Decision-making was influenced by patient values and did not vary by stage, race and ethnicity, or demographics
By Lori Solomon HealthDay Reporter
FRIDAY, June 20, 2025 (HealthDay News) — Nearly 40 percent of women with stage I breast cancer and two-thirds with stage II decide to extend endocrine therapy, according to a study published recently in JNCI: Journal of the National Cancer Institute.
Allison W. Kurian, M.D., from the Stanford University School of Medicine in California, and colleagues examined use of and decision-making about extended endocrine therapy. The analysis included women aged 20 to 79 years diagnosed with stage I to II breast cancer and reported to Georgia and Los Angeles County Surveillance, Epidemiology, and End Results registries (2014 and 2015). Participants with estrogen receptor-positive and/or progesterone receptor-positive disease were surveyed at seven months and again at six years postdiagnosis (2,361 women; 60 percent response rate).
The researchers found that of 831 women, 591 had completed or were completing five years of endocrine therapy. Among 557 participants who had decided, 46.9 percent decided to continue (39.4 percent stage I; 62.4 percent stage II). Factors associated with continuation for stage I included worry about recurrence (adjusted odds ratio [aOR], 3.35), desire for most extensive treatment (aOR, 2.15), and primary care physician participation (aOR, 4.30). Continuation was inversely associated with side effects (stage I: aOR, 0.21). For stage II, associations were similar. Bilateral mastectomy and chemotherapy were associated with continuation for stage I only. Continuation decision did not vary by race, ethnicity, or demographic factors.
“Endocrine therapy is less intensive than surgery, chemotherapy, or radiation treatment, but the fact that it lasts five years — or now 10 years — can be challenging,” co-senior author Lauren Wallner, Ph.D., from the University of Michigan in Ann Arbor, said in a statement. “It was encouraging to see that more than half of the higher-risk stage 2 patients chose to continue the therapy beyond five years.”
One author disclosed ties to the pharmaceutical industry.
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