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Background <p>Premenopausal women receiving combination endocrine therapy often experience substantial declines in quality of life (QOL), cognitive functioning, and treatment adherence. The MyChoice study evaluated whether individualized behavioral and complementary interventions could help maintain or improve QOL and treatment adherence in women with early-stage hormone receptor–positive breast cancer undergoing aromatase inhibitor- or tamoxifen-based therapy with ovarian suppression.</p> Methods <p>In this prospective multicenter phase II study, premenopausal women with newly diagnosed hormone receptor–positive breast cancer were enrolled prior to initiation of combination endocrine therapy. Tailored supportive interventions, including structured exercise programs, restorative yoga, acupuncture, and massage therapy, were offered, and women could choose one or more interventions either alone or in combination. QOL and cognitive function were assessed at baseline, 3 months, and every 6 months for up to 3 years using FACT-B, FACT-ES, and FACT–Cognitive Function instruments. Adherence to endocrine therapy was assessed at each follow-up visit using physician-conducted patient interviews and pharmacy refill records. Longitudinal changes in QOL and their demographic and clinical predictors were analyzed using linear mixed-effects models.</p> Results <p>Forty premenopausal women participated, with a median age of 43 years. Exercise was the most frequently selected intervention (61%), followed by massage therapy (44%), acupuncture (35%), and yoga (30%). Functional well-being improved significantly over time (1.65 points per year, <i>p</i> = 0.0005). Emotional well-being, social/family well-being, physical well-being, endocrine symptoms, and perceived cognitive abilities remained stable. Adherence to endocrine therapy was high at 92.5% over the follow-up period. In multivariable analyses, younger age (&lt; 35 years) was associated with less favorable outcomes across several domains, including lower FACT-ES scores and lower physical well-being.</p> Conclusion <p>Individualized, patient-selected supportive interventions may help maintain key aspects of quality of life and support adherence to endocrine therapy in premenopausal women with early-stage breast cancer. These findings support further evaluation in larger, controlled trials.</p>

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Role of individualized intervention(s) on quality of life and adherence to adjuvant endocrine therapy in premenopausal women with early-stage breast cancer: MyCHOICE study

  • 期刊论文

  • 发表日期：

    2026年6月26日

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  • Shahid Ahmed,
  • Sonya Mannala,
  • Prosanta Mondal,
  • Wardah Mahmood,
  • Haji Ibrahim Chalchal,
  • Lynn Dwernychuk,
  • Nayyer Iqbal,
  • Muhammad Salim,
  • Muhammad Imtiaz Khan,
  • Osama Ahmed,
  • Mita Manna,
  • Donelda Gowan Leverick,
  • Ambika Chandrasekhar,
  • Ayesha Bashir,
  • Kamal Haider,
  • Anne Leis,
  • Saija Kontulainen,
  • Amer Sami

摘要

Background

Premenopausal women receiving combination endocrine therapy often experience substantial declines in quality of life (QOL), cognitive functioning, and treatment adherence. The MyChoice study evaluated whether individualized behavioral and complementary interventions could help maintain or improve QOL and treatment adherence in women with early-stage hormone receptor–positive breast cancer undergoing aromatase inhibitor- or tamoxifen-based therapy with ovarian suppression.

Methods

In this prospective multicenter phase II study, premenopausal women with newly diagnosed hormone receptor–positive breast cancer were enrolled prior to initiation of combination endocrine therapy. Tailored supportive interventions, including structured exercise programs, restorative yoga, acupuncture, and massage therapy, were offered, and women could choose one or more interventions either alone or in combination. QOL and cognitive function were assessed at baseline, 3 months, and every 6 months for up to 3 years using FACT-B, FACT-ES, and FACT–Cognitive Function instruments. Adherence to endocrine therapy was assessed at each follow-up visit using physician-conducted patient interviews and pharmacy refill records. Longitudinal changes in QOL and their demographic and clinical predictors were analyzed using linear mixed-effects models.

Results

Forty premenopausal women participated, with a median age of 43 years. Exercise was the most frequently selected intervention (61%), followed by massage therapy (44%), acupuncture (35%), and yoga (30%). Functional well-being improved significantly over time (1.65 points per year, p = 0.0005). Emotional well-being, social/family well-being, physical well-being, endocrine symptoms, and perceived cognitive abilities remained stable. Adherence to endocrine therapy was high at 92.5% over the follow-up period. In multivariable analyses, younger age (< 35 years) was associated with less favorable outcomes across several domains, including lower FACT-ES scores and lower physical well-being.

Conclusion

Individualized, patient-selected supportive interventions may help maintain key aspects of quality of life and support adherence to endocrine therapy in premenopausal women with early-stage breast cancer. These findings support further evaluation in larger, controlled trials.