The American Journal of Surgery
Volume 196, Issue 4 , Pages 500-504, October 2008

Noncompliance with adjuvant radiation, chemotherapy, or hormonal therapy in breast cancer patients

Presented at the 9th Annual Meeting of the American Society of Breast Surgeons, April 30-May 4th, 2008, New York, NY.

Department of Surgery, St. Luke's-Roosevelt Hospital Center, 1111 Amsterdam Ave, Mu 2, Section D, New York, NY 10025, USA

Received 17 April 2008; received in revised form 3 June 2008

Abstract 

Introduction

There is little information on patient-driven noncompliance of adjuvant therapies and its consequences.

Methods

This retrospective study compares clinical, pathological features and outcomes of breast cancer patients who were compliant to recommended radiation, chemotherapy, and hormonal therapies to those who were noncompliant.

Results

Noncompliance rates for chemotherapy, radiation, and tamoxifen were 31 of 421 (7%), 30 of 855 (4%), and 294 of (37%) respectively. Old age was associated with noncompliance to chemotherapy and radiation, but younger women tend to be more often noncompliant to tamoxifen. Noncompliance with chemotherapy or radiation did not significantly affect 5-year local and distant disease-free survival rates. Noncompliance with tamoxifen was associated with decreased 5-year local and distant disease-free survivals (87% versus 96%, 76% versus 87%, respectively, P < .001).

Conclusion

Noncompliance with tamoxifen is the most common, resulting in significantly increased risk of local and distant disease recurrence.

Keywords: Breast cancer, Breast neoplasm, Chemotherapy, Compliance, Hormonal therapy, Radiation therapy, Survival rate, Tamoxifen

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PII: S0002-9610(08)00525-4

doi:10.1016/j.amjsurg.2008.06.027

The American Journal of Surgery
Volume 196, Issue 4 , Pages 500-504, October 2008