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"We know that hormone therapy for women with hormone receptor-positive breast cancer can reduce recurrence by up to 50 percent," study leader Dr. Dawn Hershman, an associate professor of epidemiology at Columbia University Medical Center in New York City, said in a hospital news release.
"However, work by our group and others has shown that a substantial number of women discontinue treatment before the recommended five years or do not take the prescribed dose," she added.
"Our findings suggest that more effort should be made to reduce out-of-pocket costs for these potentially life-saving medications. This is especially important given the rapid increase of expensive oral cancer therapies," explained Hershman, who is also an associate professor of medicine at Columbia's College of Physicians and Surgeons.
The study included more than 5,500 women. All were 50 years of age or older. And, all of the women had early stage breast cancer that was hormone receptor-positive. That means the cancer is fueled by the hormone estrogen, according to the American Cancer Society (ACS).
The women in the study all had surgery to remove their breast cancer. After surgery, they were prescribed drugs called aromatase inhibitors, a common type of therapy for hormone receptor-positive cancers. Aromatase inhibitors work by blocking the conversion of other hormones into estrogen. In women who've gone through menopause, these drugs can lower the amount of estrogen in the body, according to the ACS.
Even though hormone therapy significantly reduces the risk of disease recurrence in patients with this type of breast cancer, many women don't take their medications as directed, the researchers said.
The patients in the study were followed for two years. The investigators found that women who took generic aromatase inhibitors were 50 percent more likely to adhere to their drug therapy than those who took brand-name aromatase inhibitors, which are much more expensive.
"This is increasingly important because we are starting to learn that even longer therapy -- up to 10 years -- may be beneficial. It's critical that we understand why people do not take their medication and what we can do to improve adherence," concluded Hershman, leader of the Breast Cancer Program at the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian/Columbia University Medical Center.
Several factors may contribute to breast cancer patients' failure to adhere to drug therapy, the study authors suggested.
"Cost is not the only reason. But it can intensify other factors such as side effects. Up to 40 percent of women taking [aromatase inhibitors] experience joint stiffness. If you add a high co-payment to the mix, that's often enough to make them discontinue therapy," Hershman said in the news release.
The study was published online Oct. 27 in the Journal of the National Cancer Institute.
-- Robert Preidt
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