title: Predictors of Discontinuation of Adjuvant Hormone Therapy in Patients With Breast Cancer.
abstract: OBJECTIVE
  To identify predictors of discontinuation of adjuvant hormone therapy in patients with breast cancer.
  
  
  METHODS
  We conducted a record-linkage study based on data from Stockholm-Gotland Breast Cancer Register, Swedish Prescribed Drug Register, and self-reported questionnaire. Women diagnosed with breast cancer between 2005 and 2008 in Stockholm, Sweden, were prospectively followed for 5 years until 2013, starting from their first prescription of tamoxifen or aromatase inhibitors (N = 3,395).
  
  
  RESULTS
  Family history of ovarian cancer (hazard ratio [HR], 1.55; 95% CI, 1.19 to 2.02); younger (< 40 years; HR, 1.39; 95% CI, 1.08 to 1.78) and older (≥ 65 years; HR, 1.15; 95% CI, 1.03 to 1.28) age; higher Charlson comorbidity index (≥ 2 v 0; HR, 1.35; 95% CI, 1.03 to 1.76); and use of analgesics (HR, 1.33; 95% CI, 1.16 to 1.52), hypnotics/sedatives (HR, 1.24; 95% CI, 1.07 to 1.43), GI drugs (HR, 1.25; 95% CI, 1.08 to 1.43), and hormone replacement therapy (HR, 1.27; 95% CI, 1.08 to 1.49) were identified as baseline predictors for hormonal treatment discontinuation. Use of analgesics (HR, 1.22; 95% CI, 1.08 to 1.37), hypnotics/sedatives (HR, 1.21; 95% CI, 1.07 to 1.37), antidepressants (HR, 1.22; 95% CI, 1.06 to 1.40), or GI drugs (HR, 1.27; 95% CI, 1.13 to 1.43), and switching therapy between tamoxifen and aromatase inhibitors (HR, 1.50; 95% CI, 1.23 to 1.83) during the first year of hormonal treatment were associated with increased risk of discontinuation during the next 4 years.
  
  
  CONCLUSIONS
  Predictors identified in our study can be used in developing targeted intervention to prevent adjuvant hormone therapy discontinuation and subsequently to improve breast cancer outcomes.
authors.affiliation: Wei He, Fang Fang, Mikael Eriksson, Per Hall, Kamila Czene, Karolinska Institutet, Stockholm, Sweden; and Catherine Varnum, School of Medicine, University of Maryland, Baltimore, MD. wei.he@ki.se.
authors.forename: Wei
authors.initials: W
authors.lastname: He
authors.affiliation: Wei He, Fang Fang, Mikael Eriksson, Per Hall, Kamila Czene, Karolinska Institutet, Stockholm, Sweden; and Catherine Varnum, School of Medicine, University of Maryland, Baltimore, MD.
authors.forename: Fang
authors.initials: F
authors.lastname: Fang
authors.affiliation: Wei He, Fang Fang, Mikael Eriksson, Per Hall, Kamila Czene, Karolinska Institutet, Stockholm, Sweden; and Catherine Varnum, School of Medicine, University of Maryland, Baltimore, MD.
authors.forename: Catherine
authors.initials: C
authors.lastname: Varnum
authors.affiliation: Wei He, Fang Fang, Mikael Eriksson, Per Hall, Kamila Czene, Karolinska Institutet, Stockholm, Sweden; and Catherine Varnum, School of Medicine, University of Maryland, Baltimore, MD.
authors.forename: Mikael
authors.initials: M
authors.lastname: Eriksson
authors.affiliation: Wei He, Fang Fang, Mikael Eriksson, Per Hall, Kamila Czene, Karolinska Institutet, Stockholm, Sweden; and Catherine Varnum, School of Medicine, University of Maryland, Baltimore, MD.
authors.forename: Per
authors.initials: P
authors.lastname: Hall
authors.affiliation: Wei He, Fang Fang, Mikael Eriksson, Per Hall, Kamila Czene, Karolinska Institutet, Stockholm, Sweden; and Catherine Varnum, School of Medicine, University of Maryland, Baltimore, MD.
authors.forename: Kamila
authors.initials: K
authors.lastname: Czene
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects / Q000627:therapeutic use*; D047072:Aromatase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D017024:Chemotherapy, Adjuvant; D015897:Comorbidity; D011307:Drug Prescriptions; D057915:Drug Substitution; D065171:Estrogen Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000235:genetics; D019338:Polypharmacy; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D013629:Tamoxifen / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal; D047072:Aromatase Inhibitors; D065171:Estrogen Receptor Antagonists; D013629:Tamoxifen