The adherence and tolerance of adjuvant endocrine therapy in geriatric breast cancer patients

BackgroundAdherence to and tolerance of oral adjuvant endocrine therapy (ET) are important to improve survival for hormone receptor (HR)-positive breast cancer patients. To date, there has been limited literature discussing this issue in elderly patients. Herein we have presented a retrospective study to analyze the tolerance to and completion rate of ET in a single medical center in Taiwan.Patients and methodsFrom 1996 to 2009, a total of 269 female patients over 70 years of age with primary HR-positive operable breast cancer were registered and analyzed for this study.ResultsIn our study, the completion rate was 49.4% for all 269 patients and was 56.7% for those willing to initiate ET. Of the 72 patients that discontinued ET early but not due to recurrence, 9.7% had well-documented ET-related adverse events, 33.3% refused to undergo ET but remained in follow-up, 44.4% did not undergo ET because of loss of follow-up before a complete ET period, and 12.5% of the patients discontinued ET arising from other medical conditions. The switch therapy, tamoxifen followed by aromatase inhibitor, showed a greater completion rate, compared with upfront tamoxifen or aromatase inhibitor.ConclusionsThe completion rate for patients who underwent oral ET in our study was similar to previous studies. The switch method of adjuvant oral endocrine therapy demonstrated a better tolerance and adherence in elderly breast cancer patients, compared with tamoxifen or aromatase inhibitor alone.