Investigating Associations Between Health-Related Quality of Life and Endocrine Therapy Underuse in Women With Early-Stage Breast Cancer

Purpose: Endocrine therapy (ET) underuse puts women at increased risk for breast cancer (BC) recurrence. Our objective was to determine if health-related quality of life (HRQOL) subgroups were associated with underuse. Methods: Data came from the third phase of the Carolina Breast Cancer Study. We included 1,599 women with hormone receptor–positive BC age 20 to 74 years. HRQOL was measured, on average, 5 months postdiagnosis. Subgroups were derived using latent profile (LP) analysis. Underuse was defined as not initiating or adhering to ET by 36 months postdiagnosis. Multivariable logistic regression models estimated adjusted odds ratios (ORs) between HRQOL LPs and underuse. The best HRQOL LP was the reference. Chemotherapy- and race-stratified models were estimated, separately. Results: Initiation analyses included 953 women who had not begun ET by their 5-month survey. Of these, 154 never initiated ET. Adherence analyses included 1,114 ET initiators, of whom 211 were nonadherent. HRQOL was not significantly associated with noninitiation, except among nonchemotherapy users, with membership in the poorest LP associated with increased odds of noninitiation (adjusted OR, 5.5; 95% CI, 1.7 to 17.4). Membership in the poorest LPs was associated with nonadherence (LP1: adjusted OR, 2.2; 95% CI, 1.2 to 4.0 and LP2: adjusted OR,1.9; 95% CI, 1.1 to 3.6). Membership in the poorest LP was associated with nonadherence among nonchemotherapy users (adjusted OR, 2.1; 95% CI, 1.2 to 5.1). Conclusion: Our results suggest women with poor HRQOL during active treatment may be at increased risk for ET underuse. Focusing on HRQOL, a modifiable factor, may improve targeting of future interventions early in the BC continuum to improve ET initiation and adherence and prevent BC recurrence.

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Investigating associations between health-related quality of life and endocrine therapy under-utilization in women with early-stage breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.8_suppl.170 ◽

2017 ◽

Vol 35 (8_suppl) ◽

pp. 170-170

Author(s):

Laura C Pinheiro ◽

Stephanie B. Wheeler ◽

Katherine Elizabeth Reeder-Hayes ◽

Cleo A. Samuel ◽

Andrew F Olshan ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Endocrine Therapy ◽

Cancer Recurrence ◽

Health Related Quality ◽

Hormone Receptor Positive ◽

Increased Risk ◽

Related Quality ◽

Health Related

170 Background: Endocrine therapy under-utilization puts women at increased risk for breast cancer recurrence. The objective of this study was to determine if health-related quality of life (HRQOL) was significantly associated with under-utilization. Methods: Data came from the third phase of the population-based Carolina Breast Cancer Study. We included 1,599 women with hormone receptor positive disease aged 20-74 years. HRQOL was measured using the Functional Assessment of Cancer Therapy for Breast Cancer, on average, 5-months post-diagnosis. HRQOL domains included physical, functional, social, emotional, and spiritual well-being and breast cancer concerns. HRQOL subgroups were derived using latent profile analysis. Under-utilization was defined as not initiating or adhering to endocrine therapy by 36-months post-diagnosis. Multivariable logit models estimated adjusted odds ratios (aOR) between HRQOL subgroups and under-utilization. The subgroup with the best HRQOL scores across domains was the reference category. Chemotherapy and race-stratified models were estimated, separately. Results: Initiation analyses included 953 women with hormone receptor positive breast cancer who had not begun endocrine therapy by their 5-month survey, of whom 154 never initiated. Adherence analyses included 1,114 initiators, of whom 211 were non-adherent. HRQOL was not significantly associated with non-initiation except among non-chemotherapy users, with membership in the poorest subgroup associated with an increased odds of non-initiation (aOR 5.5; 1.7-17.4). Membership the two poorest HRQOL subgroups was associated with non-adherence (aOR 2.2; 1.2-4.0 and aOR1.9; 1.1-3.6), respectively. Membership in the poorest HRQOL subgroup was associated with non-adherence among non-chemotherapy users (aOR 2.1; 1.2-5.1). Conclusions: Our results suggest that women with poor HRQOL during active treatment may be at increased risk for under-utilization. Focusing on HRQOL, a modifiable factor, may improve targeting of future interventions early in the breast cancer continuum to improve endocrine therapy initiation, adherence, and breast cancer recurrence.

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Health-Related Quality of Life Coupled With Therapeutic Information on Compliance to Endocrine Therapy in Breast Cancer (COMPLIANCE)

Case Medical Research ◽

10.31525/ct1-nct04176809 ◽

2019 ◽

Author(s):

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Endocrine Therapy ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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Health-related quality of life of early-stage breast cancer patients after different radiotherapy regimens

Breast Cancer Research and Treatment ◽

10.1007/s10549-021-06314-4 ◽

2021 ◽

Author(s):

Daphne H. M. Jacobs ◽

Ramona K. Charaghvandi ◽

Nanda Horeweg ◽

John H. Maduro ◽

Gabrielle Speijer ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Early Stage ◽

Early Stage Breast Cancer ◽

Breast Irradiation ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Over Time

Abstract Purpose To evaluate and compare health-related quality of life (HRQL) of women with early-stage breast cancer (BC) treated with different radiotherapy (RT) regimens. Methods Data were collected from five prospective cohorts of BC patients treated with breast-conserving surgery and different RT regimens: intraoperative RT (IORT, 1 × 23.3 Gy; n = 267), external beam accelerated partial breast irradiation (EB-APBI, 10 × 3.85 Gy; n = 206), hypofractionated whole breast irradiation(hypo-WBI, 16 × 2.67 Gy; n = 375), hypo-WBI + boost(hypo-WBI-B, 21–26 × 2.67 Gy; n = 189), and simultaneous WBI + boost(WBI-B, 28 × 2.3 Gy; n = 475). Women ≥ 60 years with invasive/in situ carcinoma ≤ 30 mm, cN0 and pN0-1a were included. Validated EORTC QLQ-C30/BR23 questionnaires were used to asses HRQL. Multivariable linear regression models adjusted for confounding (age, comorbidity, pT, locoregional treatment, systemic therapy) were used to compare the impact of the RT regimens on HRQL at 12 and 24 months. Differences in HRQL over time (3–24 months) were evaluated using linear mixed models. Results There were no significant differences in HRQL at 12 months between groups except for breast symptoms which were better after IORT and EB-APBI compared to hypo-WBI at 12 months (p < 0.001). Over time, breast symptoms, fatigue, global health status and role functioning were significantly better after IORT and EB-APBI than hypo-WBI. At 24 months, HRQL was comparable in all groups. Conclusion In women with early-stage breast cancer, the radiotherapy regimen did not substantially influence long-term HRQL with the exception of breast symptoms. Breast symptoms are more common after WBI than after IORT or EB-APBI and improve slowly until no significant difference remains at 2 years posttreatment.

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