Noncompliance with Adjuvant Radiation, Chemotherapy, or Hormonal Therapy in Breast Cancer Patients

Introduction: There is little information on patient-driven noncompliance of adjuvant therapies and its consequences.

Methods: This retrospective study compares clinical, pathological features and outcomes of breast cancer patients who were compliant to recommended radiation, chemotherapy, and hormonal therapies to those who were noncompliant.

Results: Noncompliance rates for chemotherapy, radiation, and tamoxifen were 31 of 421 (7%), 30 of 855 (4%), and 294 of (37%) respectively. Old age was associated with noncompliance to chemotherapy and radiation, but younger women tend to be more often noncompliant to tamoxifen. Noncompliance with chemotherapy or radiation did not significantly affect 5-year local and distant disease-free survival rates. Noncompliance with tamoxifen was associated with decreased 5-year local and distant disease-free survivals (87% versus 96%, 76% versus 87%, respectively, P < .001).

Conclusion: Noncompliance with tamoxifen is the most common, resulting in significantly increased risk of local and distant disease recurrence.