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Treatment Restarting After Discontinuation of Adjuvant Hormone Therapy in Breast Cancer Patients.

Abstract Over half of breast cancer patients discontinue their adjuvant hormone therapy, permanently or temporarily. We aimed to identify predictors of treatment restarting after discontinuation of adjuvant hormone therapy and to test the hypothesis that treatment restarting is associated with better breast cancer outcomes.
PMID
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Predictors of Discontinuation of Adjuvant Hormone Therapy in Patients With Breast Cancer.

Authors

Mayor MeshTerms
Keywords
Journal Title journal of the national cancer institute
Publication Year Start




PMID- 28423398
OWN - NLM
STAT- In-Process
DA  - 20170419
LR  - 20170419
IS  - 1460-2105 (Electronic)
IS  - 0027-8874 (Linking)
VI  - 109
IP  - 10
DP  - 2017 Oct 01
TI  - Treatment Restarting After Discontinuation of Adjuvant Hormone Therapy in Breast 
      Cancer Patients.
LID - 10.1093/jnci/djx041 [doi]
AB  - Background: Over half of breast cancer patients discontinue their adjuvant
      hormone therapy, permanently or temporarily. We aimed to identify predictors of
      treatment restarting after discontinuation of adjuvant hormone therapy and to
      test the hypothesis that treatment restarting is associated with better breast
      cancer outcomes. Methods: We conducted a population-based cohort study by linking
      data from the Stockholm-Gotland Breast Cancer Register, the Swedish Prescribed
      Drug Register, and a self-reported questionnaire. We followed women diagnosed
      with breast cancer (Stockholm, Sweden, 2005-2008) from their first prescription
      of tamoxifen or aromatase inhibitors through January 31, 2015, and categorized
      them as continuers (n = 1 607), restarters (n = 953), and nonrestarters (n = 511)
      of adjuvant hormone therapy. All statistical tests were two-sided. Results:
      Factors that decrease the likelihood of treatment restarting included younger age
      (<50 years), higher Charlson Comorbidity Score (>/=2), smaller tumor size (<20
      mm), human epidermal growth factor receptor 2 negative, lymph node negative,
      family history of breast cancer negative, using hormone therapy, using symptom
      relieving drugs, and switching therapy between tamoxifen and aromatase
      inhibitors. Restarting adjuvant hormone therapy was statistically significantly
      associated with prolonged disease-free survival, with an adjusted hazard ratio of
      0.61 (95% confidence interval = 0.43 to 0.87, P = .006) for restarters vs
      nonrestarters. Conclusions: Our study provides-for the first time to our
      knowledge-evidence that restarting adjuvant hormone therapy is associated with
      better breast cancer outcomes. Clinicians now have further evidence to encourage 
      patients to restart their treatment after discontinuation of adjuvant hormone
      therapy.
FAU - He, Wei
AU  - He W
AD  - Affiliations of authors: Department of Medical Epidemiology and Biostatistics
      (WH, FF, HO, PH, KC), Clinical Epidemiology Unit (KES), and Department of
      Oncology-Pathology (SM), Karolinska Institutet, Stockholm, Sweden; Department of 
      Oncology, South General Hospital, Stockholm, Sweden (SM, PH).
FAU - Smedby, Karin E
AU  - Smedby KE
AD  - Affiliations of authors: Department of Medical Epidemiology and Biostatistics
      (WH, FF, HO, PH, KC), Clinical Epidemiology Unit (KES), and Department of
      Oncology-Pathology (SM), Karolinska Institutet, Stockholm, Sweden; Department of 
      Oncology, South General Hospital, Stockholm, Sweden (SM, PH).
FAU - Fang, Fang
AU  - Fang F
AD  - Affiliations of authors: Department of Medical Epidemiology and Biostatistics
      (WH, FF, HO, PH, KC), Clinical Epidemiology Unit (KES), and Department of
      Oncology-Pathology (SM), Karolinska Institutet, Stockholm, Sweden; Department of 
      Oncology, South General Hospital, Stockholm, Sweden (SM, PH).
FAU - Olsson, Henrik
AU  - Olsson H
AD  - Affiliations of authors: Department of Medical Epidemiology and Biostatistics
      (WH, FF, HO, PH, KC), Clinical Epidemiology Unit (KES), and Department of
      Oncology-Pathology (SM), Karolinska Institutet, Stockholm, Sweden; Department of 
      Oncology, South General Hospital, Stockholm, Sweden (SM, PH).
FAU - Margolin, Sara
AU  - Margolin S
AD  - Affiliations of authors: Department of Medical Epidemiology and Biostatistics
      (WH, FF, HO, PH, KC), Clinical Epidemiology Unit (KES), and Department of
      Oncology-Pathology (SM), Karolinska Institutet, Stockholm, Sweden; Department of 
      Oncology, South General Hospital, Stockholm, Sweden (SM, PH).
FAU - Hall, Per
AU  - Hall P
AD  - Affiliations of authors: Department of Medical Epidemiology and Biostatistics
      (WH, FF, HO, PH, KC), Clinical Epidemiology Unit (KES), and Department of
      Oncology-Pathology (SM), Karolinska Institutet, Stockholm, Sweden; Department of 
      Oncology, South General Hospital, Stockholm, Sweden (SM, PH).
FAU - Czene, Kamila
AU  - Czene K
AD  - Affiliations of authors: Department of Medical Epidemiology and Biostatistics
      (WH, FF, HO, PH, KC), Clinical Epidemiology Unit (KES), and Department of
      Oncology-Pathology (SM), Karolinska Institutet, Stockholm, Sweden; Department of 
      Oncology, South General Hospital, Stockholm, Sweden (SM, PH).
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Natl Cancer Inst
JT  - Journal of the National Cancer Institute
JID - 7503089
EDAT- 2017/04/20 06:00
MHDA- 2017/04/20 06:00
CRDT- 2017/04/20 06:00
PHST- 2016/11/14 [received]
PHST- 2017/02/22 [accepted]
AID - 3114122 [pii]
AID - 10.1093/jnci/djx041 [doi]
PST - ppublish
SO  - J Natl Cancer Inst. 2017 Oct 1;109(10). doi: 10.1093/jnci/djx041.

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