Acceptance and adherence to chemoprevention among women at increased risk of breast cancer
Acceptance and adherence to chemoprevention among women at increased risk of breast cancer
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DOI：
10.1016/j.breast.2014.11.006
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发表时间：
2015-02-01
期刊：
影响因子：
3.9
通讯作者：
Kiluk, John V.
中科院分区：
文献类型：
--
作者：
Roetzheim, Richard G.;Lee, Ji-Hyun;Kiluk, John V.
背景：化学预防是乳腺癌风险增加的女性的一种选择(5年风险=1.7%)。然而，尚不确定女性接受和完成五年治疗的频率，以及临床或人口统计学因素是否预示着治疗的完成。方法：提取了219名女性的医疗记录，这些女性的五年乳腺癌风险为>；=1.7%，她们在莫菲特癌症中心的高危乳腺诊所就诊时接受了化学预防。我们使用多变量Logistic回归和生存分析模型检验了接受化学预防和完成五年治疗的可能性，以及这些结果的潜在临床和人口学预测因素。结果：219名女性中有118人(54.4%)接受了化学预防的建议并开始治疗。接受化学预防的可能性与终生乳腺癌风险相关，对于患有特定高危条件(小叶原位癌和不典型导管增生)的女性来说，接受化学预防的可能性更高。患有骨质疏松症和饮酒的女性也更有可能接受药物治疗。有58/118(49.2%)的女性在开始治疗后至少暂时停止用药。根据生存曲线，估计60%开始化学预防的女性将完成五年的治疗。结论：相当大比例的乳腺癌风险增加的女性将放弃化学预防，在接受治疗的女性中，大约40%将因为副作用而无法完成五年的治疗。(C)2014爱思唯尔有限公司。保留所有权利。
Background: Chemoprevention is an option for women who are at increased risk of breast cancer (five year risk >= 1.7%). It is uncertain, however, how often women accept and complete five years of therapy and whether clinical or demographic factors predict completion.Methods: Medical records were abstracted for 219 women whose five year risk of breast cancer was >= 1.7% and who were offered chemoprevention while attending a high risk breast clinic at the Moffitt Cancer Center. We examined the likelihood of accepting chemoprevention and completing five years of therapy, and potential clinical and demographic predictors of these outcomes, using multivariable logistic regression and survival analysis models.Results: There were 118/219 women (54.4%) who accepted a recommendation for chemoprevention and began therapy. The likelihood of accepting chemoprevention was associated with lifetime breast cancer risk and was higher for women with specific high risk conditions (lobular carcinoma in situ and atypical ductal hyperplasia). Women with osteoporosis and those that consumed alcohol were also more likely to accept medication. There were 58/118 (49.2%) women who stopped medication at least temporarily after starting therapy. Based on survival curves, an estimated 60% of women who begin chemoprevention will complete five years of therapy.Conclusions: A substantial percentage of women at increased risk of breast cancer will decline chemoprevention and among those that accept therapy, approximately 40% will not be able to complete five years of therapy because of side effects. (C) 2014 Elsevier Ltd. All rights reserved.