PURPOSE: To identify predictors of discontinuation of adjuvant hormone therapy in
patients with breast cancer. PATIENTS AND METHODS: We conducted a record-linkage
study based on data from Stockholm-Gotland Breast Cancer Register, Swedish
Prescribed Drug Register, and self-reported questionnaire. Women diagnosed with
breast cancer between 2005 and 2008 in Stockholm, Sweden, were prospectively
followed for 5 years until 2013, starting from their first prescription of
tamoxifen or aromatase inhibitors (N = 3,395). RESULTS: Family history of ovarian
cancer (hazard ratio [HR], 1.55; 95% CI, 1.19 to 2.02); younger (< 40 years; HR,
1.39; 95% CI, 1.08 to 1.78) and older (>/= 65 years; HR, 1.15; 95% CI, 1.03 to
1.28) age; higher Charlson comorbidity index (>/= 2 v 0; HR, 1.35; 95% CI, 1.03
to 1.76); and use of analgesics (HR, 1.33; 95% CI, 1.16 to 1.52),
hypnotics/sedatives (HR, 1.24; 95% CI, 1.07 to 1.43), GI drugs (HR, 1.25; 95% CI,
1.08 to 1.43), and hormone replacement therapy (HR, 1.27; 95% CI, 1.08 to 1.49)
were identified as baseline predictors for hormonal treatment discontinuation.
Use of analgesics (HR, 1.22; 95% CI, 1.08 to 1.37), hypnotics/sedatives (HR,
1.21; 95% CI, 1.07 to 1.37), antidepressants (HR, 1.22; 95% CI, 1.06 to 1.40), or
GI drugs (HR, 1.27; 95% CI, 1.13 to 1.43), and switching therapy between
tamoxifen and aromatase inhibitors (HR, 1.50; 95% CI, 1.23 to 1.83) during the
first year of hormonal treatment were associated with increased risk of
discontinuation during the next 4 years. CONCLUSION: Predictors identified in our
study can be used in developing targeted intervention to prevent adjuvant hormone
therapy discontinuation and subsequently to improve breast cancer outcomes.Swedish Research CouncilSwedish Cancer SocietyFORTESwedish Society of Medical Research (SSMF)Accepte
