Breast Cancer Treatment-Completion: Can an Integrative Medicine Center Play a Role?



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Introduction: The survival of women with breast cancer depends on treatment-completion. We explored factors that promote treatment-completion and reduce aromatase inhibitor (AI) medication switching. We evaluated the effect of any Integrative Medicine (IM) clinic use on those outcomes. Methods: Means, frequencies, modified Poisson regression analysis, and propensity score analysis were used to examine three samples of women with hormone receptor-positive breast cancer treated with taxane chemotherapy or hormone therapy between 1/1/2009-12/31/2019 at MD Anderson Cancer Center. Treatment-completion was defined as a relative dose-intensity(RDI) of ≥85% for chemotherapy, or ≥54 months with a hormone therapy prescription; AI switching was also assessed. Sample: There were 508, 3764, and 2253 women in the chemotherapy, hormone therapy, and AI switching samples, respectively. Results: We found that 53.1% of patients completed chemotherapy, 64.3% of patients completed hormone therapy, and 68.8% of patients took just one AI medication. Less pain (RR, 0.97; 95%CI, 0.95 to 0.98; p<0.001) and SF-12 PCS (RR 1.03; 95%CI: 1.02 to 1.05; p<0.001) were associated with increase probability of hormone therapy treatment-completion in bivariate analysis. Differences between IM clinic users and non-users were not statistically significant among the samples. Discussion: Many women did not complete treatment. Two quality-of-life measures were related to hormone therapy treatment-completion. Treatment-completion of IM clinic users were not different from non-users. Some predictors of treatment-completion are changeable and warrant a central focus during treatment. Future research should include more IM treatments (e.g., 8 acupuncture treatments) for the inclusion criteria.



Breast Cancer, Treatment-Completion, Relative Dose Intensity, Integrative Medicine, Propensity Score