title: Target and reality of adjuvant endocrine therapy in postmenopausal patients with invasive breast cancer.
abstract: Previous research evaluating the use of adjuvant endocrine therapy among postmenopausal breast cancer patients showed with 15-50% wide ranges of non-adherence rates. We evaluated this issue by analysing an unselected study group comprising of 325 postmenopausal women, diagnosed from 1997 to 2003 with hormonal receptor-positive invasive breast cancer. The different clinical situations that led to the discontinuation of adjuvant endocrine therapy were clearly defined and differentiated: non-adherence was not simply the act of stopping medication, but rather the manifestation of an intentional behaviour of the patient. Of the 287 patients who initiated endocrine therapy, 191 (66.6%) fully completed this treatment. Thirty-one patients (10.8%) showed non-adherence to therapy. Patients who had follow-up with a general practitioner, rather than in an oncologic unit, were more likely to be non-adherent (P=0.0088). Of 25 patients who changed medication due to therapy-related adverse effects, 20 (80%) patients fully completed the therapy after drug change. In adjuvant endocrine therapy, a lowering of the non-adherence rate to 10.8%, the lowest reported in the literature, is realistic when patients are cared for by a specialised oncologic unit focusing on the individual needs of the patients.
authors.affiliation: Department of Gynaecology and Obstetrics, University Hospital Basel, Spitalstrasse 21, Basel CH-4031, Switzerland. ugueth@uhbs.ch
authors.forename: U
authors.initials: U
authors.lastname: Güth
authors.forename: D J
authors.initials: DJ
authors.lastname: Huang
authors.forename: A
authors.initials: A
authors.lastname: Schötzau
authors.forename: R
authors.initials: R
authors.lastname: Zanetti-Dällenbach
authors.forename: W
authors.initials: W
authors.lastname: Holzgreve
authors.forename: J
authors.initials: J
authors.lastname: Bitzer
authors.forename: E
authors.initials: E
authors.lastname: Wight
mesh_terms: D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010349:Patient Compliance; D017698:Postmenopause; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D013629:Tamoxifen / Q000627:therapeutic use*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D013629:Tamoxifen