Early discontinuation of tamoxifen intake in younger women with breast cancer: is it time to rethink the way it is prescribed?
Open accessAbstract
Background Tamoxifen is the main recommended adjuvant hormonal treatment for premenopausal women with hormone-responsive early breast cancer. Little data is available on compliance and persistence to tamoxifen intake in younger women.Methods Using the French National Health Insurance System database, we constituted a cohort of 288 women who were diagnosed with breast cancer and received at least one supply of tamoxifen for breast cancer between September 2005 and July 2011. Medical records and mailed questionnaires provided complementary sources of data. Time to treatment discontinuation and associated predictors were studied using techniques for censored data.Results Among women who received a prescription of tamoxifen, 6.1% (16) did not fill any prescription. After 2 years of tamoxifen intake, 29.7% (95%confidence interval (CI) 24.1-36.4) had discontinued their treatment; after 3 years this percentage increased to 39.5% (95% CI 32.9-47.0). The risk of treatment discontinuation rose sharply during the 1st year of treatment and remained approximately constant in the second year. After multivariate adjustment, tamoxifen discontinuation increased significantly with low social support (Hazard Ratio (HR) = 2.1; 95%CI 1.2-3.4), and self-reporting of non-compliance behaviour (HR = 2.2; 95% CI 1.3-3.7).Conclusion The consequences of high treatment discontinuation rates in younger women with long potential life expectancy may be significant. There is an urgent need to acknowledge and tackle compliance issues in the field of oncology, unless we are willing to accept inefficient prescriptions of efficacious drugs.
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Social support is associated with higher adherence in a meta-analysis with various medical conditions and in several adjuvant hormonal therapy studies with breast cancer survivors.
“Social support has also been associated with higher adherence in a meta-analysis with various medical conditions46 and in several adjuvant hormonal therapy studies with breast cancer survivors.16, 17, 47”
From Behavioral interventions to enhance adherence to hormone therapy in breast cancer survivors: a systematic literature review (2016) · cites this paper as [46]
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- Authors
- Huiart, L., Bouhnik, A.-D., Rey, D., Tarpin, C., Cluze, C., Bendiane, M. K., Viens, P., & Giorgi, R.
- Affiliations
- Inserm (FR)
- Institut Paoli-Calmettes (FR)
- Aix-Marseille Université (FR)
- ORCID
- Venue
- European Journal of Cancer
- Publisher
- Elsevier BV
- Published
- 2012-09
- Volume
- 48
- Issue
- 13
- Pages
- 1939-1946
- ISSN
- 0959-8049 (ISSN-L)
- OpenAlex
- W2039736503
- Cited by
- 97
- References
- 36
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 4 · 2023: 6 · 2022: 9 · 2021: 6 · 2020: 8 · 2019: 9 · 2018: 4 · 2017: 5 · 2016: 10 · 2015: 11 · 2014: 8 · 2013: 9 · 2012: 2
- FWCI
- 8.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Journal of Cancer (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Association pour la Recherche sur le Cancer
- National Institute for Health and Care Research
- Institut National de la Santé et de la Recherche Médicale
- Fondation de France
- Institut National Du Cancer
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- tamoxifen, treatment discontinuation, medication adherence, early breast cancer, premenopausal women, adjuvant endocrine therapy, social support, medication non-adherence, young women
- MeSH terms
- Adult, Age Factors, Breast Neoplasms, Female, France, Humans, Patient Compliance, Population Surveillance, Social Support, Tamoxifen, Time Factors, Chemotherapy, Adjuvant, Premenopause, Antineoplastic Agents, Hormonal
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