ABSTRACT
BACKGROUND: Adjuvant endocrine therapy (AET) reduces breast cancer recurrence and mortality of women with hormone-receptor-positive tumors, but poor adherence remains a significant problem. The aim of this study was to analyze AET side effects and their impact on adherence to treatment. METHODS: A total of 373 breast cancer patients treated with AET filled out a specific questionnaire during their follow up visits at the Breast Unit of our Centre. RESULTS: Side effects were reported by 81% of patients, 84% of those taking tamoxifen and 80% of those taking aromatase inhibitors (AIs). The most common side effect in the tamoxifen group was hot flashes (55.6%), while in the AI group it was arthralgia (60.6%). The addition of GnRH agonists to both tamoxifen and AI significantly worsened all menopausal symptoms. Overall, 12% of patients definitively discontinued AET due to side effects, 6.4% during the first 5 years and 24% during extended therapy. Patients who had previously received chemotherapy or radiotherapy reported a significantly lower discontinuation rate. CONCLUSIONS: AET side effects represent a significant problem in breast cancer survivors leading to irregular assumption and discontinuation of therapy. Adherence to AET may be improved by trustful patient-physician communication and a good-quality care network.
Subject(s)
Breast Neoplasms , Humans , Female , Breast Neoplasms/drug therapy , Antineoplastic Agents, Hormonal/therapeutic use , Chemotherapy, Adjuvant , Neoplasm Recurrence, Local/drug therapy , Tamoxifen/therapeutic useABSTRACT
En la Argentina, el Estado financió, construyó y operó los ferrocarriles estatales guiados por un criterio de subsidiariedad hasta el primer gobierno de Yrigoyen (1916-1922) en que se introdujeron cambios y se modificó parcialmente la orientación de la política ferroviaria. Los Ferrocarriles del Estado contribuyeron al desarrollo de la ciencia, su demanda de profesionales ayudó a la formación del campo profesional de los ingenieros y la conexión de las capitales de las provincias del centro y norte facilitó las comunicaciones y las tareas científicas, en particular aquellas que estudiaron las enfermedades endémicas del país.
In Argentina, the State financed, built, and ran government-own railroads based on recourse to subsidies until the first Yrigoyen administration (1916-1922), which introduced changes and shifted the direction of rail policy somewhat. The Ferrocarriles del Estado contributed to the development of science, created a demand for professionals which helped form the professional engineering field, and, by linking the capitals of central and northern provinces, facilitated both communications and scientific tasks themselves, especially research into diseases endemic to the country.
Subject(s)
History, 20th Century , Humans , Railroads/history , Science/history , Argentina , Biomedical Research/history , Endemic Diseases/history , Engineering/history , Financing, Government/history , Public PolicyABSTRACT
In Argentina, the State financed, built, and ran government-own railroads based on recourse to subsidies until the first Yrigoyen administration (1916-1922), which introduced changes and shifted the direction of rail policy somewhat. The Ferrocarriles del Estado contributed to the development of science, created a demand for professionals which helped form the professional engineering field, and, by linking the capitals of central and northern provinces, facilitated both communications and scientific tasks themselves, especially research into diseases endemic to the country.
