ASPO Abstracts
Correlates of willingness to extend endocrine therapy for breast cancer
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2023
Abstract Body:
Purpose of the study: NCCN breast cancer treatment guidelines recommend up to 10 years of endocrine therapy for premenopausal women. For many patients, this decision is complex and involves factors related to risk of late recurrence, tolerance, and patient preference. Given that early endocrine therapy discontinuation is associated with patient-reported outcomes, adverse events and quality of life (QoL), similar variables could impact the decision extend therapy. However, we know little about patients' willingness to extend therapy and associated factors. Methods: Patients with Stage I-III breast cancer currently prescribed endocrine therapy were recruited from a single comprehensive cancer center. Participants completed a one-time online survey assessing QoL (general, breast cancer specific, and endocrine symptoms using the FACT), perceived quality of communication with their medical oncologist, and willingness to extend endocrine therapy if recommended by their medical oncologists. Patient-reported data was supplemented with electronic medical record data, including sociodemographic and disease-related variables. Logistic regressions examined the association between willingness to extend endocrine therapy and QoL, quality of communication, and sociodemographic and disease-related variables. Results: Most participants (N=29; mean age=64 years) had Stage I (N=19) or Stage II (N=10) disease and were White (N=16, 55%) or African American (N=7). 62% indicated that they were moderately to extremely likely to extend their use of endocrine therapy if recommended by their oncologists. Patients were more willing to extend therapy if they reported better general (p=.007) and breast cancer specific (p=.04) QoL and better communication with their medical oncologist (p=.007). There were no differences in willingness to extend therapy by age (p=.49), race (p=.48), stage of disease (p=.47) or endocrine symptoms (p=.38). Conclusions: Results indicate that willingness to extended therapy is related to a combination of current QoL and patient-perceived quality of patient-provider communication. Future work in this area should examine how to support patient-provider communication and decision making about this topic.
Keywords: breast cancer, endocrine therapy, communication, decision making