PURPOSE Non-adherence to the oral anti-estrogen therapies (AET) tamoxifen and aromatase inhibitors in early-stage hormone receptor-positive breast cancer is associated with numerous negative clinical outcomes. Prior studies have identified that non-adherence is associated with psychological and menopause-related factors which are present during AET, but the presence of these characteristics prior to AET initiation has not been investigated. METHODS Psychological and menopause symptoms (depression, generalized anxiety, insomnia, somatosensory amplification, hot flash frequency, and hot flash-related interference) were assessed pre-AET initiation as predictors of subsequent non-adherence in 73 participants (Mage = 55.0, SD = 10.1 years). Participants self-reported treatment adherence after three and 6 weeks on AET. Participants who did not initiate treatment were excluded from the analysis. RESULTS Discriminant function analyses revealed that the hypothesized set of psychological and menopause symptoms at baseline (pre-AET) together statistically distinguished between those who were non-adherent (n = 19; 26.0%) from adherent (n = 54; 74.0%) at 6 weeks. Model classification accuracy was statistically significant (Wilks' ƛ = 0.782, χ2(6) = 15.50, p = 0.017) at the 6-week timepoint. Results were consistent at 3 weeks. Pre-AET psychological and menopause symptoms correctly classified 6-week treatment adherence 77.9% of the time. Depression contributed most to distinguishing between adherers and non-adherers. CONCLUSIONS The presence of a composite profile of psychological and menopause symptoms prior to AET initiation may help to identify early treatment non-adherence. Results can be used to identify patients at risk for non-adherence and to guide psychological and symptom management interventions.

中文翻译：

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早期乳腺癌患者不坚持口服抗雌激素疗法的早期治疗风险​​增加的预测因素。

目的 早期激素受体阳性乳腺癌患者不坚持口服抗雌激素疗法 (AET) 他莫昔芬和芳香酶抑制剂与许多负面临床结果相关。先前的研究已经确定，不依从性与 AET 期间存在的心理和更年期相关因素有关，但尚未调查 AET 开始之前这些特征的存在。方法 73 名参与者 (Mage = 55.0, SD = 10.1 年）。参与者在 AET 治疗 3 周和 6 周后自我报告治疗依从性。未开始治疗的参与者被排除在分析之外。结果 判别函数分析显示，假设的一组基线（AET 前）心理和更年期症状在统计学上区分了不依从者（n = 19；26.0%）和依从者（n = 54；74.0%） 6 周。模型分类准确性在 6 周时间点具有统计学意义（Wilks ƛ = 0.782，χ2(6) = 15.50，p = 0.017）。结果在 3 周时一致。AET 前的心理和更年期症状正确分类 6 周治疗依从性的比例为 77.9%。抑郁症对区分坚持者和非坚持者的贡献最大。结论 在 AET 开始之前存在心理和更年期症状的复合特征可能有助于识别早期治疗不依从性。结果可用于识别有不依从风险的患者，并指导心理和症状管理干预措施。