Study Of Adherence To Endocrine Therapy In Premenopausal Breast Cancer Patients

Objective: Breast cancer is the most common cancer among women in the world by now.The outcomes of breast cancer has been dramatically improved by the comprehensive treatment including endocrine therapy.It will take about 5 to 10 years for endocrine therapy,so it is crucial for the patients to adhere to the doctor's advice.Many evidences have published by foreign studies convinced that the outcomes of breast cancer patients was associated with the adherence of them.The patients with good adherence behavior have significantly lower risk of recurrence and mortality than the non-adherencers.Currently,domestic studies in this aspect are on the stage of start,few databased studies have published.The aim of the study is to investigate and access the adherence to endocrine therapy of premenopausal breast cancer patients,and discuss the influence factors on it,finally to help the future clinical work.Methods: Premenopausal patients with a confirmed hormonal receptor positive breast cancer diagnosed in the Breast Cancer Center of Fourth Hospital of Hebei Medical University from January 2010 to December 2011 were selected form the database.Their data are completed including clinical characteristics,therapeutic process,and follow-up data.We evaluated the adherence of taking pills by telephone and face-to-face using the questionnaire,learned the status quo of premenopausal patients' adherence,and analyzed the relative factors with adherence by statistical test(chi-square test).Results: The patients who should take endocrine therapy are 1493 totally from January 2010 to December 2011.They were all confirmed that the hormone receptor was positive.We spent six months on investigating from April to October,2016.330 patients were lost to follow-up and 112 died,10 refused to answer questions.1041 patients were successfully followed up.565 patients were premenopausal,54.3% of all,and 411 patients were defined as good adherence out of them.The samples are divided into different subgroups by relevant factors.We compared the compliance of each subgroup,and got the conclusion by statistical analysis.The results showed that the adherence ratio was 72.7%(411/565)of all premenopausal breast cancer patients.The adherence of taking pills was associated with occupation(P=0.028),drug side effects(P<0.001),perception on disease and the degree of attention on self-health(P<0.001).Conclusion: Among premenopausal hormone receptor positive breast cancer women treated by endocrine therapy,only 72.7% of them is good to adhere.And the rates of adherence gradually declined year by year.The side-effects of drug will reduce the adherence to endocrine therapy.And treatment interruptions were associated with a lack of awareness about recurrence risk and insufficient aware of self-health.Besides peasantry patients have lower adherence than nonfarm patients.The other factors have no relationship with the adherence including age,residential area,education,financial status,health insurance,chronic disease,surgical method,pathological stage,molecular subtyping,etc.This study has not proved the correlation between recurrence and adherence.