Adjuvant endocrine therapy non-initiation and non-persistence in young women with early-stage breast cancer

Rosenberg, Shoshana M.; Zheng, Yue; Gelber, Shari; Ruddy, Kathryn J.; Poorvu, Philip D.; Sella, Tal; Tamimi, Rulla M.; Wassermann, Johanna; Schapira, Lidia; Borges, Virginia F.; Come, Steven E.; Peppercorn, Jeffrey; Sepucha, Karen; Partridge, Ann H.

doi:10.1007/s10549-022-06810-1

Cited by 7 publications

(2 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Exposure to adjuvant chemotherapy has in some studies been identified as a negative predictor of adherence in early BC in women younger than 40 years of age. 25 Other studies have instead shown that it is a positive predictor of adherence. 9 However, in line with our study, several studies have not been able to show an association between adjuvant chemotherapy and adherence.…”

Section: Discussionmentioning

confidence: 99%

Follow-up Routines Matter for Adherence to Endocrine Therapy in the Adjuvant Setting of Breast Cancer

Aurell,

Haidar,

Giglio

2024

Breast Cancer�(Auckl)

View full text Add to dashboard Cite

Background: Endocrine therapy (ET) adherence leads to increased survival in breast cancer (BC). How follow-up should be done to maximize adherence is not known. Objectives: To assess adherence to ET, factors favouring adherence to ET and effects on survival in a population-based cohort of BC patients in western Sweden. Design: This is a retrospective study. Methods: We included 358 patients operated for oestrogen receptor-positive BC and recommended 5 years of ET, in Region Halland, Sweden, year 2015 to 2016. Demographical, clinical and pathological data and use of ET were retrieved from the electronic medical records. Patients were considered adherent if taking ET for 5 years or during the full extent of the follow-up, until termination of ET due to BC relapse or death and where renewals of prescriptions of ET covered ⩾80% of the ordinated dose. Two follow-up routines were employed, ie, routine A where patients were contacted annually by nurses and a more passive follow-up routine B where patients were only contacted by nurses at 2 years and 5 years following start of ET. Results: Medication persistence for 4 years and more was good and similar between patients initiating aromatase inhibitor (AI) and tamoxifen (75.7% and 72.0%, respectively, P = .43). More patients initiating AIs changed ET due to side effects compared with patients initiating tamoxifen (24.3% vs 9.9%, respectively, P < .0001). Endocrine therapy adherence was better for follow-up routine B than for follow-up routine A (hazard ratio [HR] = 2.71 [1.44-5.09], P = .0027). Conclusions: Adherence to ET in BC is high in Western Sweden. Less regular nurse-initiated contacts between BC patients and nursesled surprisingly to a better adherence than a more regular nurse-initiated contact.

show abstract

Section: Discussionmentioning

confidence: 99%

Follow-up Routines Matter for Adherence to Endocrine Therapy in the Adjuvant Setting of Breast Cancer

Aurell,

Haidar,

Giglio

2024

Breast Cancer�(Auckl)

View full text Add to dashboard Cite

show abstract

“…However, data from multiple contexts and settings have shown that ET adherence is sub-optimal, with up to 50% of people not taking ET as prescribed at five years [ 1 , 2 ]. Non-adherence is more prevalent in Black patients [ 3 ] and people younger than 50 years old [ 4 ], and prior research has demonstrated that the barriers to adherence are multifaceted and distributed differentially in these sub-populations [ 1 ]. Patient-level factors associated with ET non-adherence in observational studies include the poor management of ET-related side effects, the lack of belief in treatment efficacy, less access to ET refills [ 5 ], poor communication, and the lack of shared decision-making with providers.…”

Section: Introductionmentioning

confidence: 99%

Motivational Interviewing Counseling to Increase Endocrine Therapy Adherence in Diverse Patients

Wheeler

Spencer²,

Drier

et al. 2023

Cancers

View full text Add to dashboard Cite

Background: Oral endocrine therapy (ET) is an inexpensive and effective therapy for hormone receptor-positive (HR+) breast cancer that prevents recurrence but relies upon long-term adherence for up to ten years. More than 80% of breast cancer patients have an HR+ phenotype and are candidates for ET, but approximately half discontinue or become non-adherent by five years. ET underuse is more prevalent in Black and young (<50 yrs) women, which may contribute to outcome disparities in these groups. The objective of this study was to evaluate the feasibility, acceptability, and utility of a patient-centered counseling intervention to enhance ET adherence, with a focus on the needs of Black and younger women. Methods: We conducted a single-arm pilot study of a twelve-month motivational interviewing (MI) intervention consisting of five MI counseling sessions, an interactive workbook, a resource guide, and an educational video developed and revised with iterative patient and clinician input. The eligible participants were >18 years old, English speaking, and with stage I–III HR+ breast cancer. Participants were recruited across a large academic medical center and four community sites. Feasibility and acceptability were assessed by measures of participant recruitment, retention, session participation, and patient-reported satisfaction. ET adherence at 12 months was assessed by self-report and medication event monitoring system (MEMS) caps using a continuous measure of the proportion of days covered (PDC) as well as a dichotomous measure of the optimal adherence, defined as >80% PDC. Results: Forty-two women initiated the intervention, of whom thirty-five participants (83%) completed outcome assessments at 12 months, including thirteen Black and twenty-two non-Black participants. The average participant age was 54.8 years (range: 25–73). Overall, 97% completed at least three MI sessions and 83% completed at least four sessions. Participant retention and satisfaction were high, particularly among Black women. Self-reported adherence at 12 months was 88% overall (100% in Black women and 81% in non-Black women). The majority of women also achieved 80% of days adherent using MEMS caps, with a greater adherence in Black women. Conclusions: This study demonstrates the feasibility, acceptability, and early promise of the effectiveness of an MI counseling-based intervention to promote ET adherence and prevent breast cancer recurrence in diverse populations.

show abstract

Hormone Receptor Positive Breast Cancer in Young Women: A Review

McShane,

Zaborowski,

O'Reilly

et al. 2024

Journal of Surgical Oncology

View full text Add to dashboard Cite

The global incidence of hormone‐positive breast cancer (HR+ BC) in young women is rising, though the underlying reasons remain unclear. HR+ disease in younger women appears to represent a distinct clinical entity compared to that in older women, exhibiting distinct clinicopathological characteristics, outcomes and responses to treatment. Despite these differences, there is a paucity of large‐volume data focusing on young women with HR+ in contemporary literature. Hormone receptor positive breast cancer in young women is associated with poorer prognoses compared to older women. Additionally, early age onset breast cancer presents unique challenges, including concerns related to fertility, the toxic effects of therapeutic agents, and specific surgical considerations. The purpose of this review is to report the existing literature on HR+ disease in young women.

show abstract

Adjuvant endocrine therapy non-initiation and non-persistence in young women with early-stage breast cancer

Cited by 7 publications

References 33 publications

Follow-up Routines Matter for Adherence to Endocrine Therapy in the Adjuvant Setting of Breast Cancer

Follow-up Routines Matter for Adherence to Endocrine Therapy in the Adjuvant Setting of Breast Cancer

Motivational Interviewing Counseling to Increase Endocrine Therapy Adherence in Diverse Patients

Hormone Receptor Positive Breast Cancer in Young Women: A Review

Contact Info

Product

Resources

About