Adherence to endocrine therapy for breast cancer
Abstract
Purpose: Despite the demonstrated efficacy of long-duration adjuvant tamoxifen and aromatase inhibitor use in breast cancer management, information on adherence to such therapy is limited. Therefore, we reviewed the published literature regarding hormonal therapy adherence in clinical trial and practice settings. Methods: A systematic search of the PubMed database, augmented by a review of manuscript references and conference proceedings, commonly identified adherence reports in clinical trials but identified only 9 adherence reports in clinical practice settings. Results: In adjuvant breast cancer clinical trials with longer (≧4 years) follow-up, hormonal therapy (tamoxifen or aromatase inhibitors) was prematurely discontinued by about 23–28% of the study participants. Adherence to aromatase inhibitors did not differ from adherence to tamoxifen in this setting. In breast cancer prevention trials, tamoxifen was prematurely discontinued by 20–46% of the participants. In clinical practice settings, only 2 reports addressed longer-duration (>4 years) adherence to adjuvant tamoxifen use. In these, tamoxifen was prematurely discontinued by 30–50% of the patients. Conclusion: Adherence to prescribed breast cancer hormone therapy has not received concerted attention. Current, albeit limited, evidence suggests long-term hormone therapy adherence may represent an area limiting optimal breast cancer patient treatment.
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There is no gold standard for measuring adherence because of accuracy limitations of assessment methods.
“Due to the accuracy limitations of the methods to assess adherence (e.g., self-report, pill counts, pharmacy records, medical records, electronic medication caps),11 there is no gold standard for measuring adherence.12-14”
From Behavioral interventions to enhance adherence to hormone therapy in breast cancer survivors: a systematic literature review (2016) · cites this paper as [11]
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- Authors
- Chlebowski, R. T., & Geller, M. L.
- Affiliations
- The Lundquist Institute (US)
- ORCID
- Chlebowski, Rowan T.
- Venue
- Oncology
- Publisher
- S. Karger AG
- Published
- 2006
- Volume
- 71
- Issue
- 1-2
- Pages
- 1-9
- ISSN
- 0030-2414 (ISSN-L)
- 1423-0232
- OpenAlex
- W1540562253
- Cited by
- 251
- References
- 50
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 9 · 2023: 6 · 2022: 8 · 2021: 7 · 2020: 4 · 2019: 7 · 2018: 6 · 2017: 9 · 2016: 12 · 2015: 9 · 2014: 21 · 2013: 14 · 2012: 22
- FWCI
- 3.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Oncology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- AstraZeneca
- 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
- medication adherence, breast cancer, adjuvant endocrine therapy, tamoxifen, aromatase inhibitors, premature discontinuation, Breast Cancer Prevention Trial
- MeSH terms
- Administration, Oral, Breast Neoplasms, Clinical Trials as Topic, Female, Humans, Patient Compliance, Tamoxifen, Antineoplastic Agents, Hormonal, Aromatase Inhibitors
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