Effects of adherence to homone therapy after surgery and radiation on the outcomes of older patients with early-stage breast cancer

This study aimed to investigate the effects of adherence to hormonal therapy (HT) and radiation on the outcomes of older patients with early-stage breast cancer (BC).  

This study concluded that the lack of adherence to HT and omitting radiation can lead to poorer outcomes for these patients.  

A previous research showed that women aged 70 or older with early-stage BC can safely omit radiation therapy (RT) and be treated with breast-conserving surgery (BCS; the tumor alone is removed and the rest of the breast is preserved) and HT.  

However, many patients do not take HT correctly or stop taking it. Therefore, it is important to evaluate the impact of HT adherence after BCS in older patients with early-stage BC.

This study involved 10,719 patients aged 70 or older who underwent BCS. 7.3% of patients underwent BCS alone. 13.9% of patients underwent BCS and RT. 15.5% underwent BCS followed by HT. 63.3% underwent BCS, RT, and HT. Good adherence to HT meant they took the medication more than 80% of the days. 

For those treated with BCS and HT, adherent patients had a significantly lower recurrence rate (3.1%) of BC than did non-adherent patients (4.7%).  

There was no significant difference in recurrence rates between the group that received both RT and HT or only HT after BCS. However, patients who had RT+HT or RT alone after BCS had better overall survival at 5 years than those who received BCS alone or BCS and HT. 

This study concluded that non-adherence to HT and omitting RT can lead to poorer outcomes for older patients with early-stage BC undergoing BCS.  

This study was based on medical records. The patients were not randomly assigned to one of the treatment groups. Treatment decisions regarding RT omission should be tailored to the individual patient, taking into consideration the chances of HT non-adherence and the patients’ own risk tolerance.