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. 2019 Jan 31;17(1):24.
doi: 10.1186/s12916-019-1252-6.

Discontinuation of adjuvant hormone therapy among breast cancer patients not previously attending mammography screening

Wei He  1 , Louise Eriksson  2   3 , Sven Törnberg  4 , Fredrik Strand  2   5 , Per Hall  2   6 , Kamila Czene  2
Affiliations

Discontinuation of adjuvant hormone therapy among breast cancer patients not previously attending mammography screening

Wei He et al. BMC Med. .

Abstract

Background: Breast cancer patients who have not previously attended mammography screening may be more likely to discontinue adjuvant hormone therapy and therefore have a worse disease prognosis.

Methods: We conducted a population-based cohort study using data from Stockholm Mammography Screening Program, Stockholm-Gotland Breast Cancer Register, Swedish Prescribed Drug Register, and Swedish Cause of Death Register. Women in Stockholm who were diagnosed with breast cancer between 2001 and 2008 were followed until December 31, 2015. Non-participants of mammography screening were defined as women who, prior to their breast cancer diagnosis, were invited for mammography screening but did not attend.

Results: Of the 5098 eligible breast cancer patients, 4156 were defined as screening participants and 942 as non-participants. Compared with mammography screening participants, non-participants were more likely to discontinue adjuvant hormone therapy, with an adjusted hazard ratio (HR) of 1.30 (95% CIs, 1.11 to 1.53). Breast cancer patients not participating in mammography screening were also more likely to have worse disease-free survival, even after adjusting for tumor characteristics and other covariates (adjusted HR 1.22 (95% CIs, 1.05 to 1.42 for a breast cancer event).

Conclusions: Targeted interventions to prevent discontinuation of adjuvant hormone therapy are needed to improve breast cancer outcomes among women not attending mammography screening.

Keywords: Breast cancer; Discontinuation of adjuvant hormone therapy; Disease-free survival; Mammography screening.

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Conflict of interest statement

Ethics approval and consent to participate

All patients who participated in the questionnaire survey provided written informed consent. This study was approved by the Regional Ethical Review Board in Stockholm, Sweden (Approval number: 2009/254-31/4, 2011/2010-32).

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart of study participants
Fig. 2
Fig. 2
Tumor characteristics of women diagnosed with breast cancer in Stockholm, Sweden, 2001–2008. a Screening non-participants vs participants. b Screening non-participants vs participants diagnosed with screen-detected cancers. c Screening non-participants vs participants diagnosed with interval cancers. *p < 0.05 for comparison between the groups
Fig. 3
Fig. 3
Discontinuation of adjuvant hormone therapy (left column) and breast cancer events (right column) in women diagnosed with breast cancer in Stockholm, Sweden, 2001–2008. a Screening non-participants vs participants. b Screening non-participants vs participants diagnosed with screen-detected cancers. c Screening non-participants vs participants diagnosed with interval cancers
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References

    1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65(2):87–108. doi: 10.3322/caac.21262. - DOI - PubMed
    1. The National Board of Health and Welfare . Statistics on causes of death 2015 [in Swedish] Stockholm: Socialstyrelsen; 2016.
    1. Siu AL, Force USPST Screening for breast cancer: U.S. preventive services task force recommendation statement. Ann Intern Med. 2016;164(4):279–296. doi: 10.7326/M15-2886. - DOI - PubMed
    1. Tabar L, Fagerberg CJ, Gad A, Baldetorp L, Holmberg LH, Grontoft O, Ljungquist U, Lundstrom B, Manson JC, Eklund G, et al. Reduction in mortality from breast cancer after mass screening with mammography. Randomised trial from the Breast Cancer Screening Working Group of the Swedish National Board of Health and Welfare. Lancet. 1985;1(8433):829–832. doi: 10.1016/S0140-6736(85)92204-4. - DOI - PubMed
    1. Nystrom L, Andersson I, Bjurstam N, Frisell J, Nordenskjold B, Rutqvist LE. Long-term effects of mammography screening: updated overview of the Swedish randomised trials. Lancet. 2002;359(9310):909–919. doi: 10.1016/S0140-6736(02)08020-0. - DOI - PubMed

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