Addressing Side Effects Early Can Help Patients Adhere to Breast Cancer Treatment

In the U.S., one in eight women will be diagnosed with breast cancer at some point in their life. Breast cancer is less common in Black women than white women, but mortality for Black women is almost 40% higher.

Adjuvant endocrine therapy (AET) is a standard treatment for hormone receptor-positive breast cancer. It improves survival and lowers the risk of cancer recurrence. Adherence to AET (patients taking the treatment as directed) is low, especially for Black patients. AET’s negative side effects—like weight gain, hot flashes, and nausea—are one reason that adherence is low. 

In a recent paper published in the Journal of the National Comprehensive Cancer Center Network, researchers from Rollins School of Public Health studied the differences in AET symptoms between Black and white women. They also investigated how symptoms affected AET adherence.

What They Found

• Black women had worse side effects from AET than white women at the beginning of AET and throughout the following year.
• During the first year after starting AET, 43% of Black women took AET as directed, compared to 60% of white women.
• Experiencing worse symptoms at the beginning of AET treatment made patients less likely to adhere to their treatment during the first year.

“The consistent differences in symptom burden between Black and white women during AET point to potentially deeper, underrecognized gaps in care,” says Xin Hu, PhD, the study’s lead author.

Why This Matters

Addressing the negative side effects of AET early in treatment could improve adherence, especially for Black women.

“When symptoms go unaddressed, adherence will be affected,” says Ilana Graetz, PhD, the study’s senior author. “Our findings show Black women were less likely to stay on therapy, in part due to their higher symptom burden. We should do more to ensure side effects are communicated and managed so they don’t become a barrier to completing treatment, especially for those already facing structural inequities in care.”