Evidence map›Paper›PMID 41542104›Full record

ArticleGeburtshilfe und Frauenheilkunde2026

High Adherence to Adjuvant Endocrine Therapy Improves Outcome in Early Breast Cancer - Results from a Large Real-World Claims Data Analysis in Germany.

Dominik Dannehl, Tjeerd Dijkstra, Lea Volmer, Markus Hahn, Alexandra von Au, Sabine Hawighorst-Knapstein, Ariane Chaudhuri, Markus Wallwiener, Armin Bauer, Diethelm Wallwiener and 4 more

Abstract read
In one paragraph

Article in Geburtshilfe und Frauenheilkunde, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Dominik DannehlDepartment of Women's Health, Tuebingen University, Tübingen, Germany.
Tjeerd DijkstraDepartment of Women's Health, Tuebingen University, Tübingen, Germany.
Lea VolmerDepartment of Women's Health, Tuebingen University, Tübingen, Germany.
Markus HahnDepartment of Women's Health, Tuebingen University, Tübingen, Germany.
Alexandra von AuDepartment of Gynecology and Obstetrics, Heidelberg University, Heidelberg, Germany.
Sabine Hawighorst-KnapsteinAOK Baden-Wuerttemberg, Stuttgart, Germany.
Ariane ChaudhuriAOK Baden-Wuerttemberg, Stuttgart, Germany.
Markus WallwienerUniversity Hospital for Gynecology, Halle University, Halle, Germany.
Armin BauerDepartment of Women's Health, Tuebingen University, Tübingen, Germany.
Diethelm WallwienerDepartment of Women's Health, Tuebingen University, Tübingen, Germany.
Sara BruckerDepartment of Women's Health, Tuebingen University, Tübingen, Germany.
Stephanie WallwienerUniversity Hospital for Prenatal Medicine and Obstetrics, Halle, Germany.
Tobias EnglerDepartment of Women's Health, Tuebingen University, Tübingen, Germany.
Andreas HartkopfDepartment of Women's Health, Tuebingen University, Tübingen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In hormone-receptor positive (HR+) early breast cancer (EBC), adjuvant endocrine therapy (ET) significantly reduces recurrence and mortality. A common means of estimating therapy adherence is to use patient-reported outcome measures. Yet, this method is inaccurate due to social-desirability bias. We therefore aimed to analyze adherence to ET over the first five years of treatment by using claims data from a large health insurance provider in Germany (AOK Baden-Wuerttemberg). Female patients diagnosed with HR+ EBC who received inpatient treatment and breast cancer surgery between 1 July 2010 and 31 December 2019 were included in the analysis. Adherence to ET was defined as the ratio between the sum of the number of pills from filled prescriptions and the duration of ET in days (from the start of the first prescription after completing surgery and chemotherapy). ET use was observed over five years. Low adherence was defined as a ratio smaller than 0.8 and high adherence as a ratio larger than or equal to 0.8. Distant recurrence-free survival (DRFS) was calculated from the day of the first diagnosis of EBC until onset of distant recurrence. Overall survival (OS) was defined as the period between first diagnosis of EBC until death of any cause. In total, 16642 patients with EBC were included. Of these patients, 4303 (86%) showed high adherence to ET in the first year after initiating treatment. After five years, high adherence persisted in 68% of patients. Continuous high adherence to ET had a significant impact on DRFS (HR: 0.66; 95% CI: 0.58-0.76, p > 0.0001) and OS (HR 0.52, 95% CI: 0.47-0.57, p < 0.0001). In conclusion, adherence to ET is an independent risk factor that significantly influences DRFS and OS. Further real-world studies should explore the factors contributing to treatment discontinuation and evaluate prospective strategies to enhance adherence.

Indexed as

adherencebreast cancerendocrine therapyoutcome

Identifiers

PMID41542104
PMCPMC12803760

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.