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American Society of Clinical Oncology, Journal of Clinical Oncology, 15_suppl(38), p. e12510-e12510, 2020

DOI: 10.1200/jco.2020.38.15_suppl.e12510

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Endocrine therapy adherence of premenopausal Mexican breast cancer patients.

This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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Abstract

e12510 Background: Among premenopausal women with breast cancer (BC), adherence to endocrine therapy (ET) has often been reported suboptimal due to age-related adverse effects, lack of understandable information and inadequate social support. The current increased use of ovarian function suppression (OFS) may lead to even lower adherence rates in this group due to its high adverse effects profile. This study aims to assess the extent to which premenopausal patients comply with ET and to identify factors that hinder optimal adherence in Mexico. Methods: Women aged ≤50 years with primary stage I-III hormone receptor-positive BC receiving adjuvant ET for ≥1year were invited to fill a survey regarding their attitude towards ET and self-reported adherence. Fisher’s exact test was used to explore associations between categorical variables. This study was funded by AstraZeneca Mexico. Results: From Sep 2019 to Jan 2020, 127 patients with a median age of 45 years (range: 25-50) were included. Most had at least high school education (64%) and were unemployed (61%). ET distribution was: 69% tamoxifen (TMX) alone; 2% TMX switch to aromatase inhibitor (AI); 29% OFS plus TMX/AI. All patients recognized ET as a necessary part of their treatment and 97% believed it reduced their recurrence risk, yet 14% considered they had not received enough information about ET. Adverse effects were reported by 98%, predominantly hot flashes (82%), arthralgias (59%) and fatigue (58%). A statistically significant higher proportion of patients treated with a switch strategy or OFS experienced hot flashes, headache, insomnia, decreased libido and dyspareunia than those with TMX alone. Only 59% claimed their physician had taken measures to reduce these symptoms. Overall, 93% reported complete ET adherence. Nonetheless, 22% of them subsequently acknowledged missing 1-6 doses in the last month, the most common reasons being forgetfulness (78%), adverse effects (27%) and unwillingness to take the medication (11%). Unemployed patients were more likely to report daily compliance than students/employees (79% vs 60%; p = 0.02). No significant differences in adherence were found according to other factors, including type of ET. Conclusions: Premenopausal Mexican women self-report remarkably high rates of ET adherence. However, a considerable proportion misses ≥1 doses/month, with forgetfulness as the most common cause particularly in students/employees. Interventions aimed at reminding this group to take their ET and managing adverse effects could be crucial to improve adherence and, consequently, disease outcomes.