Sayaka Kuba1,2, Mayumi Ishida3, Yoshiaki Nakamura3, Kenichi Taguchi4, Shinji Ohno3. 1. Department of Breast Oncology, National Hospital Organization, Kyushu Cancer Center, Kyushu, Japan. sayaka20041123@yahoo.co.jp. 2. Department of Surgery, Nagasaki University, 1-7-1 Sakamoto-machi, Nagasaki, Nagasaki, 852-8501, Japan. sayaka20041123@yahoo.co.jp. 3. Department of Breast Oncology, National Hospital Organization, Kyushu Cancer Center, Kyushu, Japan. 4. Department of Pathology, National Hospital Organization, Kyushu Cancer Center, Kyushu, Japan.
Abstract
AIMS: Although 8-73 % of breast cancer patients who receive adjuvant endocrine therapy discontinue it, discontinuation is little studied in Asian breast cancer patients. MATERIALS AND METHODS: To determine frequency and reasons for discontinuation at a single institution, we reviewed records and database information for women with hormone receptor-positive breast cancer who were treated at the National Kyushu Cancer Center 2001-2006, defining "persistence" as continued endocrine treatment (even when physicians decided to stop because of recurrent disease or severe adverse effects), and "discontinuation" as ending therapy due to patient's wishes. RESULTS: Among 686 patients who started adjuvant endocrine therapy, 607 patients (88 %) persisted, 79 patients (12 %) discontinued. Of the 79 patients who discontinued, 37 (46 %) did so because of side effects, 26 (33 %) stopped appointments, 11 (14 %) stopped for "no particular reason", 4 (5 %) to get pregnant, and 1 (1 %) for economic reasons. The rate of persistence was higher in patients with lymph node involvement than in those without lymph node involvement (92 vs. 87 %; P = 0.03). CONCLUSIONS: Clinicians should discuss side effects with patients, both as part of informed consent and to prepare them to continue therapy, and should be aware that over time, patients' reasons for discontinuation change.
AIMS: Although 8-73 % of breast cancerpatients who receive adjuvant endocrine therapy discontinue it, discontinuation is little studied in Asian breast cancerpatients. MATERIALS AND METHODS: To determine frequency and reasons for discontinuation at a single institution, we reviewed records and database information for women with hormone receptor-positive breast cancer who were treated at the National Kyushu Cancer Center 2001-2006, defining "persistence" as continued endocrine treatment (even when physicians decided to stop because of recurrent disease or severe adverse effects), and "discontinuation" as ending therapy due to patient's wishes. RESULTS: Among 686 patients who started adjuvant endocrine therapy, 607 patients (88 %) persisted, 79 patients (12 %) discontinued. Of the 79 patients who discontinued, 37 (46 %) did so because of side effects, 26 (33 %) stopped appointments, 11 (14 %) stopped for "no particular reason", 4 (5 %) to get pregnant, and 1 (1 %) for economic reasons. The rate of persistence was higher in patients with lymph node involvement than in those without lymph node involvement (92 vs. 87 %; P = 0.03). CONCLUSIONS: Clinicians should discuss side effects with patients, both as part of informed consent and to prepare them to continue therapy, and should be aware that over time, patients' reasons for discontinuation change.
Entities:
Keywords:
Adjuvant endocrine therapy; Breast cancer; Discontinuation
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