ArticleJournal of the National Cancer Institute2015
Impact of Fertility Concerns on Tamoxifen Initiation and Persistence.
Article in Journal of the National Cancer Institute, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 4 of them syntheses that pooled it.
What it found
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Who cites it
68 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Influencing factors of fertility concerns in cancer patients of childbearing age: a systematic review and meta-analysis.Frontiers in oncology · 2026Pooled it
- The impact of BRCA mutation and hormone receptor status on the outcomes of fertility preservation in breast cancer patients: a systematic review and meta-analysis.Frontiers in oncology · 2025Pooled it
- The impact of medication side effects on adherence and persistence to hormone therapy in breast cancer survivors: A quantitative systematic review.Breast (Edinburgh, Scotland) · 2022Pooled it
- Practical recommendations for fertility preservation in women by the FertiPROTEKT network. Part I: Indications for fertility preservation.Archives of gynecology and obstetrics · 2018Guideline
- Adjuvant endocrine therapy non-initiation and non-persistence in young women with early-stage breast cancer.Breast cancer research and treatment · 2023Trial
- Effect of letrozole on follicular fluid steroids concentrations in cancer patients undergoing oocyte cryopreservation.Journal of assisted reproduction and genetics · 2022Trial
- Brief relaxation training is associated with long-term endocrine therapy adherence among women with breast cancer: post hoc analysis of a randomized controlled trial.Breast cancer research and treatment · 2021Trial
- Letrozole-associated controlled ovarian hyperstimulation in breast cancer patients versus conventional controlled ovarian hyperstimulation in infertile patients: assessment of oocyte quality related biomarkers.Reproductive biology and endocrinology : RB&E · 2019Trial
- Adjuvant Anti-HER2 Therapy, Treatment-Related Amenorrhea, and Survival in Premenopausal HER2-Positive Early Breast Cancer Patients.Journal of the National Cancer Institute · 2019Trial
- Fertility in breast cancer survivorship: a scoping review.Journal of cancer survivorship : research and practice · 2026Review
- Long-term tamoxifen impacts the ovary but not preimplantation embryo development†.Biology of reproduction · 2026Article
- Impact of Side Effects on 5-Year Adherence to Adjuvant Endocrine Therapy in Women with Breast Cancer: An Integrative Review.International journal of women's health · 2026Review
- Side effects and adherence trajectories of adjuvant endocrine therapy in breast cancer patients: results from the VICAN2 study.Breast cancer research and treatment · 2025Article
- Adherence to oral anticancer medications in metastatic versus nonmetastatic breast cancer patients: Insights from a low-middle-income country.Exploratory research in clinical and social pharmacy · 2025Article
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- Influencing Factors of Adherence to Adjuvant Endocrine Therapy in Breast Cancer Patients: A Meta-Analysis.Health science reports · 2025Review
- Pregnancy after breast cancer treatment in young patients.Frontiers in oncology · 2025Article
- Safe and successful pregnancy following breast cancer treatment in young patients 35 years old or under without invasive fertility preservation: a retrospective study.Annals of surgical treatment and research · 2024Article
- Characterizing attitudes related to future child-bearing in young women diagnosed with early-stage breast cancer.Breast cancer research and treatment · 2024Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundAdjuvant tamoxifen reduces breast cancer recurrence risk and mortality; however, initiation and treatment persistence are poor for younger patients. We hypothesized that a unique set of factors, including fertility concerns, would contribute to the poor tamoxifen use among premenopausal patients.
methodsFrom 2007 to 2012, 515 premenopausal patients younger than age 45 years, with stage 0 to III hormone receptor-positive breast cancer, for whom tamoxifen was recommended, were identified. Clinical and pathologic tumor characteristics, treatment regimens, and fertility concerns were recorded. Clinical factors associated with tamoxifen noninitiation and discontinuation were identified using univariate and multivariable analysis. After the recommendation for tamoxifen, patient reasons for tamoxifen noninitiation or discontinuation were also documented. All statistical tests were two-sided.
resultsBased on multivariable analysis, fertility concerns were statistically associated with both noninitiation (odds ratio = 5.04, 95% confidence interval (CI) = 2.29 to 11.07) and early discontinuation (hazard ratio = 1.78, 95% CI = 1.09 to 3.38) of tamoxifen. Other independent predictors of noninitiation included a diagnosis of ductal carcinoma in situ, declining radiation, and not receiving chemotherapy (stage I-III). Additionally, smoking and not receiving radiation therapy were statistically significant predictors of early withdrawal from therapy. Primary patient reasons for noninitiation and early discontinuation included concerns about side effects and fertility.
conclusionThis study provided insight into factors associated with tamoxifen use for reproductive-aged breast cancer survivors, with a new focus on fertility. Fertility concerns negatively impacted tamoxifen initiation and continuation among premenopausal patients. Interventions to optimize treatment initiation and persistence for young cancer patients should include access to fertility preservation options.
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