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Breast Cancer Research and Treatment

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01-01-2021 | Insomnia | Preclinical study

Predictors of increased risk for early treatment non-adherence to oral anti-estrogen therapies in early-stage breast cancer patients

Authors: Miryam Yusufov, Margo Nathan, Aleta Wiley, Julia Russell, Ann Partridge, Hadine Joffe

Published in: Breast Cancer Research and Treatment | Issue 1/2021

Abstract

Purpose

Non-adherence to the oral anti-estrogen therapies (AET) tamoxifen and aromatase inhibitors in early-stage hormone receptor-positive breast cancer is associated with numerous negative clinical outcomes. Prior studies have identified that non-adherence is associated with psychological and menopause-related factors which are present during AET, but the presence of these characteristics prior to AET initiation has not been investigated.

Methods

Psychological and menopause symptoms (depression, generalized anxiety, insomnia, somatosensory amplification, hot flash frequency, and hot flash-related interference) were assessed pre-AET initiation as predictors of subsequent non-adherence in 73 participants (M_age = 55.0, SD = 10.1 years). Participants self-reported treatment adherence after three and 6 weeks on AET. Participants who did not initiate treatment were excluded from the analysis.

Results

Discriminant function analyses revealed that the hypothesized set of psychological and menopause symptoms at baseline (pre-AET) together statistically distinguished between those who were non-adherent (n = 19; 26.0%) from adherent (n = 54; 74.0%) at 6 weeks. Model classification accuracy was statistically significant (Wilks’ ƛ = 0.782, χ²(6) = 15.50, p = 0.017) at the 6-week timepoint. Results were consistent at 3 weeks. Pre-AET psychological and menopause symptoms correctly classified 6-week treatment adherence 77.9% of the time. Depression contributed most to distinguishing between adherers and non-adherers.

Conclusions

The presence of a composite profile of psychological and menopause symptoms prior to AET initiation may help to identify early treatment non-adherence. Results can be used to identify patients at risk for non-adherence and to guide psychological and symptom management interventions.

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Title: Predictors of increased risk for early treatment non-adherence to oral anti-estrogen therapies in early-stage breast cancer patients
Authors: Miryam Yusufov
Margo Nathan
Aleta Wiley
Julia Russell
Ann Partridge
Hadine Joffe
Publication date: 01-01-2021
Publisher: Springer US
Keywords: Insomnia
Mood Disorders
Breast Cancer
Generalised Anxiety Disorder
Affective Disorder
Breast Cancer
Anxiety
Tamoxifen
Estrogens
Published in: Breast Cancer Research and Treatment / Issue 1/2021
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-020-05920-y

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Abstract

Purpose

Methods

Results

Conclusions

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