Impact of non-adherence to endocrine therapy on recurrence risk in older women with stage I breast cancer after breast-conserving surgery
- 16.06.2023
- Epidemiology
Erschienen in:
- Verfasst von
- Danielle Rodin
- Rinku Sutradhar
- Katarzyna J. Jerzak
- Ezra Hahn
- Lena Nguyen
- Matthew Castelo
- Omolara Fatiregun
- Cindy Fong
- Danilo Giffoni M. M. Mata
- Sabina Trebinjac
- Lawrence Paszat
- Eileen Rakovitch
- Erschienen in
- Breast Cancer Research and Treatment | Ausgabe 1/2023
Abstract
Purpose
We examined the impact of non-adherence to adjuvant endocrine therapy (ET) on the risk and site of recurrence among older women with early stage, hormone receptor positive (HR+) breast cancer (EBC).
Methods
A population-based cohort of women age ≥ 65 years with T1N0 HR + EBC who were diagnosed between 2010 and 2016 and treated with breast-conserving surgery (BCS) + ET was identified. Treatment and outcomes were ascertained through linkage with administrative databases. ET non-adherence was examined as a time-dependent covariate in multivariable cause-specific Cox regression models to evaluate its effect on the risks of ipsilateral local recurrence (LR), contralateral breast cancer, and distant metastases.
Results
The population cohort includes 2637 women; 73% (N = 1934) received radiation (RT) + ET and 27% (N = 703) received ET alone. At a median follow-up of 8.14 years, the first event was LR in 3.6% of women treated with ET alone and 1.4% for those treated with RT + ET (p < 0.001); the risk of distant metastases was < 1% in both groups. The proportion of time adherent to ET was 69.0% among those treated with RT + ET and 62.8% for those treated with ET alone. On multivariable analysis, increasing proportion of time non-adherent to ET was associated with increased risk of LR ((HR = 1.52 per 20% increase in time; 95%CI 1.25, 1.85; p < 0.001), contralateral BC (HR = 1.55; 95%CI 1.30, 1.84; p < 0.001), and distant metastases (HR = 1.44; 95%CI 1.08, 1.94; p = 0.01) but absolute risks were low.
Conclusion
Non-adherence to adjuvant ET was associated with an increased risk of recurrence, but absolute recurrence rates were low.
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- Titel
- Impact of non-adherence to endocrine therapy on recurrence risk in older women with stage I breast cancer after breast-conserving surgery
- Verfasst von
-
Danielle Rodin
Rinku Sutradhar
Katarzyna J. Jerzak
Ezra Hahn
Lena Nguyen
Matthew Castelo
Omolara Fatiregun
Cindy Fong
Danilo Giffoni M. M. Mata
Sabina Trebinjac
Lawrence Paszat
Eileen Rakovitch
- Publikationsdatum
- 16.06.2023
- Verlag
- Springer US
- Erschienen in
-
Breast Cancer Research and Treatment / Ausgabe 1/2023
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217 - DOI
- https://doi.org/10.1007/s10549-023-06989-x
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