scholarly journals Understanding the impact of breast cancer adjuvant endocrine therapy on cognitive function: a work in progress

2016 ◽  
Vol 114 (9) ◽  
pp. 953-955 ◽  
Author(s):  
Patricia A Ganz
2016 ◽  
Vol 1 (2) ◽  
pp. 111-120 ◽  
Author(s):  
Eleonora Mioranza ◽  
Cristina Falci ◽  
Maria Vittoria Dieci ◽  
Valentina Guarneri ◽  
Pierfranco Conte

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6605-6605 ◽  
Author(s):  
Jennifer Michelle Duff ◽  
Hui Yan ◽  
Myron Chang ◽  
Eric Rosenberg ◽  
Karen Colleen Daily

6605 Background: Adjuvant endocrine therapy for hormone receptor positive breast cancer is essential to decreasing recurrence and improving survival. However, adherence to these drugs has been reported to be suboptimal, the impact of which on breast cancer outcomes is unknown. Multiple non-modifiable risk factors have been associated with nonadherence. Identifying patients’ self-reported reasons for not taking these drugs as prescribed may be crucial to improving adherence. Methods: We obtained data from 49 women prescribed tamoxifen, letrozole, anastrozole, or exemestane for stage I-III invasive breast cancer. Written surveys were provided during the patients’ medical oncology visits. Our study collected demographic data on patient characteristics associated with nonadherence. Patients were asked to report reasons for missing doses including forgetting to take the drug, side effects, cost, and barriers to refill. Patients described their degree of adherence by identifying how often they miss a dose as never, once per month, once per week, or more than once per week. We compared their self-reported adherence to pharmacy refill records. Results: More than half the women (26 of 49) report regularly missing doses of their drug over the last year. Of these, 22 miss once per month, 3 miss once per week, and 1 misses more than once per week. Despite this, pharmacy records verified consistent refills in all 26 less adherent patients over the past year. The most common reason identified for missed doses (21 of 26) was forgetting to take the drug, followed by barriers to refill and side effects. 57% of all patients favored receiving an electronic reminder via text messaging or email. Nonadherence was associated with polypharmacy and lower levels of education, income, and activity. Conclusions: Our study provides insight into patient reported reasons for nonadherence to adjuvant endocrine therapy. Our patients reported forgetting to take their drug as most problematic. Patients’ self-reported adherence was confirmed (96%) by pharmacy records. Most patients are interested in an electronic reminder system via e-mail or text messaging, even if they report complete adherence. This has potential to be a cost effective intervention.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9022-9022
Author(s):  
Kelly-Anne Phillips ◽  
Karin Ribi ◽  
Julie Aldridge ◽  
Alastair Mark Thompson ◽  
Vernon J. Harvey ◽  
...  

9022 Background: We have previously reported that, in the BIG 1-98 trial, objective cognitive function improved in postmenopausal women one year after cessation of adjuvant endocrine therapy for breast cancer. Here we evaluate changes in subjective cognitive function (SCF). Methods: One hundred postmenopausal women, randomized to receive five years of adjuvant tamoxifen, letrozole, or sequences of both, completed self-reported measures on SCF, psychological distress, fatigue and quality of life during the fifth year of trial treatment (year 5) and one year after treatment completion (year 6). Changes between years 5 and 6 were evaluated using the Wilcoxon signed-rank test. SCF and its correlates were explored. Results: Mean age of participants was 63.9 years [SD=7.1 years]. SCF and the other patient-reported outcomes did not change significantly after cessation of endocrine therapy with the exception of improvement in hot flushes (p=0.0005). No difference in changes was found between women who were taking tamoxifen or letrozole at year 5. SCF was the only psychosocial outcome with a substantial correlation between year 5 and 6 (Spearman’s R=0.80). Correlations between SCF and the other patient-reported outcomes were generally low. Conclusions: Although objective cognitive function improved after cessation of adjuvant endocrine therapy in the BIG 1-98 trial, improvement in SCF was not evident. The underlying reason for the clear disconnect between objective and subjective cognitive function seen in this and most other studies, is a crucial issue. It should be a research priority in order to effectively tackle the concerns of women about their cognition during and after breast cancer treatment.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 566-566 ◽  
Author(s):  
Icro Meattini ◽  
Calogero Saieva ◽  
Isacco Desideri ◽  
Livia Marrazzo ◽  
Gabriele Simontacchi ◽  
...  

566 Background: The impact of age on local recurrence rate of patients affected by early breast cancer is still unclear. The standard of care for older adult largely varies depending on patient- and tumor-related features, but also on national guidelines. We recently presented the 10 years median follow update of the APBI-IMRT Florence phase III trial. The primary aim of the present analysis is to identify the potential relationship between age and ipsilateral breast tumor recurrence (IBTR) in this setting of patients. Methods: This retrospective analysis was performed on the whole series of 520 patients who were enrolled in the trial after breast conserving surgery and randomized to receive APBI or whole breast irradiation. We analyzed patients stratified by age (70+ vs 40-69 years). Results: At a median follow up time of 10.7 years, we recorded 15 IBTR events. Four hundred and three patients (77.5%) were aged less than 70 years old (11 IBTR) and 117 patients (22.5%) were aged 70 years or older (4 IBTR). At the univariate analysis the age (70+ vs 40-69 years) was not significantly correlated with IBTR occurrence (HR 1.33, 95% CI 0.42-4.17; p=0.63). The only significant prognostic factor was adjuvant endocrine therapy, also at the multivariable analysis (HR 0.26, 95% CI 0.07-0.94; p=0.041). Main results are summarized in the table. Within the luminal-like patients (n=437; 12 IBTR events), the age did not impact on the IBTR rate (HR 0.91, 95% CI 0.19-4.31; p=0.91) and adjuvant endocrine therapy lost its significance (HR 0.32, 95% CI 0.09-1.11; p=0.072). Conclusions: Our trial subanalysis did not demonstrate a significant effect of age on IBTR rate for early breast cancer patients receiving a breast conserving therapy. Due to the low number of events, the benefit of adjuvant endocrine therapy is unclear and calls for further investigations. Clinical trial information: NCT02104895 . [Table: see text]


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