Breast (Oct 2024)

Factors influencing 5-year persistence to adjuvant endocrine therapy in young women with breast cancer

  • Eleonora Pagan,
  • Monica Ruggeri,
  • Nadia Bianco,
  • Eraldo Oreste Bucci,
  • Rossella Graffeo,
  • Markus Borner,
  • Monica Giordano,
  • Lorenzo Gianni,
  • Manuela Rabaglio,
  • Andrea Freschi,
  • Elisabetta Cretella,
  • Elena Seles,
  • Alberto Farolfi,
  • Edda Simoncini,
  • Mariangela Ciccarese,
  • Daniel Rauch,
  • Adolfo Favaretto,
  • Friedemann Honecker,
  • Rossana Berardi,
  • Alessandra Franzetti-Pellanda,
  • Shari Gelber,
  • Ann H. Partridge,
  • Aron Goldhirsch,
  • Vincenzo Bagnardi,
  • Olivia Pagani,
  • Karin Ribi

Journal volume & issue
Vol. 77
p. 103765

Abstract

Read online

Purpose: Although younger age has been negatively associated with persistence to adjuvant endocrine therapy (ET), factors contributing to non-persistence remain poorly understood. We assessed factors associated with non-persistence to ET and described the 5-year trajectories of quality of life (QoL) and symptoms in young women (≤40 years) with hormone receptor-positive breast cancer (BC). Methods: We retrieved data on clinical characteristics and non-persistence from the medical annual records in the European cohort of the “Helping Ourselves, Helping Others: The Young Women's BC Study” (IBCSG 43-09 HOHO). Women completed surveys at baseline, biannually for three years, and annually for another seven years. Data collection included sociodemographic information, QoL aspects assessed by the Cancer Rehabilitation Evaluation System-Short Form and symptoms assessed by the Breast Cancer Prevention Trial symptom scales. Cox regression models were applied to identify factors associated with non-persistence. Results: The cumulative risk of interrupting ET within 5 years was 27.7 % (95 % CI, 21.5–35.2). The QoL subscale scores remained stable over 5 years, with slight improvements in the physical subscale. Hot flashes decreased (p < 0.001), while vaginal problems intensified (p < 0.001) over time. Being married without children and having difficulties interacting and communicating with the medical team were significantly associated with non-persistence. Conclusions: Discussing the desire to conceive with partnered childless women and establishing a good relationship with the medical team may be important in addressing the non-persistence in young BC survivors. As recent data suggests the safety of pausing ET to conceive, this approach may be a reasonable future option to limit non-persistence.

Keywords