title: Medication use trajectories of postmenopausal breast cancer survivors and matched cancer-free controls.
abstract: While adverse medical sequelae are associated with breast cancer therapies, information on breast cancer impact on medication use is limited. Therefore, we compared medication use before and after diagnosis of early stage breast cancer to medication use in matched, cancer-free controls. Of 68,132 Women's Health Initiative participants, 3726 were diagnosed with breast cancer and, after exclusions, in 1731 breast cancer cases, medication use before and >3 years after diagnosis (mean 5.3 ± 2.1 SD) was compared to use in 1731 cancer-free matched controls on similar inventory dates. The medication category number at follow-up inventory was the primary study outcome. Medication category use (n, mean, SD) was comparable at baseline and significantly increased at follow-up in both cases (2.48 ± 1.66 vs. 4.15 ± 2.13, baseline vs follow-up, respectively, P < .0001) and controls (2.44 ± 1.67 vs. 3.95 ± 2.13, respectively, P < .0001), with clinically marginal but statistically significant additional medication category use by cases (0.20 ± 2.40, P < .0001). Tamoxifen users used somewhat more selected medication categories at follow-up assessment (mean 3.40 ± 1.89 vs. 3.21 ± 1.99, respectively, P = 0.05), while aromatase inhibitor users used more medication categories (mean 4.85 ± 2.10 vs. 4.44 ± 1.94, respectively, P = 0.02). No increase in medication category was seen in cases who were not current endocrine therapy users. Breast cancer survivors having only a clinically marginal increase in medication use compared to cancer-free controls. These findings highlight the importance of incorporation of control populations in studies of cancer survivorship.
authors.affiliation: Harbor-UCLA Medical Center, Torrance, CA, USA.
authors.forename: Kathy
authors.initials: K
authors.lastname: Pan
authors.affiliation: Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center, 1124 W. Carson St., Torrance, CA, 90502, USA. rowanchlebowski@gmail.com.
authors.forename: Rowan T
authors.initials: RT
authors.lastname: Chlebowski
authors.affiliation: Karmanos Cancer Institute at Wayne State Universit, Detroit, MI, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Simon
authors.affiliation: Fred Hutchinson Cancer Research Center Division of Public Health Sciences, Seattle, WA, USA.
authors.forename: Roberta M
authors.initials: RM
authors.lastname: Ray
authors.affiliation: University of California at San Francisco, San Francisco, CA, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Livaudais-Toman
authors.affiliation: MedStar Washington Hospital Center, Washington, DC, USA.
authors.forename: Shannon D
authors.initials: SD
authors.lastname: Sullivan
authors.affiliation: Stanford Prevention Research Center, Stanford, CA, USA.
authors.forename: Marcia L
authors.initials: ML
authors.lastname: Stefanick
authors.affiliation: University of Iowa College of Public Health, Iowa City, IA, USA.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Wallace
authors.affiliation: Brigham and Women's Hospital, Boston Harvard Medical School, Boston, MA, USA.
authors.forename: Meryl
authors.initials: M
authors.lastname: LeBoff
authors.affiliation: Brigham and Women's Hospital, Boston Harvard Medical School, Boston, MA, USA.
authors.forename: Elizabeth Carhart
authors.initials: EC
authors.lastname: Bluhm
authors.affiliation: The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
authors.forename: Electra D
authors.initials: ED
authors.lastname: Paskett
mesh_terms: D000368:Aged; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D017741:Survivors; D013629:Tamoxifen / Q000627:therapeutic use*
chemical_list: D047072:Aromatase Inhibitors; D013629:Tamoxifen
keywords: Breast cancer; Comorbidity; Control group; Medication; Survivorship; Women’s Health Initiative