Factors Impacting Adherence to Adjuvant Endocrine Therapy in Premenopausal Women With Breast Cancer

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In a Danish study reported in the Journal of Clinical Oncology by Schmidt et al, it was found that living alone and being unemployed were associated with reduced adherence to adjuvant endocrine therapy among premenopausal women with breast cancer.

Study Details

The study involved data from a nationwide, population-based cohort of premenopausal women diagnosed with stage I to III estrogen receptor–positive breast cancer between 2002 and 2011. The study investigated the impact of social characteristics—including cohabitation/marital status and socioeconomic position (education level, employment status, and income)—on adherence to adjuvant endocrine therapy from treatment initiation to 5 years after diagnosis.

Key Findings

Among 4,353 patients included in the analysis, three adherence trajectories were identified: high adherence (57%), slow decline in adherence (36%), and rapid decline in adherence (7%).

Compared with cohabiting women, those living alone were more likely to have a slow decline in adherence vs high adherence (odds ratio [OR] = 1.26, 95% confidence interval [CI] = 1.08–1.46) and a rapid decline in adherence vs high adherence (OR = 1.66, 95% CI = 1.27–2.18).  

Compared with employed women, those not working were more likely to have a slow decline in adherence vs high adherence (OR = 1.22, 95% CI = 1.02–1.45) and a rapid decline in adherence vs high adherence (OR = 1.76, 95% CI = 1.30–2.38).

Early discontinuation of adjuvant endocrine therapy vs completion of therapy was more likely for women living alone vs cohabiting women (OR = 1.48, 95% CI = 1.23–1.78) and for unemployed vs employed women (OR = 1.44, 95% CI = 1.17–1.78).

The investigators concluded, “Adherence to adjuvant endocrine therapy was lower among women living alone or [who were] unemployed than cohabiting or employed women, respectively. These women may benefit from support programs to enhance adjuvant endocrine therapy adherence.”

Julie A. Schmidt, DPhil, of the Department of Clinical Epidemiology and the Department of Clinical Medicine, Aarhus University and Aarhus University Hospital, is the corresponding author for the Journal of Clinical Oncology article.

Disclosure: The study was supported by the Novo Nordisk Foundation, Independent Research Fund Denmark, and Danish Cancer Society. For full disclosures of the study authors, visit

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.