Noncompliance with palliative systemic therapy in patients with distant metastatic breast cancer: a blind spot for oncologists?

The goal of our study was to provide a general overview of noncompliance with palliative systemic therapy in distant metastatic breast cancer (MBC). We analyzed an unselected cohort of 339 patients who were diagnosed with MBC over a 22-year period (1990–2011, age restriction: ≥ 85 years old). Forty patients (11.8%) rejected the offered or recommended systemic therapy (age distribution of this noncompliance subgroup: ≤60 years at MBC diagnosis: 7.9%; 60–70 years: 13.2%; > 70 years: 15.6%). The rate of noncompliance was equally distributed over time (1990–1999: 12.2% vs. 2000–2011: 11.5%, p = 0.87). Compared to patients who had received palliative antineoplastic systemic therapy, those who remained untreated were significantly older (70 vs. 61 years, p = 0.015), had shorter metastatic disease survival (2 vs. 27 months, p