Patient and provider factors associated with the noninitiation of tamoxifen for young women at high-risk for the development of breast cancer

We sought to identify factors associated with disparities in tamoxifen utilization among young patients at high- risk for developing breast cancer. We identified 67 premenopausal, high- risk women age 35- 45, without surgical prophylaxis, who did not initiate tamoxifen. Factors associated with noninitiation were examined. About 37% of patients had no documented provider- based discussion regarding initiation. Type of high- risk diagnosis was the only factor associated with a provider- based discussion (P = .03). For patients offered tamoxifen, primary reasons for noninitiation were perceived minimal benefit (66.7%), fertility concerns (16.7%), and concerns about side effects (7.1%). Implementation of comprehensive educational strategies regarding the benefits of tamoxifen should be facilitated to improve initiation among young high- risk patients.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154627/1/tbj13528_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154627/2/tbj13528.pd

Patient and provider factors associated with the noninitiation of tamoxifen for young women at high-risk for the development of breast cancer

We sought to identify factors associated with disparities in tamoxifen utilization among young patients at high- risk for developing breast cancer. We identified 67 premenopausal, high- risk women age 35- 45, without surgical prophylaxis, who did not initiate tamoxifen. Factors associated with noninitiation were examined. About 37% of patients had no documented provider- based discussion regarding initiation. Type of high- risk diagnosis was the only factor associated with a provider- based discussion (P = .03). For patients offered tamoxifen, primary reasons for noninitiation were perceived minimal benefit (66.7%), fertility concerns (16.7%), and concerns about side effects (7.1%). Implementation of comprehensive educational strategies regarding the benefits of tamoxifen should be facilitated to improve initiation among young high- risk patients.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154627/1/tbj13528_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154627/2/tbj13528.pd