Deconstructing Decisions to Initiate, Maintain, or Discontinue Adjuvant Endocrine Therapy in Breast Cancer Survivors: A Mixed-Methods Study.
Shirley M Bluethmann, Caitlin C Murphy, Jasmin A Tiro and 3 others
PMID 28635973WHAT IT FOUND
Breast cancer survivors decided to continue or stop adjuvant endocrine therapy based on side effects, perceived recurrence risk, and their doctor recommendation.
Many stopped when symptoms were severe, unexpected, or unresolved, even when fear of recurrence remained.
Key findings
01Survivors' decisions to start, keep taking, or stop adjuvant endocrine therapy were shaped by accepting the doctor's recommendation, variable side effects, weighing recurrence risk against quality of life, and tolerating or stopping therapy.
02Menopausal symptoms were often manageable, while joint pain was often bothersome or debilitating, particularly for nonadherent survivors.
03Patient-provider communication was a cross-cutting challenge, and survivors preferred joint decision making about continuing or stopping therapy.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The interviewed sample was small and not necessarily representative: 30 women, mostly Caucasian, married, and college educated, with mostly stage I or II disease less than five years after diagnosis. Eligible interview participants differed from ineligible survivors; ineligible survivors were more likely to be older than 65 years, unmarried, have in situ disease, or have less than a high school education. Adherent and nonadherent status came from self-reported survey responses. The study did not test an intervention, so it cannot show which counselling, exercise, symptom-management, or communication strategies improve adherence. Qualitative findings cannot be generalised to all breast cancer survivors.
Declared interests
No conflicts-of-interest or funding declaration is included in the supplied article text. The publication metadata lists NIH extramural research support.
The easy way to misread this
Do not conclude that nurse counselling, exercise, or other strategies will improve adherence. This study described survivors' experiences; it did not test an intervention.