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Background <p>Effective long-term care for breast cancer survivors requires collaboration among providers. Traditional Chinese medicine (TCM) physicians complement symptom management and quality of life. However, how collaboration between TCM physicians and Western medical oncologists/surgeons influences treatment adherence and outcomes remains unclear. Exploring this relationship may optimize interdisciplinary care.</p> Objective <p>To explore the role of hormone therapy (HT) adherence in the relationship between physician partnership and survival outcomes in breast cancer survivors. We specifically assessed whether stronger connectedness between medical oncologists/surgeons and TCM physicians improves recurrence and mortality rates through improved HT adherence.</p> Methods <p>We conducted a retrospective, population-based study using Taiwan’s National Health Insurance Research Database. We identified adult women with newly diagnosed breast cancer who underwent mastectomy from 2007 to 2016 and received at least 12&#xa0;months of adjuvant HT. We constructed a physician-level care network for each patient where a tie between physicians was weighted by the number of patients sharing. Tie strength represented the connection between medical oncologists/surgeons and TCM physicians during the year before initial adjuvant HT. The primary endpoints were recurrence and mortality.</p> Results <p>Among 50,671 patients (median age 52&#xa0;years), only 40.6% maintained HT adherence. Patients whose oncologists/surgeons and TCM physicians had stronger connectedness showed significantly lower recurrence and mortality risks, with adjusted hazard ratios of 0.97 (95% confidence interval [CI] 0.92–1.03), 0.90 (95% CI 0.85–0.96), and 0.91 (95% CI 0.84–0.98) for low, medium, and high connectedness, respectively, compared to patients without TCM care. The effect of physician partnerships on progression-free survival was partially mediated by adherence to long-term adjuvant HT (12.2%).</p> Conclusions <p>Enhanced connectedness between oncologists/surgeons and TCM physicians was associated with increased HT adherence and improved progression-free survival in breast cancer survivors. Our findings suggested that fostering interdisciplinary physician collaboration could benefit long-term outcomes for breast cancer patients via HT adherence.</p>

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Physician Partnerships and Adverse Outcomes among Breast Cancer Survivors: The Role of Adherence to Adjuvant Hormone Therapy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月15日

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  • Chiu-Mei Yeh,
  • Yiing-Jenq Chou,
  • Shun-Ku Lin,
  • Chia-Jen Liu,
  • Nicole Huang

摘要

Background

Effective long-term care for breast cancer survivors requires collaboration among providers. Traditional Chinese medicine (TCM) physicians complement symptom management and quality of life. However, how collaboration between TCM physicians and Western medical oncologists/surgeons influences treatment adherence and outcomes remains unclear. Exploring this relationship may optimize interdisciplinary care.

Objective

To explore the role of hormone therapy (HT) adherence in the relationship between physician partnership and survival outcomes in breast cancer survivors. We specifically assessed whether stronger connectedness between medical oncologists/surgeons and TCM physicians improves recurrence and mortality rates through improved HT adherence.

Methods

We conducted a retrospective, population-based study using Taiwan’s National Health Insurance Research Database. We identified adult women with newly diagnosed breast cancer who underwent mastectomy from 2007 to 2016 and received at least 12 months of adjuvant HT. We constructed a physician-level care network for each patient where a tie between physicians was weighted by the number of patients sharing. Tie strength represented the connection between medical oncologists/surgeons and TCM physicians during the year before initial adjuvant HT. The primary endpoints were recurrence and mortality.

Results

Among 50,671 patients (median age 52 years), only 40.6% maintained HT adherence. Patients whose oncologists/surgeons and TCM physicians had stronger connectedness showed significantly lower recurrence and mortality risks, with adjusted hazard ratios of 0.97 (95% confidence interval [CI] 0.92–1.03), 0.90 (95% CI 0.85–0.96), and 0.91 (95% CI 0.84–0.98) for low, medium, and high connectedness, respectively, compared to patients without TCM care. The effect of physician partnerships on progression-free survival was partially mediated by adherence to long-term adjuvant HT (12.2%).

Conclusions

Enhanced connectedness between oncologists/surgeons and TCM physicians was associated with increased HT adherence and improved progression-free survival in breast cancer survivors. Our findings suggested that fostering interdisciplinary physician collaboration could benefit long-term outcomes for breast cancer patients via HT adherence.