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Treatment-related side effects among Hispanic and non-Hispanic white long-term breast cancer survivors by tamoxifen use and duration

  • Epidemiology
  • Published:
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Abstract

Purpose

To determine the associations between ethnicity, age at diagnosis, obesity, multimorbidity, and odds of experiencing breast cancer (BC) treatment-related side effects among long-term Hispanic and non-Hispanic white (NHW) survivors from New Mexico and explore differences by tamoxifen use.

Methods

Lifestyle and clinical information including self-reported tamoxifen use and presence of treatment- related side effects were collected at follow-up interviews (12–15 years) for 194 BC survivors. Multivariable logistic regression models were used to examine associations between predictors and odds of experiencing side effects overall and by tamoxifen use.

Results

Women ranged in age at diagnosis (30–74, M = 49.3, SD = 9.37), most were NHW (65.4%) and had in-situ or localized BC (63.4%). Less than half reportedly used tamoxifen (44.3%), of which 59.3% reported using > 5 years. Overall, survivors who were overweight/obese at follow-up were 5.42 times more likely to experience treatment-related pain (95% CI 1.40–21.0) compared to normal weight survivors. Survivors with multimorbidity, compared to survivors without, were more likely to report treatment-related sexual health issues (aOR 6.90, 95% CI 1.43–33.2) and poorer mental health (aOR 4.51, 95% CI 1.06–19.1). The statistical interactions between ethnicity and overweight/obese with tamoxifen use were significant (p-interaction < 0.05) for treatment-related sexual health issues.

Conclusion

Our results demonstrate that survivors with overweightness/obesity or multimorbidity may be more likely to experience BC treatment-related side effects. Tamoxifen use modifies associations between ethnicity, being overweight/obese, and sexual health issues following treatment. The likelihood of experiencing treatment-related side effects were more favorable for those on tamoxifen or those who had used tamoxifen for longer durations. These findings highlight the importance of fostering side effect awareness and applying appropriate interventions to assist with disease management throughout BC survivorship care.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the Principal Investigator of the study on reasonable request.

Code availability

The code generated and implemented during the current study are available from the corresponding author on reasonable request.

Abbreviations

LTQOLS:

Long-term quality of life study

NMTR:

New Mexico Tumor Registry

NMWHS:

New Mexico Women’s Health Study

NHW:

Non-Hispanic white

SEER:

Surveillance, Epidemiology, and End Results

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Funding

This work was supported by the following Grants: NIH/NCI, R01-CA55730 The New Mexico Women’s Health Study; NIH/NCI 1 R01-CA105266 Ethnicity, Breast Cancer Recurrence and Long-Term Quality of Life; Susan G. Komen Breast Cancer Disparities Epidemiology Research Training Program, Grant KG090926. KD received research support from the National Cancer Institute Cancer Epidemiology, Prevention, and Control Training Program (T32CA009314).

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Author notes

  1. Kathy B. Baumgartner and Avonne E. Connor are Joint senior authors.

Authors and Affiliations

  1. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, USA

    Kate E. Dibble & Avonne E. Connor

  2. Department of Epidemiology & Population Health, School of Public Health & Information Sciences, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, USA

    Richard N. Baumgartner, Stephanie D. Boone & Kathy B. Baumgartner

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  1. Kate E. Dibble
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  2. Richard N. Baumgartner
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Contributions

Material preparation, data analyses, and composition of the manuscript was conducted by KD and was supervised by AC. Study conceptualization, methodology, funding, and data collection was conducted by KB (Principal Investigator), RB, SB, and AC. All authors read and approved the final manuscript.

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Correspondence to Kate E. Dibble.

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Dibble, K.E., Baumgartner, R.N., Boone, S.D. et al. Treatment-related side effects among Hispanic and non-Hispanic white long-term breast cancer survivors by tamoxifen use and duration. Breast Cancer Res Treat 199, 155–172 (2023). https://doi.org/10.1007/s10549-023-06900-8

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