285P - Adherence to endocrine therapy and sexual dysfunction in patients older than 65 years with early estrogen receptor-positive breast cancer

Background

Adjuvant ET reduces breast cancer recurrence and increases overall survival among patients with early-stage ER+ breast cancer, however a suboptimal number of patients older than 65 years are included in the studies. This study aims to evaluate adherence to adjuvant ET and sexual dysfunction in women >65 years old with early breast cancer.

Methods

Women with a history of early-stage ER+ invasive carcinoma of the breast on adjuvant ET for at least 6 months were invited to participate. Adherence was assessed with Morisky Medication Adherence Scale (MMAS-8). Quality of life was assessed using EORTC QLQ C30 and BR-23 forms. Sexuality was assessed with the Female Sex Function Index questionnaire. Patients were stratified according to age <=65 years and > 65 years old. Qualitative variables were compared between groups using the Chi-square or exact Chi-square test and for quantitative variables the non-parametric Mann-Whitney test was used.

Results

From June 2021 to March 2024, 774 women from 15 Brazilian institutions were recruited. Mean age was 62 y.o, mean tumor size was 2.24 cm, mean duration of ET was 3.2y. About 191 patients (24.7%) were older than 65y, 69.6% of them were high adherent to ET and 70.7% had sexual dysfunction. In comparison with women <=65 y.o, older women were associated with private healthcare insurance (p=0.003), living with no partner (p < 0.0001), prior lumpectomy (p = 0.0017), prior sentinel node biopsy (p = 0.03), no prior chemotherapy (p < 0.0001), use of aromatase inhibitors (p < 0.0001) and use of concomitant medications (p < 0,0001). Patients older than 65 years were more associated with lower adherence (p = 0.0009), but there was no difference in sexual dysfunction in comparison with patients less than 65 y. Patients over 65 years had significantly higher scores for Emotional Functioning, Cognitive Functioning, Social Functioning, Body Image and Future Perspective domains of quality of life.

Conclusions

Patients older than 65 y.o had less aggressive treatments, many better domains in quality of life, but lower adherence to ET than patients aged up to 65 years. An important issue for womens’ health is sexual health and in this context, sexual dysfunction affects women besides age group.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.