Noncompliance with adjuvant radiation, chemotherapy, or hormonal therapy in breast cancer patients

Am J Surg. 2008 Oct;196(4):500-4. doi: 10.1016/j.amjsurg.2008.06.027.

Abstract

Introduction: There is little information on patient-driven noncompliance of adjuvant therapies and its consequences.

Methods: This retrospective study compares clinical, pathological features and outcomes of breast cancer patients who were compliant to recommended radiation, chemotherapy, and hormonal therapies to those who were noncompliant.

Results: Noncompliance rates for chemotherapy, radiation, and tamoxifen were 31 of 421 (7%), 30 of 855 (4%), and 294 of (37%) respectively. Old age was associated with noncompliance to chemotherapy and radiation, but younger women tend to be more often noncompliant to tamoxifen. Noncompliance with chemotherapy or radiation did not significantly affect 5-year local and distant disease-free survival rates. Noncompliance with tamoxifen was associated with decreased 5-year local and distant disease-free survivals (87% versus 96%, 76% versus 87%, respectively, P < .001).

Conclusion: Noncompliance with tamoxifen is the most common, resulting in significantly increased risk of local and distant disease recurrence.

MeSH terms

  • Age Factors
  • Antineoplastic Agents, Hormonal / administration & dosage
  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy*
  • Chemotherapy, Adjuvant
  • Chi-Square Distribution
  • Combined Modality Therapy
  • Female
  • Humans
  • Mastectomy, Segmental
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Patient Acceptance of Health Care
  • Patient Compliance*
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Tamoxifen / administration & dosage*

Substances

  • Antineoplastic Agents, Hormonal
  • Tamoxifen