Abstract
BackgroundAdherence to long-term adjuvant hormonal therapy in hormonal receptors (HR)-positive breast cancer is really challenging and can affect the survival outcome. The present study aims to assess rate of compliance with hormonal therapy and possible predictive factors in a single institute in Saudi Arabia.Patients &methodsWe recruited patients with HR-positive breast cancer who presented to oncology outpatient clinics. Patients were assessed for compliance using a study questionnaire. Compliance was defined as taking ≥80% of prescribed doses of oral hormonal therapy. Different epidemiological, clinical, pathological and treatment data were checked in patients’ medical records and correlated with compliance/interruption of hormonal therapy.ResultsAmong the 203 recruited patients, 95.1% were compliant with hormonal therapy, while it was interrupted in 16.7% of patients, and 58.1% reported missing intake of hormonal pills. Age >50 years, having permanent job and higher education level were significantly associated with non-compliance in univariate analysis. On multivariate analysis, job status was the only independent predictor of non-compliance. The following parameters were significantly related to hormonal therapy interruption: marital status (single: 28.8% vs married patients: 12.6%, p = 0.01) and residence location (Makkah: 11.7% vs. outside Makkah: 25.3%, p = 0.019), lymphovascular invasion (LVI) (No: 20.9%, Yes: 7.8%, p = 0.025) and N0 tumours (compared to node-positive patients, p = 0.008). On multivariate analysis, marital status, residence location and N-stage, maintained significance relation with hormonal therapy interruption.ConclusionCompliance with hormonal therapy was high in the study cohort. Marital status, residence location, job status and N-stage may be related to interruption/compliance with hormonal therapy.
Highlights
Adherence to long-term adjuvant hormonal therapy in hormonal receptors (HR)-positive breast cancer is really challenging and can affect the survival outcome
The present study aims to assess compliance to adjuvant hormonal therapy in HR-positive breast cancer patients treated in oncology centre, King Abdullah Medical City, Makkah, Saudi Arabia in addition to checking different factors associated with compliance/interruption of adjuvant hormonal therapy
We recruited patients with HR-positive breast cancer who presented to oncology outpatient clinics at King Abdullah Medical City, Makkah, Saudi Arabia within 6 months from time of study approval by the institutional review board
Summary
Breast cancer is the most common cancer among females worldwide and it ranks first among female cancers in Saudi Arabia [1,2]. Adjuvant hormonal therapy should continue for at least five years and even, several trials demonstrated improved survival outcome with extended adjuvant hormonal therapy beyond 5 years [3,4,5,6,7,8]. Given the long-term duration over years, compliance to hormonal therapy is a critical issue and several studies had reported compromised survival outcome in patients with poor compliance less than 80% of the intended dose of hormonal therapy [10]. The present study aims to assess compliance to adjuvant hormonal therapy in HR-positive breast cancer patients treated in oncology centre, King Abdullah Medical City, Makkah, Saudi Arabia in addition to checking different factors associated with compliance/interruption of adjuvant hormonal therapy
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