Background Many studies have examined patient-related factors affecting adjuvant hormone therapy adherence in breast cancer patients. Our study aimed to examine associations of family-related factors with adjuvant hormone therapy discontinuation and breast cancer-specific mortality. Methods By cross-linking seven Swedish health registers, we performed a cohort study including all breast cancer patients who initiated adjuvant hormone therapy during 2006-2019 in Sweden (N = 10,701). A group-based multi-trajectory model was used to identify familial adversity groups based on three dimensions: material deprivation, negative family dynamics, and loss or threat of loss. Cox proportional hazard models were used to investigate associations of familial adversity with hormone therapy discontinuation and breast cancer-specific mortality. Results We identified five distinctive familial adversity groups among the cohort participants. Compared to women with low familial adversity, higher risks to discontinue adjuvant hormone therapy were observed among women with material deprivation (hazard ratio (HR), 1.31; 95% CI, 1.20-1.43), negative family dynamics (HR, 1.16; 95% CI, 1.06-1.28), loss or threat to loss (HR, 1.15; 95% CI, 1.00-1.32), or high familial adversity (HR, 1.53; 95% CI, 1.40-1.68). Furthermore, women with material deprivation (HR, 1.37; 95% CI, 1.05-1.79), negative family dynamics (HR, 1.41; 95% CI, 1.01-1.97), or high adversity (HR, 1.67; 95% CI, 1.26-2.23) were at higher risks of dying from breast cancer. Conclusion Familial adversity is associated with a higher risk of adjuvant hormone therapy discontinuation and breast cancer-specific mortality. Family-related factors identified in our study may help identify high-risk patients for interventions to prevent treatment discontinuation and subsequently improve breast cancer outcomes.

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家庭逆境：与停止辅助激素治疗和乳腺癌预后相关

背景 许多研究探讨了影响乳腺癌患者辅助激素治疗依从性的患者相关因素。我们的研究旨在探讨家庭相关因素与辅助激素治疗终止和乳腺癌特异性死亡率之间的关系。方法 通过交叉链接七个瑞典健康登记册，我们进行了一项队列研究，其中包括 2006 年至 2019 年期间瑞典开始辅助激素治疗的所有乳腺癌患者 (N = 10,701)。基于群体的多轨迹模型用于根据三个维度来识别家庭逆境群体：物质匮乏、消极的家庭动态以及损失或损失威胁。Cox 比例风险模型用于研究家庭逆境与激素治疗中断和乳腺癌特异性死亡率的关联。结果 我们在队列参与者中确定了五个独特的家庭逆境群体。与家庭逆境程度低的女性相比，物质匮乏（HR，1.31；95% CI，1.20-1.43）、家庭动态消极（HR，1.16；95%）的女性中止辅助激素治疗的风险更高CI，1.06-1.28）、损失或损失威胁（HR，1.15；95% CI，1.00-1.32）或严重的家庭逆境（HR，1.53；95% CI，1.40-1.68）。此外，物质匮乏（HR，1.37；95% CI，1.05-1.79）、消极家庭动态（HR，1.41；95% CI，1.01-1.97）或高度逆境（HR，1.67；95% CI，1.26）的女性-2.23）死于乳腺癌的风险较高。结论 家庭逆境与辅助激素治疗中断和乳腺癌特异性死亡率较高的风险相关。我们的研究中确定的家庭相关因素可能有助于识别高危患者进行干预，以防止治疗中断，从而改善乳腺癌的预后。