Department of Oncology and Pathology, Karolinska Institute, Stockholm, Sweden.
Department of Oncology, Södersjukhuset, Stockholm, Sweden.
Cancer Rep (Hoboken). 2024 Aug;7(8):e2160. doi: 10.1002/cnr2.2160.
Women with newly diagnosed hormone receptor-positive breast cancer are offered adjuvant endocrine therapy (AET). Despite the survival benefits of the therapy, a significant proportion of breast cancer patients do not adhere to the anti-hormonal medication.
The purpose of this study was to analyse demographic, social, psychological and treatment-related factors influencing whether women diagnosed with early-stage breast cancer were adherent to offered therapy.
This was a long-term retrospective, medical record study, supplemented with a questionnaire, including 81 women. Data from the Swedish Prescribed Drug Register were used to examine adherence. The women were followed for 5 years of offered AET.
Out of 81 women, 67 (83%) were adherent (hade taken out 80% or more of the recommended dose), 10 (12%) were Partially Adherent and 4 (5%) never accepted AET. At baseline, the Never-Adherent group members were younger, more often considered themselves healthy and seemed much more satisfied with their lives. Baseline factors that positively affected adherence were satisfaction with the vocational situation (p = 0.023) and satisfaction with family life (p = 0.040). Cumulative musculoskeletal side effects were more frequently reported among women in the Adherent group than Partially Adherent women, after both 12 and 60 months (p = 0.018 and p = 0.011, respectively). There was also a significant difference in reported cumulative psychological side effects (p = 0.049) in disfavour of the Adherent group. Moreover, according to the questionnaire where the women retrospectively were asked which side effects, they experienced during the treatment period; sexual desire was significantly lower in the Adherent group (p = 0.0402) than in the Partially Adherent group.
It is important to consider a woman's life situation, to support those who otherwise would not be able to complete AET and to help all women relieve side effects during AET. It should be investigated why some women did not start the recommended therapy.
新诊断为激素受体阳性乳腺癌的女性可接受辅助内分泌治疗（AET）。尽管该治疗具有生存获益，但相当一部分乳腺癌患者并未坚持使用抗激素药物。
本研究旨在分析影响早期乳腺癌患者是否接受所提供治疗的人口统计学、社会心理和治疗相关因素。
这是一项长期回顾性病历研究，补充了包括 81 名女性的问卷。使用瑞典处方药物登记处的数据来检查依从性。这些女性接受了 5 年推荐剂量的 AET 治疗。
在 81 名女性中，67 名（83%）为依从者（服用了推荐剂量的 80%或以上），10 名（12%）为部分依从者，4 名（5%）从未接受过 AET。在基线时，从不接受 AET 的女性年龄更小，她们更常认为自己健康，对生活的满意度更高。对依从性产生积极影响的基线因素包括对职业状况的满意度（p=0.023）和对家庭生活的满意度（p=0.040）。在接受 AET 12 个月和 60 个月后，在报告累积肌肉骨骼副作用方面，依从组的女性比部分依从组的女性更频繁（p=0.018 和 p=0.011）。在报告累积心理副作用方面也存在显著差异（p=0.049），这对依从组不利。此外，根据女性在治疗期间回顾性报告的副作用问卷，在依从组中，性欲显著降低（p=0.0402），与部分依从组相比。
考虑女性的生活状况、支持那些否则无法完成 AET 的患者以及帮助所有女性缓解 AET 期间的副作用非常重要。应该调查为什么有些女性没有开始接受推荐的治疗。
