title: Noncompliance with adjuvant radiation, chemotherapy, or hormonal therapy in breast cancer patients.
abstract: BACKGROUND
  There is little information on patient-driven noncompliance of adjuvant therapies and its consequences.
  
  
  METHODS
  This retrospective study compares clinical, pathological features and outcomes of breast cancer patients who were compliant to recommended radiation, chemotherapy, and hormonal therapies to those who were noncompliant.
  
  
  RESULTS
  Noncompliance rates for chemotherapy, radiation, and tamoxifen were 31 of 421 (7%), 30 of 855 (4%), and 294 of (37%) respectively. Old age was associated with noncompliance to chemotherapy and radiation, but younger women tend to be more often noncompliant to tamoxifen. Noncompliance with chemotherapy or radiation did not significantly affect 5-year local and distant disease-free survival rates. Noncompliance with tamoxifen was associated with decreased 5-year local and distant disease-free survivals (87% versus 96%, 76% versus 87%, respectively, P < .001).
  
  
  CONCLUSIONS
  Noncompliance with tamoxifen is the most common, resulting in significantly increased risk of local and distant disease recurrence.
authors.affiliation: Department of Surgery, St. Luke's-Roosevelt Hospital Center, 1111 Amsterdam Ave, Mu 2, Section D, New York, NY 10025, USA. atma@chpnet.org
authors.forename: Aye Moe Thu
authors.initials: AM
authors.lastname: Ma
authors.forename: Julie
authors.initials: J
authors.lastname: Barone
authors.forename: Ashley E
authors.initials: AE
authors.lastname: Wallis
authors.forename: Nancy Jade
authors.initials: NJ
authors.lastname: Wu
authors.forename: Luiza Baez
authors.initials: LB
authors.lastname: Garcia
authors.forename: Alison
authors.initials: A
authors.lastname: Estabrook
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Rosenbaum-Smith
authors.forename: Paul Ian
authors.initials: PI
authors.lastname: Tartter
mesh_terms: D000367:Age Factors; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013629:Tamoxifen / Q000008:administration & dosage*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen