title: Persistence and discontinuation of adjuvant endocrine therapy in women with breast cancer.
abstract: OBJECTIVE
  Although 8-73 % of breast cancer patients who receive adjuvant endocrine therapy discontinue it, discontinuation is little studied in Asian breast cancer patients.
  
  
  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.
authors.affiliation: Department of Breast Oncology, National Hospital Organization, Kyushu Cancer Center, Kyushu, Japan. sayaka20041123@yahoo.co.jp.|Department of Surgery, Nagasaki University, 1-7-1 Sakamoto-machi, Nagasaki, Nagasaki, 852-8501, Japan. sayaka20041123@yahoo.co.jp.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Kuba
authors.affiliation: Department of Breast Oncology, National Hospital Organization, Kyushu Cancer Center, Kyushu, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Ishida
authors.affiliation: Department of Breast Oncology, National Hospital Organization, Kyushu Cancer Center, Kyushu, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Department of Pathology, National Hospital Organization, Kyushu Cancer Center, Kyushu, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Taguchi
authors.affiliation: Department of Breast Oncology, National Hospital Organization, Kyushu Cancer Center, Kyushu, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Ohno
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D047072:Aromatase Inhibitors / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D002277:Carcinoma / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data*; D015331:Cohort Studies; D016527:Drug Costs; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D007564:Japan; D008198:Lymph Nodes / Q000473:pathology; D008408:Mastectomy; D008875:Middle Aged; D009367:Neoplasm Staging; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012189:Retrospective Studies; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D007987:Gonadotropin-Releasing Hormone; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D020845:Selective Estrogen Receptor Modulators; C508053:ERBB2 protein, human
keywords: Adjuvant endocrine therapy; Breast cancer; Discontinuation