Full Compliance of Adjuvant Endocrine Therapy Is Associated with Higher Disease-Free Survival in Hormone Receptor-Positive and HER2-Negative Chinese Breast Cancer Patients with First Tumor Recurrence

Document Type : Research Articles


1 Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China.

2 Department of Breast Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China.

3 Department of Ultrasound, the Fourth Hospital of Hebei Medical University, Shijiazhuang, China.


Purpose: To characterize the compliance status of adjuvant endocrine therapy (aET) and its relationship with disease-free survival (DFS) in hormone receptor-positive (HR+) and HER2-negative (HER2−) in Chinese breast cancer (BC) patients with first tumor recurrence. Methods: All women with primary unilateral stage I – III HR+HER2− BC and first tumor recurrence in 2008 - 2018 at our institution were identified. Full (vs. none/partial) compliance of aET was classified from records. Multivariate Cox regression estimated the hazard ratio (HR), its 95% confidence interval (CI), and p value. DFS. Covariates included age, T stage, N stage, pathology, tumor grade, LVI, chemotherapy, radiotherapy.      Results: A total 258 patients had average age 47.4 years at BC diagnosis and median DFS 31.7 months. Patients with ipsilateral (contralateral) region and organ recurrence were 47.7% (19.8%) and 71.9%. Compared to the patients with none/partial compliance of aET, the full compliance patients (54.3% ) had a higher DFS (median 35.0 vs. 25.2 months, p=0.009). Multivariate analysis showed that the full compliance of aET was associated with a lower HR 0.614 (95%CI 0.467 – 0.807, p<0.001) on recurrence. Early discontinuation (67.5%, 56/83) due to the drug side effects was the top reason for partial compliance of aET. Conclusions: Full compliance of aET was quite low in Chinese HR+HER2− BC patients. However, it was associated with a 38.6% lower risk of first tumor recurrence. To search for effective tools to improve the compliance of aET in this population should be stressed. 


Main Subjects

Volume 23, Issue 10
October 2022
Pages 3413-3420
  • Receive Date: 12 May 2022
  • Revise Date: 04 July 2022
  • Accept Date: 07 October 2022
  • First Publish Date: 07 October 2022