc Netw. 2006;4:971–979. - PubMed
    1. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology v. 2.2011, breast cancer. www.nccn.org/professionals/physician_gls/pdf/breast.pdf. - PubMed
    1. Eisen A, Trudeau M, Shelley W, et al. Aromatase inhibitors in adjuvant therapy for hormone receptor positive breast cancer: A systematic review. Cancer Treat Rev. 2008;34:157–174. - PubMed
    1. Buzdar AU, Coombes RC, Goss PE, et al. Summary of aromatase inhibitor clinical trials in postmenopausal women with early breast cancer. Cancer. 2008;112:700–709. - PubMed
    1. Owusu C, Buist DS, Field TS, et al. Predictors of tamoxifen discontinuation among older women with estrogen receptor–positive breast cancer. J Clin Oncol. 2008;26:549–555. - PubMed

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